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1.
Asian Journal of Andrology ; (6): 208-212, 2020.
Article in English | WPRIM | ID: wpr-1009776

ABSTRACT

We retrospectively reviewed data for 286 patients with varicocele who underwent microsurgical subinguinal varicocelectomy from March 2015 to May 2017 in Shanghai General Hospital (Shanghai, China). In this surgical approach, the testis was delivered, and the gubernacular and external cremasteric veins were stripped. In addition, the spermatic cord was delivered downward with continuous double traction away from the external ring. The remaining procedure was similar to the conventional approach. We followed patients for at least 3 months and evaluated postoperative semen parameters, pain symptoms, and complications. We excluded data for 32 men due to inadequate follow-up (<3 months). Of the remaining 254 patients, 73 had oligoasthenospermia, 121 had nonobstructive azoospermia, and 60 had symptomatic varicoceles. Total progressive sperm counts increased in the oligoasthenospermic patients from a median preoperative value of 9.15 × 106 ml-1 to 25.33 × 106 ml-1 (n= 34), and 35.6% (26/73) initially oligoasthenospermic men contributed to unassisted pregnancies. Sperm returned to the ejaculate in 12.4% (15/121) azoospermia patients. In patients with scrotal pain (n = 60), 43 (71.7%) reported complete resolution of pain, 16 (26.7%) reported partial resolution, and 1 (1.7%) reported no change. No patients experienced varicocele recurrence. This double-traction strategy avoids opening the external oblique aponeurosis, and results in less damage and faster recovery. In addition, the stripping strategy eliminates potential damage to the testis caused by the varicose veins. Our results showed that microsurgical subinguinal varicocelectomy using spermatic cord double traction in conjunction with testicular delivery for vein stripping is a safe and effective approach for varicocele repair.


Subject(s)
Adolescent , Adult , Humans , Male , Middle Aged , Young Adult , Microsurgery , Retrospective Studies , Spermatic Cord/surgery , Testis/blood supply , Treatment Outcome , Urogenital Surgical Procedures/methods , Varicocele/surgery , Veins/surgery
2.
Acta cir. bras ; 35(2): e202000203, 2020. graf
Article in English | LILACS | ID: biblio-1100882

ABSTRACT

Abstract Purpose To evaluate the effect of remote ischemic conditioning associated to N-acetylcysteine (NAC) on testicular ischemia∕reperfusion (I∕R) injury in rats. Methods Twenty-five adult male Wistar rats were randomly distributed into five experimental groups (n=5), as follows: Sham, I∕R, Perconditioning (PER), NAC and PER+NAC. Two-hour ischemia was induced by rotating the left testis 720° to clockwise direction, followed by 4 hours of reperfusion. Perconditioning was performed by three I/R cycles of 10 min each on the left limb, 30 min before reperfusion. N-acetylcysteine (150 mg∕kg) was administered 30 min before reperfusion. Results Statistical differences were observed in MDA levels between I/R group with all groups (p<0.01), in addition there was statistical difference between PER and Sham, and PER+ NAC groups (p<0.05) in plasma. Conclusions The protective effect of perconditioning isolated in the reduction of lipid peroxidation related to oxidative stress was demonstrated. However, when Perconditioning was associated with NAC, there was no protective effect against testicular injury of ischemia and reperfusion.


Subject(s)
Animals , Male , Rats , Acetylcysteine/pharmacology , Testis/blood supply , Reperfusion Injury , Free Radical Scavengers/pharmacology , Oxidative Stress/drug effects , Ischemic Preconditioning/methods , Testis/drug effects , Random Allocation , Rats, Wistar , Drug Evaluation, Preclinical , Oxygen Radical Absorbance Capacity
3.
Acta cir. bras ; 35(1): e202000103, 2020. tab, graf
Article in English | LILACS | ID: biblio-1088520

