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1.
Int. braz. j. urol ; 48(1): 8-17, Jan.-Feb. 2022. graf
Article in English | LILACS | ID: biblio-1356298

ABSTRACT

ABSTRACT Objectives: In this review we will describe the testicular vessels anatomy and the implications of these vessels in surgical treatment of high undescended testis. Material and Methods: We performed a narrative review of the literature about the role of the testicular arteries anatomy in the treatment of high undescended testis. We also studied two human testes to illustrate the testicular vascularization. Results: Each testis is irrigated by three arteries: testicular artery (internal spermatic artery), a branch of the right aorta; deferential artery (vasal artery), a branch of the inferior vesicle artery that originates from the anterior trunk of internal iliac artery and cremasteric artery (external spermatic artery), a branch of the inferior epigastric artery. There are important communications among the three arteries with visible anastomotic channels between the testicular and deferential arteries. Conclusions: Laparoscopic transection of the testicular vessels by dividing the spermatic vessels (Fowler-Stephens surgery) is safe in patients with high abdominal testis due to the great collateral vascular supply between testicular, vasal and cremasteric arteries; also, two-stage Fowler-Stephens orchiopexy appears to carry a higher rate of success than the single stage approach.


Subject(s)
Humans , Male , Spermatic Cord/surgery , Laparoscopy , Cryptorchidism/surgery , Arteries/surgery , Testis/surgery , Orchiopexy
2.
Acta cir. bras ; 35(2): e202000201, 2020. tab, graf
Article in English | LILACS | ID: biblio-1100884

ABSTRACT

Abstract Purpose To evaluate the effect of a PP mesh on duct deferens morphology, testicular size and testosterone levels. Methods Forty adult male rats were distributed into groups: 1) no surgery; 2) inguinotomy; 3) mesh placed on the duct deferens; and 4) mesh placed on the spermatic funiculus. After 90 postoperative days, the inguinal region was resected, and blood samples were collected for the measurement of serum testosterone (pg/dl). The ducts deferens were sectioned in three axial sections according to the relationship with the mesh — cranial, medial and caudal. The wall thickness and duct deferens lumen area were measured. Results The morphology of the duct deferens was preserved in all groups. The mesh placement did not alter this morphology in any of the analyzed segments. Surgery, with or without mesh placement, did not alter the morphology, wall thickness or lumen area (p>0.05). In all operated groups, serum testosterone levels were similar (p>0.05) but there was a decrease in testicle size (p<0.05). Conclusion Surgery, with or without mesh placement, did not alter the morphology of the duct deferens and, although this treatment resulted in testicular size reduction, it did not affect serum testosterone levels.


Subject(s)
Animals , Male , Surgical Mesh , Vas Deferens/pathology , Foreign-Body Reaction/pathology , Inguinal Canal/surgery , Organ Size , Polypropylenes , Postoperative Period , Spermatic Cord/surgery , Testis/anatomy & histology , Testosterone/blood , Vas Deferens/surgery , Foreign-Body Reaction/blood , Rats, Wistar , Models, Animal
3.
Rev. cuba. med. mil ; 48(4): e413, oct.-dic. 2019. tab, fig
Article in Spanish | LILACS, CUMED | ID: biblio-1126644

ABSTRACT

Introducción: La hernia inguinal es una de las enfermedades que más comúnmente requiere tratamiento operatorio y representa entre el 10- 15 por ciento de todas las intervenciones programadas. El porcentaje de complicaciones posoperatorias es de 5- 10 por ciento y aunque no son totalmente evitables, deben conocerse sus posibles causas para lograr reducir su incidencia. Objetivo: Identificar los factores asociados a las complicaciones de la cirugía electiva de las hernias inguinales. Métodos: Se realizó un estudio observacional y descriptivo, de una serie de 246 pacientes operados de hernias inguinales mediante cirugía electiva en el servicio de Cirugía General del Hospital Provincial Docente "Saturnino Lora" de Santiago de Cuba durante el bienio 2016-2017. Resultados: Se constataron 18 complicaciones (7,3 por ciento). Predominó el grupo etario de 51 a 70 años (47,8 por ciento) y el sexo masculino sobre las féminas con razón de 15,4:1. El estado físico preoperatorio fue clasificado ASA 1 en 183 pacientes (74,4 por ciento) y ASA 2 en 62 (25,2 por ciento). El 72,2 por ciento de los complicados tenían al menos una enfermedad asociada. El tipo 2 según clasificación de Nyhus prevaleció con 73 (29,7 por ciento) y 8 (44,4 por ciento) de los complicados. Conclusiones: Los factores referentes a la edad mayor de 50 años, sexo masculino, antecedentes de hipertensión arterial y diabetes mellitus, y hernias tipo II según la clasificación de Nyhus se asocian a la presentación de complicaciones agudas (edema del cordón espermático e infección del sitio operatorio) y crónicas (recidiva y granuloma) de la cirugía electiva de las hernias inguinales(AU)


