Abdominal testicular vessel distribution in human fetuses - basis for Fowler-Stephens surgery

ABSTRACT Purpose: To analyze the histology and distribution of abdominal testicular vessels in human fetuses Patients and Methods: We studied 19 fetuses (34 testes) ranging in age from 12 to 19 weeks post-conception. The fetuses were evaluated regarding crown-rump length (CRL), total length (TL) and body weight immediately before dissection. Each testis was dissected and embedded in paraffin, from which 5 µm thick sections were obtained and stained with Masson's trichrome and Anti-CD31 antibody to quantify the vessels. The stereological analysis was carried out with the Image Pro and Image J programs, using a grid to determine volumetric densities (Vv). Means were statistically compared using the unpaired T-test (p<0.05). Results: The fetuses presented mean weight of 222.5g, mean CRL of 15.3 cm and mean TL of 23.2 cm. All testes were in the abdominal position. The mean percentage of vessels (Vv) in the upper portion of the testis was 7.6% (4.6 to 15%) and in the lower portion the mean was 5.11% (2.3 to 9.8%), with a significant difference (p=0.0001). In the analysis between the upper portion of the right and left testes (p=0.99) and in the analysis of the lower portion of the right and left testes (p=0.83), we did not observe significant differences. Conclusion: The upper portion of the abdominal testis in human fetuses had a higher concentration of vessels than the lower portion. These results suggest that manipulation of the lower end of the testis during Fowler-Stephens surgery should be avoided in order to preserve the collateral circulation.

Effects of dutasteride and tamsulosin on penile morphology in a rodent model

ABSTRACT Purpose To evaluate the penile morphology after the isolated and combined administration of dutasteride and tamsulosin in a rodent model. Materials and Methods Forty male rats were assigned into the following groups: Control group (C, receiving distilled water, n=10); Dutasteride group (D, receiving 0.5 mg/Kg/day of dutasteride, n=10); Tamsulosin group (T, receiving 0.4 mg/Kg/day of tamsulosin, n=10); and Dutasteride associated with Tamsulosin group (DT, receiving both drugs n = 10). All drugs were administered via oral gavage. After 40 days, the animals were submitted to euthanasia and their penises were collected for histomorphometric analyses. Data were compared using one-way ANOVA followed by Bonferroni's post-test, considering p<0.05 as significant. Results The sinusoidal space and smooth muscle fiber surface densities (Sv), and the cross-sectional penile areas of rats in groups D, T and DT were reduced in comparison to controls with the most notable reductions in the combined therapy group. The connective tissue and elastic system fibers Sv were augmented in groups D, T and DT in comparison with the control group, again with the most pronounced changes observed in animals receiving the combined therapy. Conclusion Both treatments with dutasteride or tamsulosin promoted penile morphometric modifications in a rodent model. The combination therapy resulted in more notable modifications. The results of this study may help to explain the erectile dysfunction observed in some men using these drugs.

The prostate after castration and hormone replacement in a rat model: structural and ultrastructural analysis

ABSTRACT Purpose: To evaluate if late hormonal replacement is able to recover the prostatic tissue modified by androgenic deprivation. Materials and Methods: 24 rats were assigned into a Sham group; an androgen deficient group, submitted to bilateral orchiectomy (Orch); and a group submitted to bilateral orchiectomy followed by testosterone replacement therapy (Orch+T). After 60 days from surgery blood was collected for determination of testosterone levels and the ventral prostate was collected for quantitative and qualitative microscopic analysis. The acinar epithelium height, the number of mast cells per field, and the densities of collagen fibers and acinar lumen were analyzed by stereological methods under light microscopy. The muscle fibers and types of collagen fibers were qualitatively assessed by scanning electron microscopy and polarization microscopy. Results: Hormone depletion (in group Orch) and return to normal levels (in group Orch+T) were effective as verified by serum testosterone analysis. The androgen deprivation promoted several alterations in the prostate: the acinar epithelium height diminished from 16.58±0.47 to 11.48±0.29μm; the number of mast cells per field presented increased from 0.45±0.07 to 2.83±0.25; collagen fibers density increased from 5.83±0.92 to 24.70±1.56%; and acinar lumen density decreased from 36.78±2.14 to 16.47±1.31%. Smooth muscle was also increased in Orch animals, and type I collagen fibers became more predominant in these animals. With the exception of the densities of collagen fibers and acinar lumen, in animals receiving testosterone replacement therapy all parameters became statistically similar to Sham. Collagen fibers density became lower and acinar lumen density became higher in Orch+T animals, when compared to Sham. This is the first study to demonstrate a relation between mast cells and testosterone levels in the prostate. This cells have been implicated in prostatic cancer and benign hyperplasia, although its specific role is not understood. Conclusion: Testosterone deprivation promotes major changes in the prostate of rats. The hormonal replacement therapy was effective in reversing these alterations.

