OBJECTIVE: To evaluate longitudinal changes in intravaginal ejaculatory latency time (IELT) following surgical repair of penile fracture and to identify clinical and intraoperative factors associated with long-term postoperative IELT.
MATRERIAL and METHODS: This retrospective cohort study included 38 patients who underwent surgical repair for penile fracture at a single tertiary center. Patient-reported IELT values were recorded preoperatively and at 6, 12, and 24 months postoperatively. Temporal changes in IELT were analyzed using the Friedman test with post-hoc Wilcoxon signed-rank tests and Bonferroni correction. Multivariable gamma regression analysis was performed to identify independent predictors of IELT at 24 months, including demographic variables, fracture characteristics, perioperative factors, and preoperative IELT.
RESULTS: Median IELT increased progressively from 255 seconds preoperatively to 265, 280, and 280 seconds at 6, 12, and 24 months, respectively (overall p < 0.001). Postoperative IELT was not significantly different from baseline at 6 months but was significantly prolonged at 12 and 24 months compared with preoperative values. Multivariable analysis revealed that greater tear length (Exp[B]=1.016, 95% CI 1.001–1.031; p = 0.043) and higher preoperative IELT (Exp[B]=1.006, 95% CI 1.005–1.007; p < 0.001) were independently associated with longer IELT at 24 months. Proximal fracture localization showed a borderline association with IELT prolongation, while age, diabetes mellitus, fracture orientation, and time to surgery were not significant predictors.
CONCLUSION: Surgical repair of penile fracture is associated with a delayed but sustained prolongation of ejaculatory latency. The extent of tunical injury and baseline ejaculatory function are key determinants of long-term postoperative IELT. These findings suggest that ejaculatory outcomes should be considered alongside erectile function in the evaluation and counseling of patients following penile fracture repair.

OBJECTIVE: Epididymal cysts are common benign scrotal lesions that often require surgical intervention when symptomatic, enlarging, or radiologically suspicious. This study aims to compare outcomes between total and partial excision techniques.
MATRERIAL and METHODS: A retrospective review of 52 patients (66 procedures) treated between 2021 and 2025 was performed. Outcomes assessed included recurrence, complications, and operative metrics. A subgroup analysis based on cyst size (giant vs. non-giant) was also conducted.
RESULTS: Although total excision showed a lower overall complication trend, the difference between groups was not statistically significant (p = 0.157). Recurrence rates were low and comparable between groups. Although operative times were similar, median follow-up duration was significantly longer in the partial excision group (p = 0.006). Larger cysts (≥10 cm) were more often treated with total excision.
CONCLUSION: Total excision demonstrated a favorable safety profile and similar recurrence rates, making it a preferred option when technically feasible. Partial excision remains a reasonable alternative in technically challenging cases with dense adhesions.

OBJECTIVE: The aim of this study was to comprehensively evaluate global research trends on stem cell and exosome-based-therapies for erectile dysfunction(ED), and to analyze the field’s scientific productivity, collaboration networks, conceptual structure, and thematic evolution using bibliometric methods.
MATRERIAL and METHODS: Original research articles published in Science Citation Index Expanded journals between 2010-2024 were included based on a predefined search strategy applied in the Web of Science Core Collection database. The ten most influential and productive authors, countries, and journals in this field were identified using Microsoft Excel(2016) and BibExcel(version2016-02-20). Co-authorship, co-occurrence, and co-citation analyses were performed using VOSviewer(version1.6.20), and the thematic map analysis was conducted with Biblioshiny(Bibliometrix Rpackage,version 4.1.3).
RESULTS: A total of 480 studies were identified, and 194 original research articles meeting the inclusion criteria were analyzed. These publications involved 1192 authors from 26 countries and were distributed across 101 journals. China, the United States, and South Korea were the most productive countries. The authors with the highest h-index values included Lue TomF., Lin Guiting, Lee Ji Youl, and Kim Soo Woong. The Journal of Sexual Medicine emerged as the most influential journal. Co-occurrence analysis revealed erectile dysfunction, stem cells, and diabetes mellitus as the most frequently co-occurring keywords. Co-citation analysis showed that highly cited studies predominantly focused on diabetic ED, cavernous nerve injury models, and adipose-derived stem cell applications. The thematic map identified apoptosis, Peyronie’s disease, and muscle-derived stem cells as motor themes.
CONCLUSION: This bibliometric evaluation demonstrates a marked increase in scientific interest regarding stem cell and exosome-based-therapies for ED over the past 15 years. Current research trends emphasize tissue regeneration, neurovascular repair, and antifibrotic mechanisms. Although most studies remain preclinical, the evolving thematic structure suggests a shift toward biologically targeted and translational approaches. This study provides a comprehensive overview of the existing literature and offers a guiding framework for future clinical research.

