OBJECTIVE: The molecular mechanisms underlying male infertility have not been fully elucidated, and genetic and epigenetic regulators of spermatogonial stem cell (SSC) differentiation are increasingly gaining interest. The aim of this study is to identify miRNA candidates that can target the ASCL2, EGR4, HOXC9, and DLX5 genes, which have been reported to have increased expression in SSCs of cryptozoospermic males, and the potential common target genes of these miRNAs using in silico methods.
MATRERIAL and METHODS: In the first stage, microRNAs (miRNAs) targeting differentially expressed genes were identified using miRWalk and miRDB databases. Potential target genes of these miRNAs were analyzed using miRNet and miRTarBase databases.
RESULTS: Potential target genes of miRNAs were identified as LCOR, ZZZ3, AR and TACR3 using target prediction algorithms.
CONCLUSION: Our results may contribute to a better understanding of the mechanisms underlying male infertility by identifying new candidate genes that may play a role in SSC differentiation and spermatogenesis, and miRNAs that may modulate this process at the epigenetic level. These findings may shed light on the identification of potential biomarkers and therapeutic targets in further studies.

OBJECTIVE: This study was conducted in a descriptive and correlational design to determine, on a scale-based basis, the use of Traditional and Complementary Medicine (TCM) methods and attitudes toward these methods among women and men undergoing infertility treatment.
MATRERIAL and METHODS: It was conducted in a private hospital in Istanbul between February 2023 and June 2023 in the in vitro fertilization center. A total of 341 individuals, 233 infertile women and 108 men, were included in the study. The data of the study were collected with an introductory information form and the Traditional Complementary Medicine Attitude Scale.
RESULTS: It was found that 56.9% of infertile patients used traditional methods for pregnancy, and 63.9% did not report them to their doctors. The most common methods were spiritual prayers (51.5%), onion cure (17.0%), phytotherapy (16.0%), cupping (16.5%), and fig cure (16.0%). Additionally, natural foods like honey (14.9%), carob molasses (12.4%), and avocado (11.3%) were frequently used. Those using traditional methods had significantly higher GTT attitude scores. Scores were also higher among secondary school graduates, individuals with extended families or consanguineous marriages, and those with incomes lower than their expenses.
CONCLUSION: It was determined that approximately more than half of the participants used traditional methods and that the total Traditional Complementary Medicine Attitude Scale scores of participants who used these methods were also higher. The factors affecting the total Traditional Complementary Medicine Attitude Scale score were education, family structure, income status and consanguineous marriage.

OBJECTIVE: Peyronie’s disease (PD) involves fibrotic plaque formation within the tunica albuginea, resulting in penile deviation. Although repetitive mechanical microtrauma has been implicated in the pathogenesis of PD, whether masturbation-related behaviors and hand dominance are associated with deviation characteristics remains unclear. The aim of this study is to investigate the association between masturbation-related behaviors, hand-use patterns, and penile deviation direction and degree in men with PD compared with healthy controls.

MATRERIAL and METHODS: This cross-sectional case–control study included 49 men with chronic stable-phase Peyronie’s disease and 51 healthy controls who presented between November 2024 and October 2025. Only patients with chronic, stable-phase PD of at least one year were enrolled. Data on hand dominance, masturbation hand, hand mismatch, ejaculation, coital and masturbation frequency, and lubricant use were collected based on habitual behavior over the preceding five years. Associations between sexual behavior variables and deviation direction or degree were analyzed.

RESULTS: Baseline characteristics were largely comparable between groups. Dominant hand (p=0.004) and masturbation hand (p=0.007) distributions differed between PD patients and controls, whereas lubricant use (p=0.324) and hand mismatch rates (p=0.191) were similar. Deviation direction was not associated with dominant hand (p=0.262), masturbation hand (p=0.647), or hand mismatch (p=1.000). Median deviation degree was 40° (IQR 30–50) and showed no correlation with ejaculation (p=0.672), coital (p=0.955), or masturbation frequency (p=0.522), nor with masturbation hand (p=0.995) or lubricant use (p=0.641).

CONCLUSION: In chronic PD, masturbation habits, hand dominance, hand mismatch, and sexual activity frequency are not associated with penile curvature direction or severity, indicating that habitual sexual behaviors do not independently influence curvature characteristics in the stable disease phase.

