Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility

Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm's potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause.

[Prenatal diagnosis of uropathies: a review of 10 cases]

Obstructive uropathies are a frequent cause of child renal failure. The prenatal diagnosis of such abnomalies should lead to appropriate management. to evaluate the interest of ultrosonographic prenatal diagnosis of urinary tract malformations retrospective study of 10 cases of urinary tract malformations diagnosed in utero. The mean age of the patients was 34,9 years and the mean gestationnal age at the prenatal diagnosis was 28,2 weeks of amenorrhea. The abnormalties diagnosed were: 2 cases of ureteropelvic junction obstruction, 3 cases of posterior urethral valves and 5 cases of mild hydronephrosis. The fetal karyotype, realised in 8 cases, was normal. In one case the urinary abnormalties was part of a multiple malformation syndrome and led to the termination of the pregnancy. 7 cases had a postnatal follow-up: 5 had a surgical management and two new borns had transient pyelectasies. The prediction of postnatal renal function is made by ultrasonographic appearence of the kidney and the amniotic fluid. Although the analysis of fetal urine for the assesment of renal function leads to conflicting results, it seems that sodium and beta-2 microglobulin urinary rates provide useful informations

[Ultrasonographic diagnosis of ectopic pregnancy. a review of 109 cases]

To assess the accuracy of Ultrasonographic diagnosis of ectopic pregnancies. A retrospective study of Ultrasonographic findings of 109 patients operated for ectopic pregnancy between January 1997 and December 1998. Ultrasonography was performed with an Aloka SSD 620 sonographic imager and a 5 MHz endovaginol transducer. All patients had a transvaginal sonography. Of these, 15 had a transobdominal sonogrophy. Ultrasonographic findings of the 109 ectopic pregnancies were on extrauterine gestotionnal sac in 10 cases [9,17%], on adnexel mass clearly separated from uterus and ovary in 87 cases [79,81%], a pelvic fluid in 90 cases [82,56%] and pseudogestationnal sac in 6 cases. Ultrasonographic established the diagnosis of ectopic pregnancy in 89% of cases. Serum B HCG level was needed for diagnosis in 12 cases [11%]. Transvaginal sonography is the method of choice for the evaluation of women with a suspected ectopic pregnancy. However, serum B HCG levels are useful for diagnosis in 11% of cases

Les hysterectomies abdominales indications et resultats [. propos de 250 observations]

Patients and methods: R‚trospective study of 250 patients treated by abdominal hysterectomy for benign gynecologic disease. objective: To report the indications and therapeutic results of abdominal hysterectomy. Medium age was 47 years. Anemia was found in 64% Fibroma were the main indication representing 78% of cases. In 97.6% of cases we performed a total hysterectomy and associated to bilateral oophorectomy in 53.6% of the cases. Post operative complications were dominated by urinary tract infections [27.6%]. Abdominal hysterectomy remains a frequent interventy in gynecology mainly for fibroma. This technique is rarely complicated when done by experienced teams