OBJECTIVE: The aim of this study was to evaluate the potential synergistic (combined) effects of cigarette smoking exposure and varicocele grade on semen parameters in male with infertility.
MATRERIAL and METHODS: Following approval by the institutional ethics committee (No: 09/2010/00016), data from 182 men with left-sided varicocele who presented to our clinic between 2005 and 2010 were retrospectively analyzed. Patients with right-sided varicocele, a history of orchitis or cryptorchidism, systemic diseases, or heavy alcohol consumption were excluded. The grade of varicocele was determined by physical examination and classified as Grade I–III. Cigarette consumption was categorized into four groups according to the number of cigarettes smoked per day: non-smokers (n=94), light smokers (1–10/day, n=47), moderate smokers (11–20/day, n=30), and heavy smokers (>20/day, n=11). Semen samples were collected after 2–4 days of sexual abstinence and analyzed according to World Health Organization (WHO) 2010 criteria. Serum levels of FSH, LH, and free testosterone levels were measured in the morning. Data were analyzed using MANOVA, Kruskal–Wallis, and Mann–Whitney U tests, with p<0.05 considered statistically significant.
RESULTS: Sperm concentration significantly decreased with increasing varicocele grade (Grade I: 55–60million/mL; Grade III: 30–41million/mL; p<0.001). Heavy smokers demonstrated significantly lower sperm concentration (30.1 ± 42.3 million/mL), motility (22–26%), and normal morphology rates (30–35%) compared with non-smokers (p<0.01). These differences were not statistically significant among light smokers (p>0.05). Hormone levels were generally within the physiological range. Multivariate analyses revealed a synergistic (combined) negative effect of varicocele grade and cigarette smoking on sperm motility and morphology (p<0.01).
CONCLUSION: Increasing varicocele grade was associated with a marked reduction in sperm concentration, whereas cigarette smoking—particularly at moderate and heavy levels—significantly impaired overall semen quality. The coexistence of both factors exerted an additional detrimental effect on sperm motility and morphology. These findings highlight the importance of assessing lifestyle factors during infertility evaluation and providing counseling for smoking cessation.

OBJECTIVE: This study aimed to examine the relationship between kinesiophobia and sexual function in adult women with chronic low back pain.
MATRERIAL and METHODS: This cross-sectional study was conducted between September and November 2025 at the outpatient clinic of the Department of Physical Medicine and Rehabilitation of a university hospital. A total of 90 sexually active female patients aged 18 to 55 years who had been experiencing low back pain for at least three months were included in the study. Pain intensity was assessed using the Visual Analog Scale (VAS), disability using the Roland-Morris Disability Questionnaire (RMDQ), kinesiophobia using the Tampa Scale for Kinesiophobia (TSK), and sexual function using the Female Sexual Function Index (FSFI). Correlation and multiple linear regression analyses were conducted to explore the relationships between clinical variables and FSFI scores.
RESULTS: The mean FSFI total score was 21.67 ± 3.9, and 76.7% of the participants were identified as having sexual dysfunction. Pain intensity was significantly negatively correlated with the arousal (r = –0.305, p = 0.003), satisfaction (r = –0.251, p = 0.017) subdomains, and the total FSFI score (r = –0.235, p = 0.026). Kinesiophobia levels were significantly negatively associated with desire, arousal, orgasm, satisfaction, and total FSFI score (r = –0.335, p = 0.001). In the regression analysis, age (p = 0.005), pain intensity (p < 0.001), and TSK score (p < 0.001) were identified as significant predictors of sexual function.
CONCLUSION: The findings suggest that kinesiophobia may be an important contributing factor to sexual dysfunction in women with chronic low back pain. This highlights the importance of addressing both physical and psychological components in the management of chronic low back pain to support sexual health and overall quality of life.