OBJECTIVE: To evaluate the quality, reliability, transparency, and content of YouTube videos on microdissection testicular sperm extraction (mTESE).
MATRERIAL and METHODS: In this cross-sectional study, a systematic YouTube search was performed on March 12, 2026, using the keywords “Microdissection testicular sperm extraction,” “micro TESE azoospermia,” “mTESE azoospermia,” “mTESE infertility,” “micro TESE,” “mTese,” and “micro tese infertility.” The first 50 videos ranked by relevance for each keyword were recorded. Videos were included if they were at least 30 seconds long, directly focused on mTESE or sperm retrieval in azoospermia, and were in English with accessible audiovisual content. Educational quality was assessed using the Global Quality Score (GQS), reliability using the modified DISCERN (mDISCERN), transparency using the JAMA benchmark criteria, and patient-centered content completeness using an mTESE-specific 15-item content checklist.
RESULTS: A total of 350 videos were screened, and 96 videos were included in the final analysis after duplicate and ineligible videos were excluded. The most common uploader type was hospitals/clinics (43.8%), and most videos were in an educational format (72.9%). Median video duration was 4.15 minutes (IQR: 2.29–9.76), and the median number of views was 818 (IQR: 316.25–4693.50). The median mTESE content score was 8 (IQR: 5–10), median mDISCERN score was 3 (IQR: 2–3.25), median JAMA score was 2 (IQR: 1–2), and median GQS score was 3 (IQR: 2–3). The most frequently covered content item was information on azoospermia or the basic evaluation process (81.2%), whereas complications were mentioned in only 26.0% of the videos. According to uploader type, a significant difference was observed only for JAMA scores (p=0.011). No significant association was found between video popularity indicators and quality scores.
CONCLUSION: Although YouTube videos on mTESE provide patient information, they have important limitations, particularly in transparency and counseling-related content. Higher-quality, balanced, source-based, and patient-centered content is needed to improve digital patient education.

OBJECTIVE: To determine the predictive value of preoperative serum and semen parameters in microscopic varicocelectomy.
MATRERIAL and METHODS: This retrospective observational study included a total of 76 patients who underwent microscopic varicocelectomy between 2015 and 2024. Success was defined as an improvement in total motile sperm count (TMSC) > 50%. There were 38 patients in both successful and unsuccessful groups. Age, varicocele grade, left spermatic vein diameter, sperm concentration, total sperm count, TMSC, percentage pf prograsif motility, normal morphology and vitality, and mean platelet volume (MPV) values were recorded. Both single and multiple logistic regression analyses were used to predict varicocelectomy success. Predictive values were determined using ROC curve analysis.
RESULTS: In the multiple logistic regression model, the independent variables predicting the success of varicocelectomy were TMSC and mean platelet volume (MPV) (OR=0.93; 95% CI: 0.89-0.98; p=0.005 and OR=2.06; 95% CI: 1.07-3.96; p=0.03, respectively). ROC analysis was performed, and cut-off values of 3.45 million for TMSC and 10.35 fL for MPV were calculated (AUC=0.745, 73% sensitivity, 71% specificity and AUC=0.636, 44% sensitivity, 74% specificity, respectively).
CONCLUSION: TMSC and MPV were found to be independent predictive variables that can be used to predict the success of microscopic varicocelectomy. The cut-off values for TMSC and MPV (3.45 million and 10.35 fL, respectively) can guide clinicians in patient counseling and surgical decision-making.