Introduction: Inguinal hernia is a common surgical treatment illness and represents 10-15 percent of the programmed surgery. The postoperative complications records are 5-10 percent, although they are not avoidable, it is mandatory to know the possible causes to decrease the incidence rate. Objective: To identify the associated factors on the complications of elective inguinal hernia surgery. Methods: An observational and descriptive study of a series of 246 patients operated on elective inguinal hernia surgery in the General Surgery Service of "Saturnino Lora" Hospital of Santiago de Cuba during the years 2016-2017. Results: There were 18 complications (7,3 percent) of the sample. The age group of 51 to 70 years (47,8 percent) predominated and the male sex over females with a ratio of 15,4:1. Preoperative physical state was classified ASA 1 in 183 patients (74,4 percent) and ASA 2 in 62 (25,2 percent). 72,2 percent of the complicated patients had at least one associated disease. Type 2 according to Nyhus classification prevailed with 73 (29,7 percent) patients of the sample, and eight (44,4 percent) of complicated patients. Conclusions: Associated factors on acute and chronic complications of elective inguinal hernia surgery related to age, sex, associated illness, preoperative physical state and type of hernia according to Nyhus classification do not differ from that reported by the national and foreign literature(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Postoperative Complications , Spermatic Cord , General Surgery/methods , Granuloma , Hernia, Inguinal/surgery , Infections/surgery , Age Groups
4.
Int. braz. j. urol ; 45(3): 637-638, May-June 2019. graf
Article in English | LILACS | ID: biblio-1012310

ABSTRACT

Abstract Vasitis or inflammation of the vas deferens is a rarely described condition categorized as either generally asymptomatic vasitis nodosa or the acutely painful infectious vasitis. Vasitis nodosa, the commonly described inflammation of the vas deferens, is benign and usually associated with a history of vasectomy. Clinically, patients present with a nodular mass and are often asymptomatic and require no specific treatment.


Subject(s)
Humans , Male , Adult , Vas Deferens/diagnostic imaging , Rare Diseases , Hernia, Inguinal/diagnostic imaging , Orchitis/diagnostic imaging , Spermatic Cord/diagnostic imaging , Tomography, X-Ray Computed/methods , Diagnosis, Differential
5.
Rev. cir. (Impr.) ; 71(2): 157-161, abr. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1058249

ABSTRACT

INTRODUCCIÓN: Los tumores paratesticulares representan del 7%-10% de las masas intraescrotales. Los sarcomas abarcan el 90% de las lesiones malignas del cordón espermático y de éstas, aproximadamente, el 3%-7% son liposarcomas. CASO CLÍNICO: Presentamos el caso de un varón de 45 años, que consultó en urgencias por una masa inguinoescrotal derecha no reductible, diagnosticándose de hernia inguinal incarcerada. Se realizó cirugía urgente evidenciando una gran tumoración de aspecto lipomatoso, dependiente de cordón espermático. Se realizó orquiectomía y hernioplastía inguinal. La anatomía patológica, reveló un liposarcoma bien diferenciado de cordón espermático. Posteriormente, se realizó estudio de extensión, sin afectación a distancia y no precisó tratamiento adyuvante. Actualmente, tras dos años de seguimiento no ha presentado recidiva. DISCUSIÓN: Sólo alrededor de 200 casos han sido comunicados previamente en la literatura y sólo 61 de éstos se presentaron simulando una hernia inguinal incarcerada. Debido a la baja incidencia de esta patología es difícil de conocer la historia natural y llegar a conclusiones sobre los resultados del tratamiento, el cual hasta el momento sigue siendo la orquiectomía radical, con escisión amplia de los tejidos locales. El papel de la radio y quimioterapia aun es controvertido. CONCLUSIONES: Los sarcomas del cordón espermático son neoplasias raras con alta tasa de recurrencia local. Su manejo inicial es quirúrgico. Se requiere de un alto índice de sospecha clínica para el diagnóstico ya que las implicaciones oncológicas varían en función del tratamiento que, en ocasiones, es llevado a cabo por cirujanos generales al simular una hernia inguinal.