OBJECTIVE: This study aims to examine the relationship between midwifery students’ sexual health literacy and their beliefs and attitudes toward sexual health care.
MATRERIAL and METHODS: This descriptive and correlational study was conducted with students from the midwifery department of a state university located in northern Türkiye. No sampling method was used; instead, 344 voluntary students enrolled in the midwifery program during the data collection period were included. Data were collected using the Personal Information Questionnaire, the Sexual Health Literacy Scale (SHLS), and the Sexual Attitudes and Beliefs Scale (SABS). Frequencies (number, percentage) were used for categorical variables, and descriptive statistics (mean, standard deviation) were used for numerical variables. Depending on the distribution of the data, Independent Samples T-Test and One-Way ANOVA were applied. The relationship between the scales was evaluated using Pearson correlation analysis.
RESULTS: The mean SHLS score of the students was 56.47 ± 11.08, and the mean SABS score was 33.1 ± 7.02. A moderately negative and statistically significant linear relationship was found between SHLS and SABS (r = -0.449, p < 0.001).
CONCLUSION: The results of the study indicate that as the level of sexual health literacy among midwifery students increases, negative attitudes and perceived barriers related to assessing patients’ sexuality and providing sexual health counseling decrease.

OBJECTIVE: The improvement in semen parameters after varicocelectomy varies considerably among patients. This study aimed to evaluate the association between preoperative follicle-stimulating hormone (FSH) levels and improvement in total motile sperm count (TMSC) following microscopic subinguinal varicocelectomy, along with other clinical, hormonal, and semen parameters.


MATRERIAL and METHODS: A retrospective analysis was conducted on 103 infertile men who underwent microscopic subinguinal varicocelectomy between January 2010 and December 2025. Patients were categorized into two groups according to the presence or absence of postoperative TMSC improvement. TMSC improvement was defined as an upgrade to a higher fertility category or a ≥50% increase in TMSC in the natural pregnancy group. Preoperative demographic characteristics, hormone levels (FSH, LH, testosterone), and semen parameters were compared between groups. Factors associated with TMSC improvement were analyzed using univariate and multivariate logistic regression mo

RESULTS: Postoperative TMSC improvement was observed in 36 patients (35.0%). Patients with TMSC improvement had lower preoperative FSH levels and significantly higher sperm concentration and TMSC values. In multivariate analysis, lower FSH levels (OR: 0.815; 95% CI: 0.650–0.925; p=0.020), higher preoperative sperm concentration (OR: 1.145; 95% CI: 1.065–1.310; p=0.002), and higher preoperative TMSC (OR: 1.127; 95% CI: 1.015–1.240; p=0.001) were identified as independent predictors of TMSC improvement. Varicocele grade and laterality were not significantly associated with postoperative outcomes.


CONCLUSION: Preoperative FSH levels and baseline semen parameters are significant predictors of TMSC improvement after varicocelectomy. FSH may serve as a clinically useful surrogate marker of spermatogenic reserve when selecting candidates for varicocelectomy and counseling patients regarding postoperative expectations.

Objective: In this review, we aimed to highlight the current status and clinical challenges in fertility preservation practices in testicular cancer patients.
Materials and Methods: The review was prepared based on a structured literature search in the MEDLINE (PubMed) database using predetermined inclusion and exclusion criteria.
Results: Testicular cancer (TC) is the most common solid malignancy in men aged 15-44 years. Radical inguinal orchiectomy (RIO) is the standard first step in diagnosis and treatment before further chemotherapy and radiotherapy. However, all these treatment modalities and TC cause fertility problems of varying degrees, up to permanent infertility. Since it is not known which patients will be affected by clinical consequences that may lead to permanent infertility, cryopreservation is the only and most important way for fertility preservation today. However, sperm banking is applied in approximately 30-40% of TC patients. Considering the irreversible physical and psychological effects of cancer and treatment-related infertility, it is necessary to investigate the underlying causes. In this review, we aimed to highlight the current status and clinical challenges in fertility preservation practices in testicular cancer patients. These challenges can be evaluated under the headings of physician, patient, economic, and sociocultural reasons. These factors cannot be evaluated independently and should be considered when tailoring management for each patient.
Conclusion: Awareness of the clinical challenges for fertility preservation will help preserve fertility in TC, which has excellent long-term survival outcomes.