ABSTRACT

Abstract Purpose To investigate the protective effect of Ganoderma lucidum on testicular torsion/detorsion (T/D)-induced ischemia-reperfusion (I/R) injury. Methods Thirty male Wistar albino rats were randomly categorized into 3 groups: Group 1: sham, Group 2 ( T/D): 2,5 hours of ischemia and 7 days of reperfusion, Group 3 (T/D+ G. lucidum ): 2,5 hours of ischemia and 7 days of reperfusion and 7 days of 20 mg/kg via gastric gavage G. lucidum polysaccharides per day. Biochemical assays of Malondialdehyde (MDA), superoxide dismutase (SOD), Catalase (CAT), Glutathione (GSH) levels , histopathology and expression levels of VEGF and Bcl-2 with immunohistochemical methods were examined in testicular tissue. Results G. lucidum treatment was found to have prevented the T/D-induced I/R injury by decreasing MDA levels of the testis. SOD, CAT and GSH activities were decreased in group 2, while they were increased in group 3 (p<0.001) and significant improvement in the tube diameter was observed in group 3. Bcl-2-positive germinal cells were lowered in group 3 compared to the group 2. VEGF expression showed an increase in group 2, whereas it decreased in group 3. Conclusion The antioxidant G. lucidum is thought to induce angiogenesis by reducing the apoptotic effect in testicular torsion-detorsion.


Subject(s)
Animals , Male , Rats , Spermatic Cord Torsion/complications , Testis/blood supply , Reperfusion Injury/prevention & control , Reishi/chemistry , Antioxidants/therapeutic use , Spermatic Cord Torsion/metabolism , Superoxide Dismutase/metabolism , Testis/drug effects , Testis/pathology , Reperfusion Injury/etiology , Catalase/metabolism , Random Allocation , Rats, Wistar , Vascular Endothelial Growth Factor A/metabolism , Drug Evaluation, Preclinical , Malondialdehyde/metabolism , Antioxidants/pharmacology
4.
Acta cir. bras ; 34(11): e201901102, Nov. 2019. tab, graf
Article in English | LILACS | ID: biblio-1054682

ABSTRACT

Abstract Purpose: To investigate the effect of Picroside II on testicular ischemia and reperfusion (l/R) injury and the underlying mechanism. Methods: Sprague-Dawley rats were randomly divided into 4 groups: sham operated group (Sham), Sham with Picroside II treatment group (Sham+ Pic II), l/R group (l/R) and l/R with Picroside II treatment group (I/R+ Pic II). l/R model was established by rotating the left testis 720° in a clock-wise direction for 4 hours. The histopathologic and spermatogenetic evaluation was performed. The apoptosis changes and the levels of HO-1 (heme oxygenase-1), MPO (myeloperoxidase), NOX (NADPH oxidase), SOD (superoxide dismutase), XO (xanthine oxidase) and NOS (nitric oxide synthase) were measured. Results: The seminiferous tubules were damaged in l/R rats, but Picroside II alleviated the changes induced by l/R. The increased level of apoptosis was decreased by Picroside II (P=0.01, 9.05±0.35 vs. 4.85±0.25). The activities of HO-1, MPO, NOX, XO and MDA content were increased and the SOD activity was decreased in l/R (P<0.05) and could be reversed by Picroside II (P=0.03, 405.5±7.5 vs. 304±17U/mgprot; P=0.02, 0.99±0.05 vs. 0.52±0.04 mgprot; P=0.01, 260+7 vs. 189±2 mgprot; P=0.04, 10.95+0.55 vs. 8.75+0.35 U/mgprot; P=0.045, 6.8+0.7 vs. 3.75+0.35 mgprot; P=0.04, 44.5+3.5 vs. 57.5+3.5 mgprot). Western blot showed that the expression of iNOS, nNOS and eNOS were increased in l/R (P<0.05); however, they were decreased after Picroside II treatment (P<0.05). Conclusion: Picroside II attenuated testicular I/R injury in rats mainly through suppressing apoptosis and oxidative stress through reduction of nitric oxide synthesis.


Subject(s)
Animals , Male , Testis/blood supply , Reperfusion Injury/prevention & control , Cinnamates/pharmacology , Apoptosis/drug effects , Oxidative Stress/drug effects , Iridoid Glucosides/pharmacology , Nitric Oxide/biosynthesis , Reperfusion Injury/metabolism , Reperfusion Injury/pathology , Random Allocation , Blotting, Western , Rats, Sprague-Dawley , Peroxidase/analysis , In Situ Nick-End Labeling , Heme Oxygenase-1/analysis , Malondialdehyde/analysis , NADP/analysis
5.
Int. j. morphol ; 37(2): 682-684, June 2019. graf
Article in English | LILACS | ID: biblio-1002276