Erectile dysfunction (ED) is defined as the inability to achieve or maintain a penile erection sufficient for satisfactory sexual intercourse. Its prevalence increases with age and can reach up to 33% in individuals over 40 years old in our country. Multifactorial causes play a role in the etiology of ED, such as cardiovascular risk factors, neurogenic causes, endocrine disorders, psychogenic conditions, and dysfunctions in the lumbopelvic region. All these factors lead to endothelial dysfunction and systemic inflammation, excessive sympathetic activity and increased peripheral catecholamines, decreased pelvic blood flow and penile oxygenation, and consequently result in ED.
This review examines physical therapy and rehabilitation approaches in ED alongside current guidelines (AUA 2018, EAU 2025) and evidence-based literature, with a level of evidence analysis performed using the Oxford Centre for Evidence-Based Medicine (OCEBM 2011) classification.
Evidence level analysis indicates that lifestyle modifications (Level 1-3) and aerobic/resistance exercise training (Level 1-2) have the strongest evidence base. Pelvic floor muscle training also stands out with a strong level of evidence (Level 1-2); however, further randomized controlled trials are needed to achieve more definitive conclusions in this area. Low-intensity extracorporeal shock wave therapy (LI-ESWT) (Level 1) represents an alternative treatment option in patients with mild vasculogenic ED and partial responders to PDE5i, while evidence for electrical stimulation (Level 1-2) and manual therapy (Level 5) is insufficient.
When establishing physical therapy programs for individuals with ED, these evidence levels and clinical recommendations should be considered, and a multidisciplinary team approach should be adopted. Furthermore, additional randomized controlled trials are needed, particularly for methods with low levels of evidence.

Testicular compartment syndrome is a less known and underdiagnosed pathology if not suspected. Compartment syndrome is a well defined phenomenon in most parts of human body. Testicular compartment syndrome is reported as testicular ischemia due to corruption of microcirculation that caused by increased pressure in tunica albuginea. Spesific causes as hematoma, hydrocele, varicocele, scrotal hernia, testicular torsion, orchitis, epididymitis are reported. Ischemia/reperfusion injury that may develop after correction of primary etiology can cause testicular compartment syndrome. Decreasing pressure in tunica albuginea that accompanied to correction of primary etiology is important for treatment. Antioxidant therapy can reduce ischemia/reperfusion injury. Testicular compartment syndrome can damage endocrine function and spermatogenesis due to testicular injury unless sufficent and suitable treatment.

Objectives
Male infertility is a multifactorial condition involving complex molecular and cellular mechanisms that influence sperm function and reproductive potential. Conventional semen analysis remains the cornerstone of clinical evaluation; however, parameters such as sperm concentration, motility and morphology often fail to reflect underlying molecular abnormalities. This review aims to summarize current knowledge regarding the biological architecture of human spermatozoa and the major molecular mechanisms responsible for sperm dysfunction in male infertility.
Materials and Methods
A narrative literature review was conducted using PubMed, Scopus, Web of Science and Google Scholar databases to identify relevant publications on sperm biology and mechanisms of sperm dysfunction in male infertility. Studies published between 2000 and 2025 were evaluated with particular emphasis on recent literature addressing oxidative stress, sperm DNA fragmentation, epigenetic regulation and emerging molecular determinants of sperm function.
Results
Current evidence indicates that oxidative stress, mitochondrial dysfunction, chromatin remodeling defects and sperm DNA fragmentation represent central mechanisms contributing to impaired fertilization and adverse reproductive outcomes. In addition to genomic damage, spermatozoa transmit regulatory RNAs and epigenetic information that may influence early embryonic development and offspring health. Emerging data also suggest that molecular profiling and artificial intelligence–based sperm evaluation may provide novel tools for identifying functionally competent spermatozoa.
Conclusion
Male infertility cannot be fully explained by conventional semen parameters alone. Integrating molecular assessments such as sperm DNA fragmentation and oxidative stress evaluation with traditional semen analysis may improve diagnostic accuracy and clinical decision-making. Advances in molecular sperm biology and emerging technologies may contribute to the development of more precise and individualized approaches in reproductive medicine.

46,XY gonadal dysgenesis is a rare disorder of sex development resulting from impaired testicular differentiation. In this report, we present two sibling cases who were evaluated for primary amenorrhea and found to have a 46,XY karyotype. Both patients exhibited female external genitalia, delayed pubertal development, bilateral atrophic testicular tissue located in the inguinal canals, and histopathological findings of Sertoli cell–only tubules. Bilateral inguinal orchiectomy was performed to reduce the risk of gonadal malignancy, followed by initiation of hormone replacement therapy. These cases are noteworthy because of their familial occurrence and their clinical features, which differ from those of classical Swyer syndrome and are more consistent with the spectrum of 46,XY gonadal dysgenesis.