Effects of L-Glutamine oral supplementation on prostate of irradiated rats

ABSTRACT Objectives To investigate the protective effect of L-Glutamine in animals undergone to ventral radiation when the target organ is not the prostate. Materials and Methods Wistar rats were divided into groups of 10 animals each: Controls (C), maintained under standard conditions and not exposed to radiation, Radiated group (R) undergone to abdominal radiation only and Radiated plus supplemented by L-glutamine group (R+G). The animals of group R+G were supplemented with L-glutamine at the beginning of the experiment until death in the 22nd day. The ventral prostate was dissected and processed for morphometrical analysis. The epithelial height, collagen density and acinar area were objectively assessed in histological sections. Results Epithelial height was significantly reduced in R group in comparison to C group (p= 0.005). However, there was no statistical difference between the C and R+G groups. Collagen surface density in the C and R groups were not statistically different, but a significant difference was observed when comparing groups R+G and R (p= 0.040). The R+G group values did not differ significantly from C group. The acinar prostate area of group R was similar to that of C (p= 0.971), but in R+G it was significantly reduced when compared with the C (p= 0.038) and R (p= 0.001) groups. Conclusions Pelvic radiation promotes structural modifications in ventral prostate of rats, which can be reduced by L-Glutamine.

Metabolic and Testicular Effects of the Long-Term Administration of Different High-Fat Diets in Adult Rats

To evaluate the effects of different high-fat diets on body mass, carbohydrate metabolism and testicular morphology in rats seven months old.

Effects of prepubertal corticosterone treatment on urinary bladder

PURPOSE: The aim of this work was to analyze the bladder wall modifications after a chronic treatment with high doses of corticosterone in prepubertal rats. METHODS: This study included 26 male rats assigned into four groups: T30 was treated with corticosterone until 29 days of age and killed at day 30, while T65 group received the same treatment but was killed at day 65. Each group had its own control group (C30 and C65). For treated animals, daily intraperitoneal injections of corticosterone (20 mg/Kg) were administered between 7th and 29th day of life. Bladders were removed and collagen, smooth muscle, elastic fibers system, vascular density and epithelium were analyzed by morphometrical methods, immunofluorescence, and biochemistry. RESULTS: Vascular density in lamina propria was reduced by 40% (p<0.05) in group T65. Collagen organization was altered in T30 and T65, although total collagen concentration was unchanged. The T65 group had an increase in elastic system fibers. There was no difference in epithelial height and cell density between the groups. Concerning the smooth muscle fibers density we observed a 19% increase (p<0.05) in the T65 group. CONCLUSION: Prepubertal administration of corticosterone induces structural modifications in the bladder of rats in a medium term analysis. .

Leptin and leptin receptor expressions in prostate tumors may predict disease aggressiveness?

PURPOSE: The aim of this study was to evaluate the expression of leptin and its receptor in histological sections of prostate tumors, and their association with prognostic factors. METHODS: A total of 532 surgical specimens from prostate cancer were studied. After histopathological diagnosis, the samples were included in tissue microarrays containing cores from tumor and non-tumor (benign prostatic hyperplasia) areas. These were immunostained with anti-leptin and anti-leptin-receptor antibodies. Objective and subjective analyses were performed. Student's-t-test and ANOVA were used to compare mean values, and linear regression was used to evaluate the correlation between histological results and prognostic indicators. RESULTS: Leptin receptor expression was reduced in tumors with a positive surgical margin, urethral margin involvement, and seminal vesicles invasion. Further, there was a negative correlation between the expression of leptin receptor in tumor areas and the sum of prognostic factors, suggesting that leptin receptor may predict the aggressiveness of disease. CONCLUSION: Our findings suggest that leptin receptor expression is a potential prognostic factor for PCa. Further investigation is needed to support the use of leptin receptor as a novel biomarker, although leptin itself does not seem to predict the aggressiveness of prostate cancer. .