ABSTRACT

Complete duplication of testicular veins is a rare phenomenon. However, a few cases of duplication of gonadal veins have been reported. Here, I report a case of unusual formation and termination of the right testicular vein in an adult male cadaver. Five veins arose from the pampinniform plexus and entered the abdomen through the deep inguinal ring. The most medial among the five was large (3 mm in diameter) and it continued as a testicular vein and opened into the right edge of the inferior vena cava, 1 cm above the union of the common iliac veins. The other four veins were about 1 mm in diameter and they united to form two veins in front of the lower part of the right psoas and iliacus muscles (about 2 cm above the deep inguinal ring) and the two veins united to form upper testicular vein, 4 cm above the deep inguinal ring. This testicular vein was 3 mm in diameter and it opened into the inferior vena cava, 4 cm above the union of common iliac veins. Having five veins at deep inguinal ring might increase the chances of varicocele and decrease the chances of indirect inguinal hernia.


La duplicación completa de las venas testiculares es un fenómeno raro. Sin embargo, se han reportado algunos casos de duplicación de venas gonadales. En el presente trabajo se informa un caso de formación y terminación inusual de la vena testicular derecha en un cadáver de un hombre adulto. Cinco venas surgieron del plexo pampiniforme y penetraron en el abdomen a través del anillo inguinal profundo. El más medial entre los cinco fue de gran tamaño (3 mm de diámetro) y continuó como una vena testicular y se abrió hacia el margen derecho de la vena cava inferior, 1 cm por encima de la unión de las venas ilíacas comunes. Las cuatro venas restantes eran de 1 mm de diámetro aproximadamente, y se unieron para formar dos venas frente a la parte inferior de los músculos psoas e ilíaco derechos (aproximadamente 2 cm por encima del anillo inguinal profundo). Se unieron dos venas para formar la vena testicular superior, la cual medía 3 mm de diámetro y se abría hacia la vena cava inferior, 4 cm por encima de la unión de las venas ilíacas comunes. Cinco venas en el anillo inguinal profundo podrían aumentar las posibilidades de varicocele y disminuir las posibilidades de una hernia inguinal indirecta.


Subject(s)
Humans , Male , Middle Aged , Veins/abnormalities , Inguinal Canal/blood supply , Testis/blood supply , Varicocele/etiology , Vena Cava, Inferior/abnormalities , Gonads/blood supply , Hernia, Inguinal/etiology
6.
Bol. méd. Hosp. Infant. Méx ; 75(6): 373-376, nov.-dic. 2018. graf
Article in Spanish | LILACS | ID: biblio-1011485

ABSTRACT

Resumen: Introducción: El aneurisma de la arteria testicular es poco frecuente; el término se describe como la dilatación de cualquier vaso sanguíneo en el cuerpo. Caso clínico: Se presenta el caso de un paciente de 15 años con un aneurisma de la arteria testicular izquierda sin ningún antecedente de importancia familiar ni personal, quien se presentó a consulta por aumento de volumen en la región inguinal de larga evolución, acompañado de dolor esporádico y sin más síntomas. Se diagnosticó hernia inguinal y se procedió a cirugía. El diagnóstico se realizó de manera posoperatoria por medio de estudio histopatológico. En este caso, se destaca la presentación de un aneurisma verdadero de la arteria testicular y el resultado después del tratamiento quirúrgico definitivo. Conclusiones: La etiología del aneurisma y del pseudoaneurisma reportada en la literatura se describe posterior a un traumatismo testicular, y en pocos casos de origen congénito. Las manifestaciones clínicas pueden ser dolor y una masa inguinal, y muchas de las veces pueden confundirse con hernias inguinales o ser una patología agregada, por lo que el abordaje de los pacientes con patología inguinal o testicular debe ser protocolizado e incluir el aneurisma dentro de los diagnósticos diferenciales.


Abstract: Background: Aneurysm of the testicular artery is a rare entity; the term is described as the dilation of any blood vessel in the body. Case report: An 18-year-old patient with a left testicular artery aneurysm, with no family or personal history of medical importance, presented for consultation due to a volume increase of long evolution in the inguinal region, accompanied by sporadic pain with no other symptoms. The testicular artery aneurysm was not detectable preoperatively by ultrasound, which only reported data compatible with left inguinal hernia and varicocele. The diagnosis was made postoperatively by a histopathological study. This case highlights the presentation of a true aneurysm of the testicular artery and the result after definitive surgical treatment. Conclusions: The etiology of the aneurysm and pseudoaneurysm reported in the literature is described after a testicular trauma and, a few cases of congenital origin. The clinical manifestations are pain and an inguinal mass, which can be frequently confused with inguinal hernias or an aggregated pathology. Therefore, the approach of patients with inguinal or testicular pathology should be protocolized and include aneurysm within the differential diagnoses.