INTRODUCTION: Paratesticular tumors represent 7%-10% of intraescrotal masses. Sarcomas account for 90% of malignant lesions of the spermatic cord and of these approximately 3%-7% are liposarcomas. CLINICAL CASE: This is the case of a 45 year old male who consulted in the emergency department for a non-reducible right inguino-scrotal mass and was diagnosed with an incarcerated inguinal hernia. Emergency surgery was performed which revealed a large lipomatous tumor, originating from the spermatic cord. Orchiectomy and hernioplasty were performed. Histopathology revealed a well-differentiated liposarcoma of the spermatic cord. Later extension study was conducted, without distant affectation, and did not require adjuvant treatment. Today, after two years of monitoring has been no recurrence. DISCUSSION: Only about 200 cases have been previously reported in the literature and only 61 of these were presented mimicking an incarcerated inguinal hernia. Due to the low incidence of this disease it is difficult to know the natural history and draw conclusions on the results of treatment, which so far remains the radical orchiectomy with wide local excision of the tissue. The role of radiotherapy and chemotherapy is still controversial


Subject(s)
Humans , Male , Middle Aged , Testicular Neoplasms/surgery , Liposarcoma/surgery , Spermatic Cord , Spermatic Cord/pathology , Testicular Neoplasms/diagnosis , Orchiectomy/methods , Tomography, X-Ray Computed , Diagnosis, Differential , Hernia, Inguinal/surgery , Hernia, Inguinal/diagnosis , Liposarcoma/diagnosis
6.
The World Journal of Men's Health ; : 78-84, 2019.
Article in English | WPRIM | ID: wpr-719628

ABSTRACT

PURPOSE: Chronic testicular pain remains an important challenge for urologists. At present there are many treatment modalities available for chronic orchialgia. Some patients remain in pain despite a conservative treatment. Microsurgical denervation of spermatic cord appears to be successful in relieving pain in patients who fail conservative management. We assessed the long-term efficacy, complications and patient perceptions of microsurgical denervation of the spermatic cord in the treatment of chronic orchialgia. MATERIALS AND METHODS: A prospective study was conducted from January 2007 to January 2016 which included men with testicular pain of >3 months duration, failure of conservative management, persistent of pain for >3 months after treating the underlying cause. Total 48 patients with 62 testicular units (14 bilateral) showed the response to spermatic cord block and underwent Microsurgical Denervation of Spermatic Cord. RESULTS: Out of 62 testicular units (14 bilateral) which were operated, complete 2 years follow-up data were available for 38 testicular units. Out of these 38 units, 31 units (81.57%) had complete pain relief, 4 units (10.52%) had partial pain, and 3 units (7.89%) were non-responders. Complications were superficial wound infection in 3 units (4.83%), hydrocele in 2 units (3.22%), subcutaneous seroma in 2 units (3.22%), and an incisional hematoma in 1unit (1.61%) out of 62 operated testicular units. CONCLUSIONS: Idiopathic chronic orchialgia remains a difficult condition to manage. If surgery is considered, microsurgical denervation of spermatic cord should be considered as a first surgical approach to get rid of pain and sparing the testicle.