Study of the ureter structure in anencephalic fetuses

Purpose The objective of this paper is to analyze the structure of the ureter in normal and anencephalic human fetuses. Materials and Methods We studied 16 ureters from 8 human fetuses without congenital anomalies aged 16 to 27 weeks post-conception (WPC) and 14 ureters from 7 anencephalic fetuses aged 19 to 33 WPC. The ureters were dissected and embedded in paraffin, from which 5 µm thick sections were obtained and stained with Masson trichrome, to quantify smooth muscle cells (SMC) and to determine the ureteral lumen area, thickness and ureteral diameter. The samples were also stained with Weigert Resorcin Fucsin (to study elastic fibers) and Picro-Sirius Red with polarization and immunohistochemistry analysis of the collagen type III fibers to study collagen. Stereological analysis of collagen, elastic system fibers and SMC were performed on the sections. Data were expressed as volumetric density (Vv-%). The images were captured with an Olympus BX51 microscope and Olympus DP70 camera. The stereological analysis was done using the Image Pro and Image J programs. For biochemical analysis, samples were fixed in acetone, and collagen concentrations were expressed as micrograms of hydroxyproline per mg of dry tissue. Means were statistically compared using the unpaired t-test (p < 0.05). Results The ureteral epithelium was well preserved in the anencephalic and control groups. We did not observe differences in the transitional epithelium in the anencephalic and control groups. There was no difference in elastic fibers and total collagen distribution in normal and anencephalic fetuses. SMC concentration did not differ significantly (p = 0.1215) in the anencephalic and control group. The ureteral lumen area (p = 0.0047), diameter (p = 0.0024) and thickness (p = 0.0144) were significantly smaller in anencephalic fetuses. Conclusions Fetuses with anencephaly showed smaller diameter, area and thickness. These differences could indicate ...

Structural analysis of testicular appendices in patients with cryptorchidism

Objectives Report the incidence and structure of testicular appendices (TAs) in patients with cryptorchidism, comparing their incidence with epididymal anomalies (EA) and patency of the vaginal process (PVP) and analyzes the structure of TAs. Material and Methods We studied 72 testes of patients with cryptorchidism (average of 6 years), and 8 testes from patients with hydroceles (average of 9 years). We analyzed the relations among the testis, epididymis and PVP and prevalence and histology of the TAs. The appendices of 10 patients with cryptorchidism and 8 with hydrocele were dissected and embedded in paraffin and stained with Masson trichrome; Weigert and Picro-Sirius Red with polarization and immunohistochemistry analysis of the collagen type III fibers to observe collagen. The stereological analysis was done with the software Image Pro and Image J, using a grid to determine volumetric densities (Vv). Means were statistically compared using the ANOVA and unpaired T test (p < 0.05). Results Of the 72 testes with cryptorchidism, 20 (27.77%) presented EA, 41 (56.9%) had PVP and 44 (61.1%) had TAs. Of the 44 testes with cryptorchidism and appendices, 30 (68.18%) presented PVP and 11 (25%) presented EA. There was no alteration of the epithelium in the appendices of patients in both groups. Stereological analysis documented the prevalence of ESFs (mean of 1.48%), prevalence of veins (mean of 10.11%) and decrease (p = 0.14) of SMCs in the TAs of patients with cryptorchidism (mean = 4.93%). Collagen III prevailed in the TAs of patients with cryptorchidism. Conclusion The testicular appendices presented significant structural alteration in the patients with cryptorchidism, indicating that TAs present a structural remodeling. .