Subject(s)
Adolescent , Humans , Male , Testis/blood supply , Hernia, Inguinal/surgery , Aneurysm/surgery , Arteries , Hernia, Inguinal/diagnosis , Aneurysm/diagnosis
7.
Int. braz. j. urol ; 44(3): 617-622, May-June 2018. graf
Article in English | LILACS | ID: biblio-954058

ABSTRACT

ABSTRACT Objective: To investigate the effect of papaverine and alprostadil on testicular torsion-detorsion injury in rats. Materials and Methods: A total of 40 male Wistar-Albino rats were used in this study. Four hours of right testicular torsion was applied to each group, excluding sham oper- ated group. The torsion-detorsion (T/D), T/D + papaverine and T/D + alprostadil groups received saline, papaverine and alprostadil at the same time as surgical detorsion, respectively. At 14 days after the surgical detorsion, ischaemic changes and the degree of damage were evaluated with Cosentino scoring and the Johnson tubular biopsy score (JTBS). Results: JTBS was determined as 8.8±2.7 in the Sham group, 5.08±1.9 in the T/D+papaverine group, 5.29±2.3 in the T/D +alprostadil group and 2.86±1.9 in the TD group. The JTBS was determined to be statistically significantly high in both the T/D + papaverine group and the T/D + alprostadil group compared to the T/D group (p=0.01, p=0.009). In the T/D + papaverine group, 3 (43%) testes were classified as Cosentino 2, 3 (43%) as Cosentino 3 and 1 (14%) as Cosentino 4. In the T/D +alprostadil group, 5 (50 %) testes were classified as Cosentino 2, 3 (30 %) as Cosentino 3 and 2 (20%) as Cosentino 4. Conclusion: The present study indicated that spermatic cord administration of alprostadil and papaverine showed a protective effect against ischemia/reperfusion injury after right-side testes torsion and histological changes were decreased after testicular ischemia reperfusion injury.


Subject(s)
Animals , Male , Papaverine/therapeutic use , Spermatic Cord Torsion/prevention & control , Testis/blood supply , Vasodilator Agents/pharmacology , Alprostadil/pharmacology , Ischemia/prevention & control , Papaverine/pharmacology , Spermatic Cord Torsion/pathology , Testis/pathology , Vasodilator Agents/therapeutic use , Biopsy , Severity of Illness Index , Alprostadil/therapeutic use , Reperfusion Injury/prevention & control , Random Allocation , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Protective Agents/therapeutic use , Protective Agents/pharmacology
8.
Acta cir. bras ; 33(3): 268-281, Mar. 2018. tab, graf
Article in English | LILACS | ID: biblio-886268

ABSTRACT

Abstract Purpose: To evaluate the behavior of arterial circulation and testicular volume in patients submitted to conventional inguinal hernia repair without the use of a synthetic prosthesis to reinforce the posterior wall. Methods: A prospective observational clinical trial was performed on 26 male patients with unilateral inguinal hernia types I and II by the Nyhus classification, who underwent surgical correction using the modified Bassini technique. Bilateral Doppler ultrasonography was performed preoperatively, at the third and at the sixth postoperative month. The studied variables were: systolic peak velocity (SPV), diastolic peak velocity (DPV), resistance index (RI), pulsatility index (PI) and testicular volume. Results: There were no statistically significant changes over time in the variables studied on the operated side: SPV (p = 0.916), DPV (p = 0.304), RI (p = 0.879), PI (p = 0.475), and testicular volume (p = 0.100). The variables on the control side also did not change statistically until the sixth postoperative month: SPV (p = 0.784), DPV (p = 0.446), RI (p = 0.672), PI (p = 0.607), and testicular volume (p = 0.413). Conclusion: Surgical correction of the inguinal hernia without the use of a prosthesis does not cause alterations in vascularization and testicular volume in the first six months postoperatively.


