Overview
Established in 1998, the Andrology Department of Nanjing Drum Tower Hospital has its andrology laboratory founded in 1999, and became an independent discipline in October 2012, a Nanjing municipal key department. The Andrology Deptment of Nanjing Drum Tower Hospital is currently one of the earliest independent departments among the top-level Western medicine hospitals in China. It has become a professional and standard medical center for men’s diseases that integrates andrological medicine, teaching and scientific research. At present, there are 40 beds in the andrological wards and 34 employees, including 1 doctoral tutor, 3 master tutors, 1 part-time professor, 1 chief physician, 3 deputy chief physicians, 2 attending physicians, 1 deputy chief nurse, 6 supervisor nurses, 1 deputy chief technician, 1 supervising technician (4 with a doctoral degree and 8 with a master degree). Its employees have served as the chairman, deputy chairman, standing committee member, and committee member of the Chinese Medical Association, the China Sexology Association, and provincial and municipal medical associations (more than 20 person-time). The Andrology Deptment is now the base of the doctoral and master programs of Nanjing University and Nanjing Medical University. Relying on its strong overall strength and distinctive technical merits, it has formed special diagnosis and treatment technologies for male prostate diseases, male reproductive system tumors, male sexual dysfunction, male infertility, penile scrotum / spermatic cord / seminal vesicle diseases, and reached the outpatient visit amount of above 80,000 person-time per year and the operation volume of above 3,200 per year. Since its establishment, the Andrology Deptment has gained 9 national natural programs and more than 20 provincial and municipal scientific research projects, with a total research funding of more than 10 million CNY. Besides, the Deptment / the staff has won 4 provincial and municipal scientific and technological progress awards, 5 provincial new technology introduction awards and 12 national patent authorizations, published more than 70 SCI-hub papers and more than 100 papers in domestic core journals, and edited or participated in the edition of more than 10 monographs. With various domestically leading technologies, the Andrology Department is a training base(Jiangsu Province) for Chinese andrological physicians granted by the Andrology Branch of the Chinese Medical Association, a training base for diagnosis and treatment of sexual dysfunction granted by the China Sexology Association, a Chinese training base for Rigiscan technology, a Chinese training center for andrological neuroelectrophysiological diagnosis technology, and the Chinese training center for AMS700TM inflatable penile prosthesis implantation, being one of the best andrology departments in comprehensive top level hospitals in China.
Conditions Treated
1. Individualized Diagnosis and Treatment of Erectile Dysfunction: Determine the disease causes of erectile dysfunction through systematic etiology examination; multi-dose multi-combination therapeutic regimens based on PDE5 inhibitors, androgens, ARBs, hypoglycemic and lipid-lowering drugs are combined with penile surgery and other approaches to cure the disease from the source. The erectile dysfunction diagnosis and treatment strategy won the first prize of Jiangsu Provincial Medical Science and Technology Award.
2. Etiological Diagnosis and Individualized Treatment of Premature Ejaculation: The Department took the lead, both domestically and internationally, in offering neuroelectrophysiological examinations for premature ejaculation, and integrates brain functional MRI to determine the disease causes and consequently targeted therapeutic schemes. With the help of neuroelectrophysiology, the effective rate of pharmaceutical and surgical treatment of premature ejaculation reaches above 95%. The diagnosis and treatment technology for premature ejaculation won the second prize of Jiangsu Provincial New Technology Introduction Award, while the Department has been entitled as a Jiangsu Provincial Key Center for Special Diseases.
3. Male Infertility: The Department offers lots of special technologies, such as sperm morphology examination, sperm DNA fragmentation rate assay, acrosomal enzyme examination, reproductive immunity examination, microscopic sperm extraction and so on, and completes more than 30,000 semen examinations every year, being the andrological medical unit with the largest specimen number in the province. A large number of male infertility patients have achieved good results through pharmaceutical, surgical or assisted fertility treatment.
4. Prostate Diseases: Prostate glands are males’ accessory sex gland organs. Systemic pharmaceutical treatment, thermal therapy, and minimally invasive treatment for diseases such as prostatitis, benign prostatic hyperplasia, and prostate cancer are the characteristic technologies of the Andrology Department.
5. Andrology Minimally Invasive Surgeries: Andrological microsurgeries (spermatic cord ligation, vas deferens anastomosis, vas deferens epididymal anastomosis, microscopic sperm extraction, and dorsal penile nerve block operation); andrological endoscopic surgeries (spermary endoscopy for refractory hematospermia, and minimally invasive resection of prostate), implantation of inflatable penile prosthesis for erectile dysfunction, penile deformity correction, etc.