Does prolonged pneumoperitoneum affect the kidney? Oxidative stress, stereological and electron microscopy study in a rat model

Purpose: Pneumoperitoneum (Pp) at 12 to 15 mmHg in rats is associated with kidney damage. However, Pp at 8 mmHg is now known to best correlate to working pressures used in humans. Thus the aim of this work was to study the kidney of rats submitted to prolonged Pp at 8 mmHg. Materials and Methods: Rats were divided into a Sham group (n = 14), submitted to anesthesia, and a Pp group (n = 14), submitted to Pp at 8 mmHg, followed by deflation. In both groups, 7 animals were immediately killed and their kidneys were used for oxidative stress analyses. The remaining 7 rats in each group were evaluated after 6 weeks for the number of glomeruli and podocyte morphology. Results: For all analyzed parameters Sham and Pp groups presented no statistical difference. Conclusion: When submitted to adequate Pp pressures (8 mmHg), no kidney damage occurs in rats. .

Stereological and biochemical analysis of the urethral edges in patients submitted to end-to-end anastomosis for bulbar urethral stricture

PURPOSE: To study the morphologic alterations in the proximal and distal urethral edges from patients submitted to end-to-end bulbar urethroplasty. MATERIALS AND METHODS: We analyzed 12 patients submitted to anastomotic urethroplasty to treat bulbar strictures less than 2.0 cm in length. After excision of the fibrotic segment to a 28Fr urethral caliber, we obtained biopsies from the spongious tissue of the free edges (proximal: PROX and distal: DIST). Controls included normal bulbar urethras obtained from autopsies of 10 age matched individuals. The samples were histologically processed for smooth muscle cells (SMC), elastic system fibers and collagen. Stereological analysis was performed to determine the volumetric density (Vv) of each element. Also, a biochemical analysis was performed to quantify the total collagen content. RESULTS: Vv of SMC was reduced in PROX (31.48 ± 7.01 p < 0.05) and similar in DIST when compared to controls (55.65 ± 9.60%) with no statistical difference. Elastic fibers were increased in PROX (25.70 ± 3.21%; p < 0.05) and were similar to controls in DIST (15.87 ± 4.26%). Total collagen concentration in PROX (46.39 ± 8.20 μg/mg), and DIST (47.96 ± 9.42 μg/mg) did not differ from controls (48.85 ± 6.91 μg/mg). Type III collagen was similarly present in all samples. CONCLUSIONS: After excision of the stenotic segment to a caliber of 28Fr, the exposed and macroscopically normal urethral edges may present altered amounts of elastic fibers and SMC, but are free from fibrotic tissue. When excising the peri-stenotic tissue, the surgeon should be more careful in the proximal end, which is the most altered.

High concentration of reticular fibers in periurethral region of the prostatic urethra from patients with benign prostatic hyperplasia as revealed by stereology / Alta concentración de fibras reticulares en la región periuretral de la uretra prostática de pacientes con hiperplasia prostática benigna revelada por estereología

The goal of this investigation was to analyze and quantify changes of the reticular fibers in the prostatic urethra of patients with benign prostatic hyperplasia (BPH) and compare with a control group. Prostatic urethra tissue samples were obtained from ten patients (age range 65 to 79 years, mean 66) with clinical symptoms of bladder outlet obstruction who had undergone open prostatectomy. The ten control group samples (urethral tissue samples from the transitional zone) were collected from prostates obtained during autopsy of accidental death adults of less than 25 years. The Vv of the reticular fibers was determined with stereologic methods from 25 random fields per sample using the point-count method with a M-42 grid test system. The quantitative data were analyzed using the Kolmogorov-Smirnov and Mann-Whitney U tests. The Vv (mean+/-SD) in the control and BPH groups respectively were: 23.4+/- 1.8 and 30.3 +/- 1.2 (0.001). BPH cause significant increase of reticular fibers in prostatic urethra...

El objetivo de esta investigación fue analizar y cuantificar los cambios de las fibras reticulares en la uretra prostática de pacientes con hiperplasia prostática benigna (HPB) y compararlo con un grupo control. Muestras de tejido de uretra prostática se obtuvieron de diez pacientes (rango de edad 65 a 79 años, media 66) con síntomas clínicos de obstrucción del tracto urinario inferior que se habían sometido a prostatectomía abierta. Las diez muestras del grupo de control (muestras uretrales de tejido de la zona de transición) se obtuvieron de próstatas durante la autopsia de sujetos adultos con muerte accidental menores de 25 años. El Vv de las fibras reticulares se determinó con métodos estereológicos de 25 campos al azar por muestra utilizando el método de valor de conteo con el sistema M-42. Los datos cuantitativos se analizaron mediante la prueba de Kolmogorov-Smirnov y Mann-Whitney U. El Vv (media +/- DE) en el grupo control y BPH, respectivamente, fueron: 23,4 +/- 1,8 y 30,3 +/- 1,2 (0,001). La BPH causó aumento significativo de fibras reticulares en uretra prostática...