Subject(s)
Humans , Male , Chronic Pain , Denervation , Follow-Up Studies , Hematoma , Pain Management , Prospective Studies , Scrotum , Seroma , Spermatic Cord , Testis , Wound Infection
7.
urol. colomb. (Bogotá. En línea) ; 28(4): 330-332, 2019. ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-1402699

ABSTRACT

Introducción Los liposarcomas son lesiones que se originan en el tejido mesodérmico, su localización paratesticular es muy rara. Se divide en 4 subtipos histológicos, siendo el mixoide el más infrecuente. Tiene una recurrencia del 70%, Por lo que su tratamiento inicial debe ser agresivo. Objetivo resaltar su gran tamaño y que sea considerado como diagnóstico diferencial de masa inguinoescrotal. Presentación del caso Paciente masculino de 87 años con masa dolorosa inguinoescrotal derecha con diagnóstico de hernia inguinal unilateral, se realiza orquiectomía inguinal derecha. En patología se recibe pieza quirúrgica de 2440 g; al estudio histológico se observa lesión tumoral mesenquimal maligna, rodeado por estroma nodular mixoide prominente. Se diagnostica liposarcoma mixoide de cordón espermático. (Figura 2). Conclusiones Son neoplasias raras mal diagnosticadas como hernia inguinal, escrotal o lipoma de la médula espermática. Tiene un alto riesgo de metástasis, siendo la orquiectomía inguinal con resección del cordón espermático el manejo quirúrgico ideal.


Introduction Liposarcomas are lesions originated in the mesodermal tissue, paratesticular location is very rare. It is divided into 4 histological subtypes, being the most uncommon the myxoid. It has a recurrence of 70%, so the treatment should be aggressive. Objective to emphasize the large size and the differential diagnosis of inguinoescrotal mass. Case Presentation 87-year-old male patient with right inguinoescrotal pain with diagnosis of unilateral inguinal hernia, right inguinal orchiectomy is performed. A surgical specimen of 2440 g is received in pathology. Histological study shows malignant mesenchymal tumor lesion, surrounded by prominent myxoid nodular stroma. Myxoid liposarcoma of the spermatic cord is diagnosed. (Fig. 2). Conclusions they are rare neoplasms and are poorly diagnosed as inguinal hernia, scrotal or lipoma of the spermal cord. It has a high risk of metastasis, the ideal surgical management is an inguinal orchiectomy with resection of the spermatic cord.


Subject(s)
Humans , Male , Aged, 80 and over , Spermatic Cord , Liposarcoma, Myxoid , Liposarcoma , Therapeutics , Orchiectomy , Ficus , Diagnosis, Differential , Neoplasm Metastasis
8.
Korean Journal of Urological Oncology ; : 86-88, 2018.
Article in English | WPRIM | ID: wpr-741471

ABSTRACT

Myxoid liposarcoma arose from the spermatic cord is very rare. Also, it is difficult to diagnose by clinical findings or radiologic study. Even if it was a malignant tumor, scrotal malignancy is often misdiagnosed in many cases. A 55-year-old man presented with a mass in the left scrotum. Tumor markers showed all normal range. A scrotal magnetic resonance imaging scan revealed a vascular tumor such as a hemangioma. But, we performed radical orchiectomy. The mass was diagnosed as paratesticular myxoid liposarcoma. It is important to keep in mind the differential diagnosis of paratesticular liposarcoma in the case of a painless scrotal tumor.


Subject(s)
Humans , Middle Aged , Biomarkers, Tumor , Diagnosis, Differential , Hemangioma , Liposarcoma , Liposarcoma, Myxoid , Magnetic Resonance Imaging , Orchiectomy , Reference Values , Scrotum , Spermatic Cord
9.
Nuclear Medicine and Molecular Imaging ; : 357-359, 2017.
Article in English | WPRIM | ID: wpr-786947

ABSTRACT

A 77-year-old male underwent open repair for a right indirect inguinal hernia and complained of right scrotal pain on the third postoperative day. Color Doppler imaging revealed decreased blood flow with heterogeneous hypoechogenicity in the right testis. A Tc-99m pertechnetate testicular scan showed diffuse hyperemia and increased uptake in the right scrotum. Additional SPECT/CT revealed a photon defect in the right testicle with increased uptake in the peri-testicular area. A subsequent operation revealed a large hematoma in the right spermatic cord and consequent right testicular infarction, and right orchiectomy was performed.


