Chuan-Shu Chen

Time	Session

13:30 15:00	Free Paper 【Podium】 (27) Andrology (D) Chuan-Shu ChenTaiwan Moderator Severity of sexual dysfunction in Taiwanese patients with and without type 2 diabetes mellitus.introduction Patients with type 2 diabetes are at a higher risk of developing sexual dysfunction. This study aims to investigate the current prevalence of sexual dysfunction in Taiwanese patients with and without type 2 diabetes mellitus(DM) and to explore patterns in how affected individuals seek management or treatment for this condition. Materials and Methods Between June 2023 and October 2024, a total of 450 patients visiting our urology outpatient department were invited to complete a questionnaire comprising the Men's Sexual Health Questionnaire (MSHQ) and supplementary questions assessing patterns of seeking management for sexual dysfunction. Results Of the 402 subjects who completed the questionnaire, 28.1% (113/402) had type 2 diabetes mellitus (DM). Among patients with varying degrees of sexual dysfunction, those in the DM group reported significantly greater severity across all domains of the MSHQ—erection, ejaculation, satisfaction, frequency of sexual activity, and sexual desire—compared to the non-DM group. After applying propensity score matching for age and comorbid chronic diseases, the scores in each domain were as follows (DM group vs. non-DM group): erection (9.55 vs. 10.94, p = 0.028), ejaculation (25.87 vs. 28.26, p = 0.012), sexual desire (12.38 vs. 13.34, p = 0.020), satisfaction (20.51 vs. 21.64, p = 0.112), and frequency of sexual activity (10.29 vs. 10.58, p = 0.465). Notably, 73% of patients with DM expressed a desire to discuss sexual health issues with their physicians. However, only 10% reported that their doctors had initiated such conversations. The most commonly cited reason for not discussing sexual problems was feeling embarrassed. Additionally, 54% of DM patients with sexual dysfunction reported receiving no form of management, despite 57% expressing interest in treatment. Conclusions The prevalence of sexual dysfunction and related concerns was high among diabetic patients; however, only a small proportion had sought professional help. Routine screening for sexual dysfunction in patients with diabetes is therefore recommended. Hyun Jun Park Korea (Republic of) Moderator The Evolutionary Role of Varicocelectomy in Andrology Varicocelectomy is among the most commonly performed surgical procedures in contemporary andrological practice. Historically, varicocele management focused primarily on alleviating symptomatic discomfort and addressing infertility characterized by impaired semen parameters. However, the conceptual framework and indications for varicocelectomy have evolved significantly over recent decades, reshaping its clinical implications and expanding its therapeutic potential. Initially, open surgical approaches such as retroperitoneal and inguinal varicocelectomy were predominant, yet they carried considerable risks, including recurrence, hydrocele formation, and potential damage to testicular arteries. With the advent of microsurgical techniques, particularly subinguinal microsurgical varicocelectomy, procedural efficacy and safety have markedly improved. This has resulted in reduced complication rates and enhanced fertility outcomes, positioning microsurgical varicocelectomy as the current gold standard. Modern andrological literature emphasizes varicocelectomy’s broader physiological benefits beyond fertility. Recent studies highlight its role in improving testosterone production, mitigating hypogonadism, and enhancing overall testicular function. Additionally, varicocelectomy has been demonstrated to significantly improve sperm DNA integrity and reduce oxidative stress levels, thus positively impacting assisted reproductive technology (ART) outcomes. Furthermore, contemporary research suggests that varicocelectomy may provide systemic health benefits by reducing chronic inflammation and oxidative damage, conditions associated with metabolic and cardiovascular disorders. This evolving understanding positions varicocelectomy not merely as a fertility treatment but as an integral part of comprehensive male reproductive health management. These insights prompt a proactive approach, encouraging clinicians to recognize varicocelectomy’s extended potential in enhancing male reproductive longevity and general health. In conclusion, the evolution of varicocelectomy, characterized by advancements in surgical techniques and expanded clinical indications, underscores its significant role in modern andrology. An integrated appreciation of its multifaceted therapeutic benefits facilitates informed clinical decision-making, ultimately enhancing patient care and outcomes in andrological practice. Yu-Sheng ChengTaiwan Moderator DNA Fragmentation’s Impact on Male Infertility: Advanced molecular approaches in male infertility diagnosis Semen analysis remains the cornerstone to accessing male fertility potential despite many drawbacks and fails to predict the male fertility potential with high sensitivity and specificity. The integrity of sperm DNA is crucial for successful fertilization, embryo growth, and the precise transmission of genetic information to progeny. Increasing research suggests that higher sperm DNA fragmentation (SDF) may correlate with clinical varicocele, unexplained infertility, recurrent pregnancy loss, and offspring health. Currently, several tests are available to assess sperm DNA fragmentation in clinical settings. The degree of sperm DNA damage can be measured using the sperm DNA fragmentation index (DFI), which provides more insight into the quality of sperm. Recently, several laboratories have integrated SDF testing into routine semen analysis for the assessment of male infertility. Nonetheless, several aspects of SDF remain unresolved. This presentation will provide an introduction to existing SDF assays, including recent innovative tests for double-strand breaks (DSBs) in human ejaculated sperm, as well as a discussion on the clinical indications for SDF testing based on recent scientific findings. TICC - 1F 101D