Structural alterations of foreskin caused by chronic smoking may explain high levels of urethral reconstruction failure using foreskin flaps

OBJECTIVES: The aim of the present study was to perform a stereological and biochemical analysis of the foreskin of smoker subjects. MATERIALS AND METHODS: Foreskin samples were obtained from 20 young adults (mean = 27.2 years old) submitted to circumcision. Of the patients analyzed, one group (n = 10) had previous history of chronic smoking (a half pack to 3 packs per day for 3 to 13 years (mean = 5.8 ± 3.2). The control group included 10 nonsmoking patients. Masson's trichrome stain was used to quantify the foreskin vascular density. Weigert’s resorcin-fucsin stain was used to assess the elastic system fibers and Picrosirius red stain was applied to study the collagen. Stereological analysis was performed using the Image J software to determine the volumetric densities. For biochemical analysis, the total collagen was determined as µg of hydroxyproline per mg of dry tissue. Means were compared using the unpaired t-test (p < 0.05). RESULTS: Elastic system fibers of smokers was 42.5% higher than in the control group (p = 0.002). In contrast, smooth muscle fibers (p = 0.42) and vascular density (p = 0.16) did not show any significant variation. Qualitative analysis using Picrosirius red stain with polarized light evidenced the presence of type I and III collagen in the foreskin tissue, without significant difference between the groups. Total collagen concentration also did not differ significantly between smokers and non-smokers (73.1µg/mg ± 8.0 vs. 69.2µg/mg ± 5.9, respectively, p = 0.23). CONCLUSIONS: The foreskin tissue of smoking patients had a significant increase of elastic system fibers. Elastic fibers play an important role in this tissue’s turnover and this high concentration in smokers possibly causes high extensibility of the foreskin. The structural alterations in smokers’ foreskins could possibly explain the poor results in smoking patients submitted to foreskin fasciocutaneous flaps in urethral reconstruction surgery.

The position of the testis during the fetal period: an additional parameter to estimate fetal weight

PURPOSE: To establish a correlation between testicular position and fetal weight, in order to provide an additional prenatal parameter for fetal weight estimation. MATERIALS AND METHODS: We studied 288 testes from 144 human fetuses. The fetuses were assessed as regards weight, total length, crown-rump length and foot length. Fetal age was calculated according to the foot length criteria. The position of the testis was classified as abdominal, inguinal or scrotal. RESULTS: One hundred and ninety seven testes (68.4 percent) were abdominal, 43 (14.9 percent) were inguinal and 48 (16.6 percent) were scrotal. In the fetuses weighing up to 500 grams, 147 testes (93.5 percent) were abdominal and 5 testes (6.5 percent) were inguinal. In fetuses weighing between 501 and 1000 grams, 54 testes (68.6 percent) were abdominal, 28 testes (32.5 percent) were inguinal and 4 testes (4.6 percent) were scrotal. In fetuses weighing between 1001 and 1500 grams, 4 testes (13.3 percent) were abdominal, 3 (10 percent) were inguinal and 23 (76.6 percent) were scrotal. All fetuses weighing more than 1500 grams presented the testes with a migration to the scrotum (10 fetuses - 20 testes). CONCLUSIONS: To our knowledge, this is the first study correlating the testicular position to the fetal weight during testicular migration in human fetuses. Identification of the testes during the prenatal period could be a useful alternative parameter for estimating fetal weight.