Subject(s)
Humans , Male , Adolescent , Adult , Young Adult , Testis/anatomy & histology , Hernia, Inguinal/surgery , Testis/blood supply , Testis/diagnostic imaging , Prospective Studies , Ultrasonography , Treatment Outcome , Hernia, Inguinal/diagnostic imaging
9.
Acta cir. bras ; 33(2): 125-133, Feb. 2018. tab, graf
Article in English | LILACS | ID: biblio-886259

ABSTRACT

Abstract Purpose: To investigate the biochemical, histopathologic, and spermatogenetic changes in the detorsionated testicle after experimental torsion and to study the antioxidant effects of pheniramine maleate and nebivolol. Methods: Twenty-four Sprague-Dawley male rats were divided into 4 groups: Group 1: Sham; Group 2: Torsion/Detorsion (T/D); Group 3: T/D + Pheniramine maleate (PM); Group 4: T/D + Nebivolol (NB) group. Paroxanase (PON), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stres index (OSI) were measured, and spermatogenetic and histopathologic evaluation was performed in tissue and blood samples. Results: The evaluation of tissue TAS indicated no statistically significant difference in Group 3 compared to Group 2. A statistically significant increase was detected in Group 4 compared to Group 2. Serum PON levels revealed a statistically significant increase in Groups 3 and 4 compared to Groups 1 and 2. The Johnsen testicular biopsy score decreased in Groups 3 and 4, but the decrease was not statistically significant. Conclusions: Pheniramine maleate and nebivolol have antioxidant effects against ischemia-reperfusion damage. They also support tissue recovery, which is more significantly observed by nebivolol.


Subject(s)
Animals , Male , Rats , Pheniramine/pharmacology , Spermatic Cord Torsion/drug therapy , Testis/drug effects , Oxidative Stress/drug effects , Nebivolol/pharmacology , Antioxidants/pharmacology , Spermatic Cord Torsion/pathology , Spermatogenesis/drug effects , Testis/blood supply , Testis/pathology , Time Factors , Reperfusion Injury/drug therapy , Rats, Sprague-Dawley , Adrenergic beta-Antagonists/pharmacology , Aryldialkylphosphatase/blood , Histamine H1 Antagonists/pharmacology
10.
Int. braz. j. urol ; 43(6): 1160-1166, Nov.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-892919

ABSTRACT

ABSTRACT Objective: Testicular torsion (TT) refers to rotation of the testis and twisting of the spermatic cord. TT results in ischemia-reperfusion (I/R) injury involving increased oxidative stress, inflammation and apoptosis, and can even lead to infertility. The aim of this study was to investigate the effect of ozone therapy on testicular damage due to I/R injury in an experimental torsion model. Materials and Methods: 24 male Sprague-Dawley rats were divided into 3 groups; shamoperated, torsion/detorsion (T/D), and T/D+ozone. Ozone (1mg/kg) was injected intraperitoneally 120 minutes before detorsion and for the following 24h. Blood and tissue samples were collected at the end of 24h. Johnsen score, ischemia modified albumin (IMA), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) levels were determined. Results: Levels of IMA, TOS, OSI, and histopathological scores increased in the serum/tissue of the rats in the experimental T/D group. Serum IMA, TOS, and OSI levels and tissue histopathological scores were lower in the rats treated with ozone compared with the T/D group. Conclusion: Our study results suggest that ozone therapy may exhibit beneficial effects on both biochemical and histopathological findings. Clinical trials are now necessary to confirm this.


Subject(s)
Animals , Male , Rats , Ozone/therapeutic use , Spermatic Cord Torsion/drug therapy , Reperfusion Injury/prevention & control , Oxidative Stress/drug effects , Testis/blood supply , Rats, Sprague-Dawley , Disease Models, Animal
11.
Acta cir. bras ; 32(9): 755-766, Sept. 2017. tab, graf
Article in English | LILACS | ID: biblio-886239