Subject(s)
Aged , Humans , Male , Diagnosis , Hematoma , Hernia, Inguinal , Herniorrhaphy , Hyperemia , Infarction , Orchiectomy , Scrotum , Sodium Pertechnetate Tc 99m , Spermatic Cord , Testis
10.
National Journal of Andrology ; (12): 987-990, 2017.
Article in Chinese | WPRIM | ID: wpr-812845

ABSTRACT

Objective@#To investigate the effect of laparoscopic extraperitoneal (LSEP) high ligation of the spermatic vein in the treatment of varicocele.@*METHODS@#We retrospectively analyzed the clinical data about 80 cases of varieocele, 48 treated by LSEP and the other 32 by laparoscopic transabdominal retroperitoneal (LSTR) high ligation of the spermatic vein. We recorded the semen parameters before and at 1, 3 and 6 months after surgery, intraoperative blood loss, operation time, postoperative complications, time of gastrointestinal function recovery and rate of pregnancy, followed by comparison of the data obtained between the two groups of patients.@*RESULTS@#Semen parameters were remarkably improved in both the LSEP and LSTR groups of patients postoperatively as compared with the baseline (P 0.05). The intraoperative blood loss was less in the LSEP than in the LSTR group ([8.3 ± 5.2] vs [9.1 ± 6.1] ml, P >0.05), the operation time was shorter in the former than in the latter ([38.27 ± 9.23] vs [43.46 ± 11.72] min, P >0.05), and so was the time of gastrointestinal function recovery ([1.27 ± 0.26] vs [2.43 ± 0.41] d, P 0.05).@*CONCLUSIONS@#Laparoscopic extraperitoneal high ligation of the spermatic vein is safe and effective and has the advantage of quick recovery in the treatment of varicocele.


Subject(s)
Female , Humans , Male , Pregnancy , Blood Loss, Surgical , Emphysema , Laparoscopy , Ligation , Methods , Operative Time , Postoperative Complications , Recurrence , Retroperitoneal Space , Retrospective Studies , Scrotum , Spermatic Cord , Treatment Outcome , Varicocele , General Surgery , Veins , General Surgery
11.
National Journal of Andrology ; (12): 1080-1084, 2017.
Article in Chinese | WPRIM | ID: wpr-812831

ABSTRACT

Objective@#To explore the effect of spermatic vein ligation under the microscope in the treatment of varicocele (VC).@*METHODS@#A total of 120 VC patients received in our department from September 2011 to February 2015 were randomly divided into an experimental and a control group of equal number, the former treated by microscopic spermatic vein ligation and the latter by conventional open high ligation. Comparisons were made between the two groups of patients in the internal diameters of the spermatic vein during eupnea and Valsalva maneuver, the reflux time of the spermatic vein, blood flow parameters of the testicular artery, and semen quality before and at 3 months after surgery.@*RESULTS@#At 3 months after surgery, the experimental group, as compared with the control, showed significantly decreased reflux time of the spermatic vein ([0.41 ± 0.10] vs [1.08 ± 0.10] s, P <0.05) and peak systolic velocity (9.26 ± 1.35 vs 10.64 ± 1.28, P <0.05) and resistance index (0.52 ± 0.03 vs 0.61 ± 0.03, P <0.05) of the testicular artery but markedly increased internal diameters of the spermatic vein during eupnea ([1.63 ± 0.07] vs [1.59 ± 0.06] mm, P <0.05) and Valsalva maneuver ([1.72 ± 0.05] vs [1.68 ± 0.07] mm, P <0.05), sperm concentration ([46.84 ± 5.24] vs [35.35 ± 4.26] ×10⁶/ml, P <0.05), sperm motility ([63.75 ± 7.73] vs [53.87 ± 6.46] %, P <0.05), and total sperm count ([89.54 ± 7.95] vs [75.24 ± 8.43] ×10⁶/ml, P <0.05).@*CONCLUSIONS@#Microscopic spermatic vein ligation has a definite effect in the treatment of varicocele, which can significantly improve the testicular blood flow and semen quality of the patient.