Disposition of the striated urethral sphincter and its relation to the prostate in human fetuses

OBJECTIVE: To describe the arrangement of the muscle fibers of the striated urethral sphincter and its relationship with the prostate during the fetal period in humans. MATERIALS AND METHODS: We analyzed 17 prostates from well preserved fresh human fetuses ranging in age from 10 to 31 weeks postconception (WPC). Transversal sections were obtained and stained with Gomori's trichrome and immunolabeled with anti alpha-actin antibody. RESULTS: We found that the urethral striated sphincter (rabdosphincter) is located on the periphery of the smooth muscle and there was no merge between striated and smooth muscle fibers in any fetal period. In the prostate apex, the striated sphincter shows a circular arrangement and covers completely the urethra externally, whereas adjacent to verumontanum, it looks like a "horseshoe" and covers only the anterior and lateral surfaces of the urethra. Near the bladder neck, in fetuses younger than 20 WPC, we have found striated muscle fibers only at the anterior surface of the prostate, while in fetuses older than 20 WPC, the striated muscle covers the anterior and lateral surfaces of the prostate. CONCLUSIONS: The urethral sphincter muscle covers the anterior and lateral surfaces of the urethra in all fetuses older than 20 WPC, close to the bladder neck and at the distal prostate. In the region of the prostate apex, the urethral sphincter covers completely the urethra circularly. The knowledge of the normal anatomy of the urethral sphincter in fetuses could be important to understand its alterations in congenital anomalies involving the base of the bladder, the bladder neck and the proximal urethra.

Applied anatomic study of testicular veins in adult cadavers and in human fetuses

OBJECTIVES: Analyze the anatomic variations of the testicular veins in human cadavers and fetuses. MATERIALS AND METHODS: One hundred male adult cadavers and 24 fetuses were studied. Four anatomic aspects were considered: 1) Number of testicular veins, 2) The local of vein termination, 3) Type and number of collaterals present and 4) Testicular vein termination angle. RESULTS: Cadavers - Right side - One testicular vein occurred in 85 percent and 2 veins in 5 percent of the cases. There were communicating veins with the colon in 21 percent of the cases. Left side - One testicular vein occurred in 82 percent, two veins in 15 percent, three veins in 2 percent and four veins in 1 percent of the cases. There were communicating veins with the colon in 31 percent of the cases. Fetuses - Right side -One testicular vein occurred in all cases. This vein drained to the vena cava in 83.3 percent of the cases, to the junction of the vena cava with the renal vein in 12.5 percent and to the renal vein in 4.2 percent. There were communicating veins with the colon in 25 percent of the cases. Left side - One testicular vein occurred in 66.6 percent of the cases, and 2 veins in occurred 33.3 percent. Communicating veins with the colon were found in 41.6 percent of the cases. CONCLUSION: The testicular vein presents numeric variations and also variations in its local of termination. In approximately 30 percent of the cases, there are collaterals that communicate the testicular vein with retroperitoneal veins. These anatomic findings can help understanding the origin of varicocele and its recurrence after surgical interventions.

Structural analysis of gubernaculum testis in cryptorchid patients submitted to treatment with human chorionic gonadotrophin

OBJECTIVES: To make a histological and stereological analysis of gubernaculum testis elastic system fibers, collagen and striated muscle cells in patients with cryptorchidism treated with human chorionic gonadotrophin (hCG). MATERIALS AND METHODS: Gubernacula tissue samples were obtained from 12 patients with cryptorchidism. Patients' ages ranged from 1 to 3 years (mean 1.8). Of the 12 patients, 6 were treated with hCG. The samples were stained with Masson's trichrome to highlight muscle fibers and collagen, and Weigert's resorcin-fuchsin to highlight the elastic system fibers. The volumetric density of these components was determined by stereological methods. RESULTS: The volumetric density of collagen was increased in patients treated with hCG, ranging from 85.62 percent to 94.48 percent, while in patients not submitted to hCG treatment the volume density ranged from 52.12 percent to 89.46 percent (p = 0.0052). The volumetric density of the elastic system fibers was higher in patients treated with hCG, ranging from 9.62 percent to 19.62 percent, while patients not submitted to hCG treatment the volume density of elastic system fibers was between 10.38 percent and 12.38 percent (p = 0.0030). The volume density of striated muscle fibers in patients treated with hCG ranged from 4.76 percent to 39.16 percent, while and in patients not treated hCG it ranged from 3.24 percent to 11.14 percent (p = 0.0052). CONCLUSION: Gubernacular components alter significantly when submitted to treatment with hCG. Patients who underwent hCG treatment and had no complete testicular migration had an increase in the concentration of elastic and striated muscle fibers and a decrease in the volumetric density of collagen.