ABSTRACT

Abstract Purpose: To determine the effect of folic acid (FA) on experimental testicular ischemia/reperfusion (I/R) in rats. Methods: Sixty male Wistar rats were randomly divided into 6 groups. The control group received physiologic saline orally. The sham-operated group received physiologic saline orally then exposed to midline laparotomy without clamping the IR. The I/R rats received oral gavage of the saline then subjected to 1h ischemia /24h reperfusion, period. In folic acid (2mg/kg+IR) rats received oral gavage of the FA (2mg/kg) then subjected to 1h I/24h R. groups 5-6 received FA (5 and 10 mg/kg), then subjected to 1 h I/24 h, respectively. At the end of the study, semen samples were collected for spermatozoa characteristics. The left testis was removed for histological analysis and superoxide dismutase (SOD), malondialdehyde (MDA) and glutathione peroxidase (GPx) measurement. Results: Spermatozoa mobility, mortality (%) significantly decreased in I/R group (P<0.05). Dose dependent increase observed on spermatozoa mobility, mortality (%) using different levels of the FA (2, 5 and 10 mg/kg) treated rat (P<0.05). Tissue MDA levels significantly increased in I/R rat (P<0.05) while FA (2, 5 and 10mg/kg) in a dose dependent manner decreased I/R-induced MDA (P<0.05). Experimental I/R significantly decreased SOD and GPx activity (P<0.05). Administration of the FA (2, 5 and 10mg/kg) significantly increased tissue SOD and GPx activity in I/R rat (P<0.05). Seminiferous tubules degenerated and loss of spermatogenesis with few spermatocytes was observed in degenerated testis tubules in I/R rat. Orally administration of the FA (5 and 10 mg/kg) improved testis characteristics with few normal seminiferous tubules and spermatocyte in seminiferous tubules in experimental I/R-induced rat. Conclusion: The treatment of folic acid had a benefit effect against ischemia-reperfusion.


Subject(s)
Animals , Male , Rats , Testis/blood supply , Reperfusion Injury/drug therapy , Folic Acid/therapeutic use , Spermatozoa/drug effects , Spermatozoa/physiology , Random Allocation , Rats, Wistar , Disease Models, Animal
12.
J. vasc. bras ; 16(2): 174-177, abr.-jun. 2017. graf
Article in English | LILACS | ID: biblio-954672

ABSTRACT

Abstract Variations of the testicular veins are relevant in clinical cases of varicocele and in other therapeutic and diagnostic procedures. We report herein on a unique variation of the left testicular vein observed in an adult male cadaver. The left testicular vein bifurcated to give rise to left and right branches which terminated by joining the left renal vein. There was also an oblique communication between the two branches of the left testicular vein. A slender communicating vein arose from the left branch of the left testicular vein and ascended upwards in front of the left renal vein and terminated into the left suprarenal vein. The right branch of the testicular vein received an unnamed adipose tributary from the side of the abdominal aorta. Awareness of these venous anomalies can help surgeons accurately ligate abnormal venous communications and avoid iatrogenic injuries and it is important for proper surgical management.


Resumo Variações nas veias testiculares têm relevância em casos clínicos de varicocele e em outros procedimentos terapêuticos e diagnósticos. Relatamos aqui uma variação peculiar de veia testicular esquerda observada em um cadáver adulto do sexo masculino. A veia testicular esquerda bifurcava para dar origem aos ramos esquerdo e direito, os quais terminavam juntando-se à veia renal esquerda. Foi observada também comunicação oblíqua entre os dois ramos da veia testicular esquerda. Uma fina veia comunicante originava-se do ramo esquerdo da veia testicular esquerda e ascendia até a frente da veia renal esquerda, terminando na veia suprarrenal esquerda. O ramo direito da veia testicular recebia um tecido adiposo tributário não especificado da lateral da aorta abdominal. Conhecimento dessas anomalias venosas pode ajudar os cirurgiões a ligar corretamente comunicações venosas anormais e evitar danos iatrogênicos e é importante para um manejo cirúrgico apropriado.


Subject(s)
Humans , Male , Aged , Renal Veins/anatomy & histology , Testis/anatomy & histology , Testis/blood supply , Aorta, Abdominal , Renal Veins/abnormalities , Testis/abnormalities , Varicocele
13.
Int. braz. j. urol ; 42(6): 1210-1219, Nov.-Dec. 2016. tab, graf
Article in English | LILACS | ID: biblio-828923