Leadership
Yutian Dai, the administrative officer and the academic leader of the Andrology Department of Nanjing Drum Tower Hospital, a chief physician, a professor, a doctoral supervisor, a visiting professor of the University of Texas MD Anderson Cancer Center, the executive vice president of China Sexology Association, the committee chairman of the Sexual Medicine Branch of China Sexology Association, the vice-chairman of Global Chinese Andrology and Sexual Medicine Congress, a committee member of the 3rd and 4th WHO International Committee of Medical Experts, the deputy director of the Sexual Dysfunction Study Group of the Andrology Branch of Chinese Medical Association, the vice chairman of Jiangsu Sexology Association, and the former committee chairman of the Andrology Branch of Nanjing Medical Association. He holds the post of editorial advisory board members for Asian Journal of Andrology, National Journal of Andrology, Chinese Journal of Urology, Practical Geriatrics and other journals. He led 4 programs supported by the National Natural Science Foundation of China and more than 10 programs at the provincial level (more than 6 million RMB), published more than 30 SCI papers and more than 60 papers in domestic core journals, and published more than 10 monographs as the editor-in-chief or a coeditor. He, as the first person, won 4 provincial and municipal awards for scientific and technological progress and 5 provincial awards for introduction of a new technology. He has been occupied in urology and andrology for more than 30 years, specializing in the diagnosis, treatment and surgical treatment of difficult andrological diseases.
Research&Achievement
1. Individualized treatment strategies of Erectile Dysfunction
Erectile dysfunction (ED) is one of the most common complications in diabetic men. ED can also be one of the first symptoms of diabetes. The pathogenesis of diabetic ED is multifactorial, involving neural, vascular, endocrine, and metabolic changes. Diabetic erectile dysfunction is one of the most common form of erectile dysfunction. We have been studied mechanisms of ED in recent years and actively explored new treatment. We found that chronic administration of melatonin has a beneficial effect on preventing ED in type I diabetic rats, and promoting the mobilisation of endothelial progenitor cells(EPCs) is one of the possible mechanisms involved in the improvement of ED (Asian Journal of Andrology, 2012). We investigated the effect of mesenchymal stem cells (MSCs) on improving erectile function in diabetic rats, and validated the effect of intracavernous injection of MSCs for diabetes-associated erectile dysfunction in an animal model. The combined strategy of MSC injection with VEGF gene therapy enhanced therapy of MSCs for the treatment of diabetes-associated erectile dysfuction(Journal of Andrology, 2012). We found that ADSCs labeled with superparamagnetic iron oxide nanoparticles (SPIONs) kept long-term cell retention in the corpus cavernosum and improved the erectile function of diabetic rats compared with ADSC injection alone (Asian Journal of Andrology, 2016). Now we are doing a clinical trial that ivestigate the treatment of diabetic ED by human umbilical cord MSCs combinated with collagen-base rack. Psychogenic erectile dysfunction is also an important form of erectile dysfunction. Despite increasing understanding of the cerebral functional changes and structural abnormalities in erectile dysfunction, alterations in the topological organization of brain networks underlying psychogenic erectile dysfunction remain unclear. Recently our findings suggested that the damaged white matter and the abnormal hub distribution of the left prefrontal and limbic cortex might contribute to the pathogenesis of psychogenic erectile dysfunction and provided new insights into the understanding of the pathophysiological mechanisms of psychogenic erectile dysfunction (International Journal of Neuroscience, 2018).
2. The new classification system establishment and standard diagnosis and
treatment of PE
Premature ejaculation is a sexual dysfunction, which has a significant impact on men and their partners’ sexual life. SSR located in the penis (PSSR) is considered to be a promising method to evaluate the sympathetic innervations of the penis. We studied the PSSR of the PPE patients in comparison with a normally potent control group, and found that patients with PPE have hyperactivity of the sympathetic nervous system, which may be another factor involved in the pathological mechanisms of PPE, and the PSSR is an objective test to evaluate patients with PPE(International Journal of Impotence Research, 2013). We found hyperexcitable ejaculatory reflex neurological factor was linked to PPE, because of hypersensitivity of the penile, accelerated conduction and cortical amplification of the genital stimuli. The PLA cream could delay sensory latency and decrease penile hyperexcitability, which may be the mechanism for PPE treatment(International Journal of Impotence Research, 2014). Now we are doing a clinical multi-center research of PE new classification. The nerve electrophysiological tests may differentiate the treatment of primary premature ejaculation (PPE) in our previous studies, we confirmed lately that abstinence time does not interfere with the nerve electrophysiological test, which is stable in determining the nerve function of PPE patients Asian Journal of Andrology, 2018).
Education&Training
1. China training class on diagnosis and treatment of sexual dysfunction
The Andrology Department of Nanjing Drum Tower Hospital is one of China's three major sexual dysfunction diagnosis and treatment technology training base. Three times a year, each period of 10 students, small-size class teaching, hands-on training, has been successfully held nine times and had a great training effect. The students come from all over the country, and now the students in waiting list has exceeded 100.
2. The on-job training course of Andrology
The Andrology Department is a training base(Jiangsu Province) for Chinese andrological physicians granted by the Andrology Branch of the Chinese Medical Association. The refresher course is divided into three months, six months and one year. The advanced courses include the diagnosis and treatment of common diseases and frequently occurring diseases in andrology, as well as the common surgery and microsurgery in andrology. At the same time, the advanced courses in andrology (48 class hours) are arranged.
3. Jinling Sexual Medicine Forum
Since 2008, Jinling Sexual Medicine Forum has been successfully held for 12 sessions, with its influence gradually radiating from the region to the whole country, even to the world, and widely recognized and praised by experts in andrology and sexual medicine at home and abroad. In 2019, it attracted more than 400 participants from all over the country.