Stereological study of collagen and elastic system in the detrusor muscle of bladders from controls and patients with infravesical obstruction

OBJECTIVE: Compare detrusor muscle of normal and patients with infravesical obstruction, quantifying the collagen and elastic system fibers. MATERIALS AND METHODS: We studied samples taken from bladders of 10 patients whose ages ranged from 45 to 75 years (mean = 60 years), who underwent transvesical prostatectomy for treatment of BPH. Control material was composed of 10 vesical specimens, removed during autopsies performed in cadavers of accident victims, with ages between 18 and 35 years (mean = 26 years). RESULTS: The results of collagen and elastic fibers quantification (volumetric density) demonstrated the following results in percentage (mean +/- standard deviation): collagen in BPH patients = 4.89 +/- 2.64 and 2.32 +/- 1.25 in controls (p < 0.0001), elastin in BPH patients = 10.63 percent +/- 2.00 and 8.94 percent +/- 1.19 in controls (p < 0.0001). CONCLUSION: We found that the components of connective tissue, collagen and elastic system fibers are increased in the detrusor muscle of patients with infravesical obstruction, when compared to controls.

Stereological and morphometric analysis of collagen and seminiferous tubules in testes of patients with cryptorchidism submitted or not to treatment with human chorionic gonadotrophin

OBJECTIVES: Quantify the distribution of collagen and analyze the seminiferous tubules diameter in the testis of patients with cryptorchidism, to verify if the previous use of human chorionic gonadotrophin (hCG) affects these structures. MATERIALS AND METHODS: Samples of parenchymal tissue of cryptorchid testis obtained during peroperative biopsies were collected from 26 patients. Sixteen samples were embedded in paraffin and stained with picrosirius red to evidence fibers of collagen system. The quantification of these fibers was determined by stereological methods, using a test system M-42. To obtain seminiferous tubules diameter we used 10 of the 26 samples. These samples were embedded in Epon and the analyses were carried out in semi-thin sections, stained with toluidin blue. The selected results of each group were statistically analyzed and compared by the student's t and Tukey-Kramer's tests. RESULTS: The testicular interstitium and lamina propria of patients treated with hCG showed statistically significant less collagen system fibers, when compared to the testes of patients nontreated (0.30 percent versus 0.39 percent, p = 0.0079). The seminiferous tubules diameters were not statistically significant different between the testes of patients treated and nontreated with hCG (67.5 versus 59.35 µm, p = 0.0609). CONCLUSIONS: hCG use in the cryptorchidism could delay, at least temporarily, a progressive growth of fibers of collagen system. We did not find statistically significant difference in the seminiferous tubular diameters between treated and nontreated patients.

Relationship between the persistence of the processus vaginalis and age in patients with cryptorchidism

OBJECTIVES: To assess if there is an age group where the occurrence of persistent processus vaginalis is more frequent in patients with cryptorchidism. MATERIALS AND METHODS: We studied 24 fetuses with gestational age between 23 and 35 weeks postconception (control group) and 102 patients (137 testes) with cryptorchidism aged between 1 and 33 years (mean 10.3 years). We considered 2 situations for analysis of the processus vaginalis: a) complete persistence of processus vaginalis and, b) complete obliteration of the processus vaginalis between the internal inguinal ring and the upper pole of the testis. RESULTS: Of the 137 cases of cryptorchidism, the processus vaginalis was patent in 79 (57.6 percent) and obliterated in 58 (42.4 percent). Of the 55 patients between 1 and 4 years old, 37 (67.2 percent) had a patent processus vaginalis and 18 (32.8 percent) an obliterated one. Of the 37 patients between 5 and 8 years, 17 (45.9 percent) had patent processus vaginalis and 20 (54.1 percent) had an obliterated processus. In the 45 patients over 9 years of age, in 25 (55.5 percent) the processus vaginalis was patent and in 20 (44.5 percent) it was obliterated. In the fetuses, we found 4 cases (8.3 percent) of persistence of the processus vaginalis. CONCLUSIONS: There was no difference in the occurrence of patent processus vaginalis between the various age ranges under study. Patent processus vaginalis was more frequent in patients with cryptorchidism than in fetuses.