ABSTRACT

Abstract Purpose To investigate the roles of age, testicular rotation and time in the surgical outcome of intravaginal testicular torsion (iTT). Patients and Methods We retrieved the records of all iTT patients treated in our unit from January 2012 to January 2014. Explanatory variables were: age (years); presentation delay (PrD, time between symptoms and hospitalization); surgical delay (SurgD, time between hospitalization and surgery) and testicular rotation (rotation), with surgical outcome (orchidopexy, orchidectomy) as response variable. Differences in PrD, SurgD, age and rotation by surgical outcome were evaluated non-parametrically. Step-down logistic regression included age, PrD, SurgD and rotation as predictors. Statistical significance and confidence intervals (CI) were set at p<0.05 and 0.95. Odds ratios (OR) were computed from the model's coefficients. Results Complete variable information was available for 117 patients, and most (61, 52.1%) underwent orchidectomy. Ages were similar between orchidectomy and orchidopexy patients (median 15.8 vs. 16.0 years, p=0.78). In contrast, PrD (85.0 vs. 8.4 hours, p<0.001), SurgD (3.0 vs. 16.0 hours, p<0.001) were different between orchidectomy and orchidopexy patients. SurgD was similar with PrD<24 hours (4.0 vs. 2.8, p=0.1). Orchidectomy patients had greater rotation (3.0π vs. 2.0π radians, p<0.001). Logistic regression revealed that PrD (OR 0.94; 0.92–0.97; p<0.001) and rotation (OR 0.43; 0.27–0.70; p<0.001) were inversely associated with orchidopexy. Conclusion Testicular rotation exerts a multiplicative effect on PrD, so time should not be regarded as the sole predictor of surgical outcome in iTT.


Subject(s)
Humans , Male , Child , Adolescent , Spermatic Cord Torsion/surgery , Testis/surgery , Orchiectomy/methods , Prognosis , Testis/blood supply , Time Factors , Treatment Outcome , Statistics, Nonparametric
14.
Int. braz. j. urol ; 42(5): 1028-1032, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: lil-796899

ABSTRACT

ABSTRACT Report case (s) relevant aspects: Man, 27 years old, complaining of acute testicular pain by 2 hours in the remaining left testicle. Denies fever, lower urinary tract symptoms such as dysuria, urinary frequency, concommitant or prior urethral discharge to the painful condition. He underwent right orchiectomy 13 years ago by testicular torsion. He is a chronic user of cocaine for 15 years and during the last three days the drug use was continuous and intense. Proposed premise substantiating case (s) description: Initial diagnostic hypothesis: Syndromic: Acute Scrotum Syndrome (SEA) Main Etiologic (testicular torsion) Secondary Etiologic (acute orchiepididymitis) Briefly delineates what might it add? Lines of research That Could be Addressed: In this challenging clinical case we presented an alternative and new etiologic diangosis for the acute scrotum which the main etiologic factor remains testicular torsion. This new diangosis is acute testicular ischemia as a complication of cocaine abuse.


Subject(s)
Humans , Male , Adult , Scrotum/blood supply , Testicular Diseases/etiology , Testis/blood supply , Cocaine-Related Disorders/complications , Acute Pain/etiology , Ischemia/etiology , Scrotum/pathology , Spermatic Cord Torsion/pathology , Testicular Diseases/pathology , Testis/pathology , Vasoconstrictor Agents/poisoning , Cocaine/poisoning , Diagnosis, Differential , Ischemia/pathology
15.
Int. j. morphol ; 34(3): 950-952, Sept. 2016. ilus
Article in English | LILACS | ID: biblio-828968

ABSTRACT

Any compression of testicular arteries may lead to loss of spermatogenesis and gonadal hormone production, existence of the variational arteries is accountable in cases of vasoligation, orchidopexy and other surgical approach on them. Anomalies of the testicular blood arteries were observed during dissection of the pelvic cavity in a 68-year-old male cadaver. This report describes a very rare case of lack of testicular arteries. For the blood supply to the testis, thick deferential arteries form some vascular winding and loops and course accompanied by deferent duct to the testis. This case report would serve as ray of light for knowledge of the possible variations of the testicular arteries during surgical procedures.


Cualquier compresión de las arterias testiculares puede conducir a la pérdida de la espermatogénesis y la producción de hormonas gonadales. La existencia de variaciones en las arterias testiculares es relevante en los casos de vasectomía, orquidopexia y otros tipos de abordaje quirúrgico. Se observaron anomalías de las arterias testiculares durante la disección de la cavidad pélvica de un cadáver de sexo masculino de 68 años de edad. En este trabajo se describe un caso muy poco frecuente de ausencia de arterias testiculares. Para el suministro sanguíneo del testículo, se encontraron arterias deferentes gruesas que producen sinuosidad y tortuosidad vascular junto al conducto deferente en los testículos. Este caso podría ser útil para el conocimiento de las posibles variaciones de las arterias testiculares durante los procedimientos quirúrgicos.