Infertility is a public health issue affecting approximately 15% of couples, with about 50% of cases attributed to sperm-related deficiencies. The proper maintenance of spermatogenesis depends on factors within the testicular microenvironment. To elucidate the molecular mechanisms of testicular pathologies and to develop appropriate therapeutic strategies, it is essential to identify the factors within the testicular microenvironment that regulate spermatogenesis. C-X-C chemokine ligand 12 (CXCL12) is a homeostatic chemokine that binds to C-X-C chemokine receptor type 4 (CXCR4), regulating many cellular functions. It is known that CXCL12/CXCR4 signaling is excessively activated in diseases such as cancer, rheumatoid arthritis, osteoarthritis, asthma, and amyotrophic lateral sclerosis, and that inhibition of this signaling pathway exerts protective or therapeutic effects in many diseases. In the testis, CXCL12 is secreted by Sertoli cells, while CXCR4 is expressed in spermatogonia and somatic cells. It has been shown that CXCL12 and CXCR4 are largely conserved during postnatal development and in adult mice, primates, and humans. The CXCL12/CXCR4 signaling pathway is known to regulate primordial germ cell migration, proliferation and colonization of spermatogonial stem cells, and to activate spermatogenesis following testicular damage. Furthermore, it has been demonstrated that this pathway is overactivated in testicular pathologies (such as varicocele, seminoma, and non-seminoma), although its exact role in these conditions has not yet been fully clarified. In this review, the roles of CXCL12/CXCR4 signaling in the male reproductive system are examined.

Prostatitis represents a group of clinical conditions frequently seen in practice, yet characterized by considerable heterogenity in etiology, clinical course and response to treatment. A major challenge in management comes from the overlap between infectious and non-infectious mechanisms, which complicates both diagnostic evaluation and therapeutic decision-making. Accordingly, assessment of prostatitis requires an Infectious Diseases and Clinical Microbiology perspective. In acute bacterial prostatitis, early recognition and timely initiation of appropriate antimicrobial therapy play a key role in reducing complications and preventing progression to chronic disease. In contrast, treatment outcomes in chronic bacterial prostatitis are closely linked to antimicrobial penetration into prostatic tissue, treatment duration, and pathogen-specific characteristics. Within the spectrum of culture-negative prostatitis and chronic prostatitis/chronic pelvic pain syndrome, the clinical benefit of antibiotic therapy is often limited, while repeated empirical antibiotic use may contribute to antimicrobial resistance and suboptimal patient outcomes. From an Infectious Diseases standpoint, the primary goal in prostatitis management is the accurate identification of true infection and the rational use of antimicrobial agents. An individualized and multidisciplinary approach guided by clinical presentation, microbiological data, and prior treatment response is essential to optimize clinical outcomes while minimizing unnecessary antibiotic exposure and reducing the long-term burden of antimicrobial resistance.

Introduction: Pleomorphic fibroma is a rare benign fibrous skin tumor first described by Kamino et al. in 1989. Although it has been reported at various cutaneous sites, involvement of the male genital region has not previously been documented.
Case Presentation: We report a 27-year-old male presenting with a slowly enlarging, painless mass located at the penile frenulum. The patient had a history of repeatedly applying adhesive tape around the frenulum to prevent urethral discharge during sexual arousal, resulting in chronic mechanical irritation. Complete surgical excision was performed under spinal anesthesia. Histopathological examination revealed pleomorphic fibroblast-like cells without nuclear atypia, with strong vimentin positivity, consistent with pleomorphic fibroma. No recurrence was observed during six months of postoperative follow-up.
Discussion: Pleomorphic fibroma is an uncommon benign fibrous neoplasm characterized by marked cytologic pleomorphism despite an indolent clinical course. Genital involvement is exceedingly rare, and this case represents the first reported occurrence on the penis. Chronic mechanical microtrauma may play a contributory role in tumor development by inducing fibroblastic proliferation. Despite histologic similarities to atypical fibroxanthoma, pleomorphic dermatofibroma, and low-grade sarcomas, features such as low cellularity, absence of mitotic activity, thickened collagen bundles, and a consistent immunophenotype support a benign diagnosis.
Conclusion: Pleomorphic fibroma should be considered in the differential diagnosis of penile masses, particularly in patients with chronic local irritation. Complete local excision is curative, and recurrence is exceptionally rare.