Subject(s)
Humans , Male , Ligation , Methods , Perineum , Semen Analysis , Sperm Count , Sperm Motility , Spermatic Cord , Spermatozoa , Testis , Varicocele , General Surgery , Veins , General Surgery
12.
Acta cir. bras ; 31(7): 479-485, tab, graf
Article in English | LILACS | ID: lil-787267

ABSTRACT

ABSTRACT PURPOSE: To compare the measurement of the testicular volume of Wistar rats using a caliper and ultrasonography. METHODS: Forty Wistar rats were randomly assigned into four groups. A tensile force of 1.6 Newton (N) and 1.0 N was applied to the right spermatic cord in group I and group II, respectively. Group III was the sham group, and group IV served as a control. The initial and final testicular volumes were measured using a caliper and ultrasonography and compared. A significance level of 5% was used. RESULTS: The Kappa coefficient was equal to 0.292 (p = 0.006). The Pearson correlation coefficient obtained for the percent reduction in the right testicular volume using ultrasonography and a caliper was equal to 0.696 (p < 0.001). CONCLUSION: There was reasonable agreement and a significant positive correlation between the percent reduction in the right testicular volume using ultrasonography and a caliper.


Subject(s)
Animals , Male , Testis/anatomy & histology , Ultrasonography/methods , Organ Size , Spermatic Cord , Testis/surgery , Testis/diagnostic imaging , Traction/methods , Random Allocation , Rats, Wistar , Models, Animal
13.
National Journal of Andrology ; (12): 406-410, 2016.
Article in Chinese | WPRIM | ID: wpr-262338

ABSTRACT

<p><b>OBJECTIVE</b>To study the numbers and locations of spermatic veins, testicular arteries, and lymphatic vessels in the spermatic cord of the varicocele patient under the laparoscope.</p><p><b>METHODS</b>Fifty-seven varicocele patients received laparoscopic ligation of spermatic veins, during which we recorded the numbers and observed the locations of spermatic veins, testicular arteries, and spermatic lymphatic vessels.</p><p><b>RESULTS</b>During the surgery, we identified 3.3 ± 1.2 spermatic veins, 1.4 ± 0.9 testicular arteries, and 4.3 ± 1.1 spermatic lymphatic vessels. No statistically significant differences were observed between the two side in the numbers of the spermatic veins, testicular arteries and spermatic lymphatic vessels (P > 0.05). The testicular arteries were seen on the exterior of the spermatic veins and winding around them, while the spermatic lymphatic vessels mostly between the veins.</p><p><b>CONCLUSION</b>The spermatic veins, testicular arteries, and lymphatic vessels in the spermatic cord of the varicocele patient have their specific anatomic characteristics. Laparoscopic identification of these vessels may contribute to the surgical treatment of varicocele.</p>


Subject(s)
Humans , Male , Arteries , Laparoscopy , Ligation , Spermatic Cord , Testis , Varicocele , Pathology , Veins
14.
National Journal of Andrology ; (12): 195-199, 2016.
Article in Chinese | WPRIM | ID: wpr-304729

ABSTRACT

Chronic orchialgia (CO) is a common complaint in urology or andrology. Due to its complicated pathogenesis, the diagnosis and treatment of CO are quite challenging. Based on different etiologies, CO can be idiopathic or secondary. Idiopathic CO accounts for approximately 50% of the cases and is probably associated with Wallerian degeneration in the spermatic cord nerves and peripheral sensitization. Secondary CO can be attributed to direct causes and its treatment focuses on the pathologic condition identified. The main methods for the treatment of CO include conservative and surgical strategies, among which microsurgical spermatic cord denervation ( MSCD) is an effective and minimally invasive option, while orchiectomy is but the last alternative when no other means is left.


