Introduction and hypothesis The aim of this study was to evaluate the long-term effect of thermoablative fractional CO₂ laser (TACO2L) as an alternative treatment for early stages of stress urinary incontinence (SUI) in postmenopausal women with genitourinary syndrome of menopause. Methods A total of 161 postmenopausal patients (age 53.38 ± 5.1 years, range 45–65 years) with a clinical diagnosis of mild SUI were prospectively enrolled in the study. Patients received one treatment with TACO2L every 30–45 days, each treatment comprising four sessions, followed in all patients by a yearly treatment session at 12, 24 and 36 months. SUI was evaluated using the International Continence Society 1-h pad test and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) before and after TACO2L treatment. Results TACO2L treatment was associated with a significant improvement in ICIQ-UI SF scores and 1-h pad weight test at 12 months (both p < 0.001), 24 months (both p < 0.001) and 36 months (both p < 0.001). Improvements were maintained for up to 36 months without the need for any further intervention. The results were confirmed by significant histological changes related to trophic restoration of the vagina, responsible for extrinsic and intrinsic mechanisms involved in urinary continence. Conclusions Our results suggest that TACO2L is an efficient and safe novel treatment strategy in patients with mild SUI. Further investigation to confirm the long-term results presented here is still warranted.

Because the assessment of sperm DNA fragmentation (SDF) plays a key role in male fertility, our study was designed to find the relationships between SDF and standard semen parameters. The receiver operating characteristic (ROC) curve showed that 18% SDF is a prognostic parameter for discriminating between men with normal and abnormal standard semen parameters (n = 667). Men with > 18% SDF had significantly lower quality semen, a higher prevalence of abnormal semen characteristics, and a higher odds ratio for abnormal semen parameters compared to men with ≤ 18% SDF. An ROC analysis provided predictive values for age and semen parameters to distinguish between men with SDF > 18% and men with ≤ 18% SDF. SDF was positively correlated with male age and teratozoospermia index but negatively with sperm concentration, total number of spermatozoa, sperm morphology, progressive motility, and vitality. Our study shows that 18% SDF has a predictive value for distinguishing between men with normal and abnormal semen characteristics. Men with >18% SDF have a higher risk for abnormal semen parameters, while age and obtained semen parameters have a predictive value for SDF. There is a relationship between SDF and conventional sperm characteristics, and thus, SDF can be incorporated into male fertility assessment.

Since varicocele is so common in infertile men, this study intends to analyse the relationships between varicocele and conventional semen characteristics, sperm nuclear DNA dispersion and oxidation-reduction potential (ORP) in semen. Varicocele-positive and varicocele-negative infertile men (study groups) showed significantly lower standard sperm parameters and higher sperm DNA fragmentation (SDF) and ORP in semen than healthy volunteers and subjects with proven fertility (control groups). A lower proportion of low SDF levels (0–15% SDF) and higher incidence of high SDF levels (>30% SDF), as well as a higher prevalence of high ORP values (>1.37 mV/10⁶ sperm/mL), were found in the study groups vs. the control groups. Moreover, infertile men had significantly lower odds ratios (ORs) for low SDF levels and significantly higher ORs for high SDF levels and high ORP. SDF and ORP were negatively correlated with sperm number, morphology, motility and vitality. Furthermore, a significant positive correlation was found between SDF and ORP. The obtained results suggest that disorders of spermatogenesis may occur in varicocele-related infertility. These abnormalities are manifested not only by reduced standard semen parameters but also by decreased sperm DNA integrity and simultaneously increased oxidative stress in semen.

The aim of the study was to assess changes in the consistency of the uterine cervix and correlate the obtained results with the risk of premature delivery and time from examination to delivery Elastographic images of the cervix in a group of 44 patients, admitted to the hospital due to uterine contractions before 37 weeks of gestation, were recorded and analyzed. Elastograms were assessed with the use of Elastography Index (El), a five-step (0-4) color scale, which visualizes tissue hardness by encoding numerical values in specific colors (0-violet/the hardest tissue; 4-red/the softest tissue). Correlation between El for different parts of the uterine cervix was evaluated and analyzed in relation to preterm delivery and time from examination to delivery. Twenty-one patients delivered before term and 23 at term. A strong correlation for El of the internal os and time from examination to delivery (Pearson test, p<0.001), and risk of preterm birth (Mann-Whitney-Wilcoxon test, p<0.001), was noted. We also found a strong correlation between cervical canal length and risk of preterm delivery (Anova test, p=0.001), and time from examination to delivery (Pearson test, p=0.006). Elastography may offer a chance for an objective assessment of elasticity of the uterine cervix and may become an alternative to vaginal examination and Bishop score. Proper selection of patients with high or low risk of preterm delivery may facilitate good management decisions and, consequently decrease the percentage of immature deliveries, unnecessary medical procedures, and hospitalization.