Chuan-Shu ChenTaiwan Moderator Severity of sexual dysfunction in Taiwanese patients with and without type 2 diabetes mellitus.introduction Patients with type 2 diabetes are at a higher risk of developing sexual dysfunction. This study aims to investigate the current prevalence of sexual dysfunction in Taiwanese patients with and without type 2 diabetes mellitus(DM) and to explore patterns in how affected individuals seek management or treatment for this condition. Materials and Methods Between June 2023 and October 2024, a total of 450 patients visiting our urology outpatient department were invited to complete a questionnaire comprising the Men's Sexual Health Questionnaire (MSHQ) and supplementary questions assessing patterns of seeking management for sexual dysfunction. Results Of the 402 subjects who completed the questionnaire, 28.1% (113/402) had type 2 diabetes mellitus (DM). Among patients with varying degrees of sexual dysfunction, those in the DM group reported significantly greater severity across all domains of the MSHQ—erection, ejaculation, satisfaction, frequency of sexual activity, and sexual desire—compared to the non-DM group. After applying propensity score matching for age and comorbid chronic diseases, the scores in each domain were as follows (DM group vs. non-DM group): erection (9.55 vs. 10.94, p = 0.028), ejaculation (25.87 vs. 28.26, p = 0.012), sexual desire (12.38 vs. 13.34, p = 0.020), satisfaction (20.51 vs. 21.64, p = 0.112), and frequency of sexual activity (10.29 vs. 10.58, p = 0.465). Notably, 73% of patients with DM expressed a desire to discuss sexual health issues with their physicians. However, only 10% reported that their doctors had initiated such conversations. The most commonly cited reason for not discussing sexual problems was feeling embarrassed. Additionally, 54% of DM patients with sexual dysfunction reported receiving no form of management, despite 57% expressing interest in treatment. Conclusions The prevalence of sexual dysfunction and related concerns was high among diabetic patients; however, only a small proportion had sought professional help. Routine screening for sexual dysfunction in patients with diabetes is therefore recommended.

Hyun Jun Park Korea (Republic of) Moderator The Evolutionary Role of Varicocelectomy in Andrology Varicocelectomy is among the most commonly performed surgical procedures in contemporary andrological practice. Historically, varicocele management focused primarily on alleviating symptomatic discomfort and addressing infertility characterized by impaired semen parameters. However, the conceptual framework and indications for varicocelectomy have evolved significantly over recent decades, reshaping its clinical implications and expanding its therapeutic potential. Initially, open surgical approaches such as retroperitoneal and inguinal varicocelectomy were predominant, yet they carried considerable risks, including recurrence, hydrocele formation, and potential damage to testicular arteries. With the advent of microsurgical techniques, particularly subinguinal microsurgical varicocelectomy, procedural efficacy and safety have markedly improved. This has resulted in reduced complication rates and enhanced fertility outcomes, positioning microsurgical varicocelectomy as the current gold standard. Modern andrological literature emphasizes varicocelectomy’s broader physiological benefits beyond fertility. Recent studies highlight its role in improving testosterone production, mitigating hypogonadism, and enhancing overall testicular function. Additionally, varicocelectomy has been demonstrated to significantly improve sperm DNA integrity and reduce oxidative stress levels, thus positively impacting assisted reproductive technology (ART) outcomes. Furthermore, contemporary research suggests that varicocelectomy may provide systemic health benefits by reducing chronic inflammation and oxidative damage, conditions associated with metabolic and cardiovascular disorders. This evolving understanding positions varicocelectomy not merely as a fertility treatment but as an integral part of comprehensive male reproductive health management. These insights prompt a proactive approach, encouraging clinicians to recognize varicocelectomy’s extended potential in enhancing male reproductive longevity and general health. In conclusion, the evolution of varicocelectomy, characterized by advancements in surgical techniques and expanded clinical indications, underscores its significant role in modern andrology. An integrated appreciation of its multifaceted therapeutic benefits facilitates informed clinical decision-making, ultimately enhancing patient care and outcomes in andrological practice.

Yu-Sheng ChengTaiwan Moderator DNA Fragmentation’s Impact on Male Infertility: Advanced molecular approaches in male infertility diagnosis Semen analysis remains the cornerstone to accessing male fertility potential despite many drawbacks and fails to predict the male fertility potential with high sensitivity and specificity. The integrity of sperm DNA is crucial for successful fertilization, embryo growth, and the precise transmission of genetic information to progeny. Increasing research suggests that higher sperm DNA fragmentation (SDF) may correlate with clinical varicocele, unexplained infertility, recurrent pregnancy loss, and offspring health. Currently, several tests are available to assess sperm DNA fragmentation in clinical settings. The degree of sperm DNA damage can be measured using the sperm DNA fragmentation index (DFI), which provides more insight into the quality of sperm. Recently, several laboratories have integrated SDF testing into routine semen analysis for the assessment of male infertility. Nonetheless, several aspects of SDF remain unresolved. This presentation will provide an introduction to existing SDF assays, including recent innovative tests for double-strand breaks (DSBs) in human ejaculated sperm, as well as a discussion on the clinical indications for SDF testing based on recent scientific findings.

17th August 2025