Subject(s)
Humans , Male , Denervation , Methods , Microsurgery , Orchiectomy , Pain , Diagnosis , Pain Management , Methods , Spermatic Cord , Testicular Diseases , Diagnosis , Therapeutics
15.
National Journal of Andrology ; (12): 645-648, 2016.
Article in Chinese | WPRIM | ID: wpr-304696

ABSTRACT

<p><b>Objective</b>To investigate the clinical effect of Jujing No.2 Decoction on male infertility induced by varicocele.</p><p><b>METHODS</b>We equally randomized 70 male patients with varicocele-induced infertility into a treatment group and a control group, the former treated with modified Jujing No.2 Decoction (1 dose a day, bid) and the latter given Danshen Tablets (4 tablets once, tid) plus Liu Wei Di Huang Wan (8 pills once, tid), both for 3 months. We examined the spermatic veins of the patients by ultrasonography and performed seminal analysis before and after medication.</p><p><b>RESULTS</b>Compared with the controls, the patients in the treatment group showed significant improvement after medication in sperm concentration ([12.35±2.12] vs [18.56±4.16] ×10⁶/ml, P<0.05), progressively motile sperm ([16.18±6.34] vs [24.63±8.51] %, P<0.05), and morphologically normal sperm ([11.59±5.31] vs [14.17±6.02] %, P<0.05). In the control group, sperm concentration was increased from (12.29±2.07) ×10⁶/ml at the baseline to (13.13±3.13) ×10⁶/ml after medication, progressively motile sperm from (16.13±6.45) % to (20.55±7.30) % (P<0.05), and morphologically normal sperm from (11.62±5.35) % to (12.69±5.77) %. The total effectiveness rate was significantly higher in the treatment than in the control group (71.88% vs 46.67%, P<0.05). The inner diameter of the left spermatic vein was decreased from (0.32±0.05) mm at the baseline to [0.26±0.05] mm after medication in the treatment group (P<0.05) and from (0.32±0.03) mm to (0.29±0.04) mm in the control (P<0.05), with statistically significant difference between the two groups after medication (P<0.05).</p><p><b>CONCLUSIONS</b>Jujing No.2 Decoction is effective in the treatment of varicocele-induced male infertility.</p>


Subject(s)
Humans , Male , Drugs, Chinese Herbal , Therapeutic Uses , Infertility, Male , Drug Therapy , Sperm Count , Sperm Motility , Spermatic Cord , Diagnostic Imaging , Varicocele , Drug Therapy , Veins , Diagnostic Imaging
17.
Annals of Coloproctology ; : 202-204, 2015.
Article in English | WPRIM | ID: wpr-226777

ABSTRACT

Metastatic tumors of the spermatic cord are extremely rare, and the prognosis for patients is typically poor. In the majority of cases, the primary tumor occurs in the gastrointestinal tract. We report a case of a 62-year-old man with a metastatic spermatic cord tumor. The patient complained of groin discomfort with a tender mass in the right inguinal area. An excisional biopsy was performed, and the pathologic finding was a metastatic mucinous adenocarcinoma. We performed a systemic evaluation including colonoscopy, abdominal computed tomography, and total-body positron emission tomography, and the primary tumor was confirmed to involve the total colon, including the cecum, sigmoid colon, and rectum. The pathologic finding for rectum revealed a mucinous adenocarcinoma compatible with a metastatic spermatic cord tumor.


Subject(s)
Humans , Middle Aged , Adenocarcinoma, Mucinous , Biopsy , Cecum , Colon , Colon, Sigmoid , Colonoscopy , Colorectal Neoplasms , Gastrointestinal Tract , Groin , Neoplasm Metastasis , Positron-Emission Tomography , Prognosis , Rectum , Spermatic Cord
19.
Rev. cuba. med. mil ; 43(4): 481-498, oct.-dic. 2014. Ilus
Article in Spanish | LILACS, CUMED | ID: lil-735366

