ABSTRACT
Undescended testes are a common problem, affecting up to 3% of newborn males. The goals of orchiopexy in humans are to provide adequate scrotal fixation, to prevent recurrent torsion of the testis and spermatic cord or ascent of the testis, and to achieve these goals with minimal trauma to the testis. The best method of achieving fixation remains controversial. The aim of our study is to evaluate our modified extradartose pouch technique in retaining testis in the scrotum. Patients and methods: Between August 2005 and September 2008. Our studied group included 61 patients with 72 orchiopexies age ranged from 5 months to 15 years with the mean age of 58.5 +/- 40 months [4.8 years] all cases had palpable undescended testis 20 pa tients [32.7%] had unilateral left side 30 patients [49.1%] had unilateral right side and 11 patients [18%] had bilateral undescended testis. Testis was located in the superficial inguinal pouch in 33 cases [45.85%], intra-canalicular in 39 cases [54.16%]. Hernial sac was found in 69 cases [95.8%], postoperative wound infection occurred in one case[1.38%] and haematoma formation in two cases [2.77%] no ascent of the testis nor testicular atrophy was observed in the follow up period. which extends now up to 3 years and we still follow up those cases.3 patients [4 orchiopexies] lost follow up. Our modified technique for extradartose pouch fixation seems to be a fast reliable method for orchiopexy however comparative studies and long term assessment is still needed to establish this method
Subject(s)
Humans , Male , Cryptorchidism , Follow-Up StudiesABSTRACT
lnhibin B generated by Sertoli cells provides negative feedback on FSH secretion. In men, inhibin B seems to be physiologically important form of inhibin. Lactic dehydrogenase [LDH], an intracellular enzyme that indicates cellular damage. Varicocele has been associated with infertility and disturbed spermatogenesis. We aimed to investigate the relationship between varicocele, LDH and inhibin B. This study was conducted on forty infertile men with varicocele and twenty age matched control men. LDH and inhibin B were measured in the blood samples of these 40 patients with varicocele which were obtained synchronously from spermatic and peripheral veins during operation and in peripheral vein of control men. Varicocele patients were classified into two groups: group I twenty patients with normal sperm concentration [> 20 million /ml], and group II twenty patients with low sperm concentration [< 20 million /ml]. FSH and testosterone were measured by chemilurninescence while inhibin B was measured by enzyme immunoassay method. LDH enzyme activities were assayed by enzymatic U.V methods. Sperm counts ranged from 3.9 to 60 million/ml, while motility ranged from 15 to 48%. LDH level and inhibin B in spermatic vein were significantly higher than the level in peripheral vein. There was no correlation between sperm counts and LDH level in spermatic vein. lnhibin B concentrations in spermatic vein correlated significantly with serum concentration of FSH [r= -0.63, p < 0.001] and free testosterone [r= 0.34, p<0.05] and also correlated significantly with sperm counts [r= 0.44, p < 0.01] and total testicular volume [r= 0.56, p< 0.01]. lnhibin B showed significant reduction in patients with varicocele than in control men, while LDH showed no significant difference. There were significant increases in inhibin B and LDH in both peripheral vein and spermatic vein of men with sperm count > 20 million /ml when compared with men who had count < 20 million/ml. Significant increase in spermatic vein LDH and inhibin B levels were observed in varicocele. These findings suggest that inhibin B may be offer an improved diagnosis of testicular dysfunction. Consequently, spermatic vein LDH activity and inhibin B level can be predictors of testicular dysfunction in varicocele