ABSTRACT

Entre los tumores paratesticulares, los del cordón espermático y las túnicas escrotales son los más frecuentes y en su mayoría benignos. En este trabajo se realizó la actualización del tema; se hizo énfasis en aspectos del diagnóstico y tratamiento. Se efectuó una búsqueda bibliográfica en libros de consulta, así como en las bases de datos de Hinari, PubMed/MEDLINE, LILACS y en el motor de búsquedas de Google, entre el 2009 y el 2013. Se utilizaron los términos del MeSH, en idiomas español e inglés: tumores paratesticulares, tumores intraescrotales, tumores del cordón espermático y tumores de las túnicas escrotales. Clínicamente, es básico realizar el diagnóstico diferencial con la hernia inguinal y con el hidrocele. El ultrasonido es el estudio de imagen de elección para su valoración inicial, aunque por su inespecificidad se recurre a la tomografía axial computarizada y a la resonancia magnética nuclear, para obtener más detalles. Para establecer el diagnóstico de certeza, se recomienda la biopsia por congelación transoperatoria, vía inguinotomía. La citología aspirativa con aguja fina, es una opción confiable para clasificarlos si existe sospecha preoperatoria de benignidad, es posible la tumorectomía en los benignos y se evita la orquiectomía radical con ligadura alta del cordón espermático, indicada para los malignos. Una vez confirmado el diagnóstico histológico y el estadio, el manejo debe ser onco-urológico para decidir la conveniencia de tratamientos adyuvantes. Los tumores malignos recurren con mucha frecuencia y a veces tardíamente, lo que obliga al seguimiento estricto y prolongado de estos pacientes.


Among the paratesticular tumors, the spermatic cord and the scrotal tunica tumors are the most frequent and benign. This paper updated this topic, making emphasis in diagnosis and treatment issues. A literature search was made in books and in Hinari, PubMed/MEDLINE, LILACS databases and in Goggle in the period of 2009 through 2013. The MeSH terms in English and Spanish were used: paratesticular tumors, intrascrotal tumors, spermatic cord tumors and scrotal tunica tumors. From the clinical viewpoint, it is fundamental to make the differential diagnosis with the inguinal hernia and hydrocele. The US testing is the imaging study of choice for initial assessment, although its lack of specificity makes specialists to resort to computer axial tomography and nuclear magnetic resonance to have more details of the case. For the purpose of reaching a precise diagnosis, the transoperative freezing biopsy through inguinotomy was recommended. The fine needle aspiration cytology is a reliable option to classify them if the case is suspected of benignancy preoperatively. It is possible to perform tumorectomy in the benign tumors, thus avoiding radical orchiectomy with upper ligature of the spermatic cord, which is the indicated approach to the malignant ones. Once the histological diagnosis and the staging are confirmed, the management should be oncological and urological in order to decide whether the adjuvant treatments are convenient or not. The malignant tumors recurred very frequently and sometimes in later phases, so these patients must be strictly followed-up for a long time.


Subject(s)
Humans , Scrotum/injuries , Spermatic Cord/injuries , Diagnostic Imaging , Review Literature as Topic , Biopsy, Fine-Needle/methods , Genital Diseases, Male
20.
Acta cir. bras ; 29(8): 499-507, 08/2014. tab, graf
Article in English | LILACS | ID: lil-719185

ABSTRACT

PURPOSE: To determine whether tension in the spermatic cord of rats causes lesions in the testis, epididymis or vas deferens. METHODS: Forty Wistar rats were randomly allocated into four groups. A traction force of 1.6 Newton (N) in group I and 1 N in group II was applied to the right spermatic cord. Group III was the sham, and group IV served as the control. RESULTS: Testicular lesions occurred on the right side in 66.7% of the rats and on the left side in 46.1% of the rats. The testes showed a decreased number of Sertoli cells, necrosis and a decreased number of germ cells in the seminiferous tubules. Anatomopathological changes in the vas deferens were not identified. There was no decrease in the thickness of the muscle wall of the vas deferens. In the right epididymis, 71.8% of the animals showed a reduction and 5% showed an absence of intraluminal sperm. In the left epididymis, 37.5% of the rats showed a reduction. The volume and the final testicular weight of the right side in group IV was different from those in the other groups. CONCLUSIONS: Anatomopathological lesions were found in the testis and epididymis. .


Subject(s)
Animals , Male , Spermatic Cord/pathology , Traction/adverse effects , Epididymis/injuries , Epididymis/pathology , Models, Animal , Necrosis/etiology , Organ Size , Rats, Wistar , Seminiferous Tubules/pathology , Spermatic Cord/injuries , Testis/injuries , Testis/pathology , Vas Deferens/pathology
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