Subject(s)
Humans , Male , Aged , Testis/blood supply , Umbilical Arteries/abnormalities , Anatomic Variation , Cadaver , Umbilical Arteries/anatomy & histology , Vas Deferens/blood supply
16.
Acta cir. bras ; 31(6): 411-416, tab, graf
Article in English | LILACS | ID: lil-785016

ABSTRACT

ABSTRACT PURPOSE: To investigate the protective effect of metformin on testicular ischemia/reperfusion (I/R) injury in rats. METHODS: Eighteen adult male Wistar rats were randomly divided into three experimental groups (n=6), as follows: Sham, I/R, and Metformin. 1-hour ischemia was induced by the left testicular artery and vein clipping followed by 7 days of reperfusion. Metformin (100 mg/kg) was administrated orally for 7 days via oral gavage after ischemic period. At the end of trial, the left testis was removed for histological analysis and oxidative stress measurement. RESULTS: I/R reduced superoxide dismutase (SOD) activities and testicular Johnsen's scores accompanied by an elevation in malondialdehyde (MDA) and myeloperoxidase (MPO) levels in comparison with the sham group (P < 0.05). Compared to I/R group, metformin restored testicular Johnsen's scores, SOD activity, MDA and MPO levels (P < 0.05). CONCLUSION: Metformin has a protective effect against I/R injury on the testis.


Subject(s)
Animals , Male , Testis/blood supply , Reperfusion Injury/prevention & control , Protective Agents/pharmacology , Metformin/pharmacology , Superoxide Dismutase/metabolism , Testis/metabolism , Reperfusion Injury/metabolism , Random Allocation , Rats, Wistar , Peroxidase/metabolism , Oxidative Stress/drug effects , Models, Animal , Malondialdehyde/metabolism
17.
Acta cir. bras ; 30(6): 414-421, 06/2015. tab, graf
Article in English | LILACS | ID: lil-749644

ABSTRACT

PURPOSE: To investigate the protective effect of dexmedetomidine (Dex) on testicular damage induced by ischemia-reperfusion injury in rats. METHODS: Sham group underwent left scrotal exploration only (group 1). The ischemia-reperfusion only group underwent left testicular torsion and detorsion (group 2). The ischemia-reperfusion plus Dex group underwent left testicular torsion, received 50 µg/kg Dex (group 3) and 100 µg/kg Dex (group 4) intraperitoneally at minute 180 of ischemia and then underwent detorsion. We determined histopathological findings and performed specific biochemical analyses. RESULTS: Increasing doses of Dex significantly increased TAS, and significantly decreased OSI. Analyzing the antioxidant effects of increasing doses of Dex in torsion and contrlateral testicles: Dex 100 µg/kg statistically significant increased the tissue total antioxidant status (TAS) and oxidative stress index (OSI) when compared with Dex 50 µg/kg but not found significantly change on the tissue total oxidant status (TOS). However, Dex did not significantly improve these histological alterations. CONCLUSION: The antioxidant effects of dexmedetomidine on testicular ischemia-reperfusion injury in ipsilateral and contrlateral testis, but in the histopathological level, there was no difference statistically according to Johnsen's scoring system between groups at both sides. .


Subject(s)
Animals , Male , /pharmacology , Antioxidants/pharmacology , Dexmedetomidine/pharmacology , Reperfusion Injury/prevention & control , Spermatic Cord Torsion/prevention & control , Testis/blood supply , /therapeutic use , Dexmedetomidine/therapeutic use , Immunohistochemistry , Ischemia/pathology , Ischemia/prevention & control , Oxidative Stress/drug effects , Prospective Studies , Random Allocation , Rats, Wistar , Reference Values , Reperfusion Injury/pathology , Severity of Illness Index , Spermatic Cord Torsion/pathology , Time Factors , Testis/pathology
18.
Acta cir. bras ; 29(7): 450-456, 07/2014. graf
Article in English | LILACS | ID: lil-714577

ABSTRACT

PURPOSE: To evaluate the effects of acupuncture (Ac) and electroacupuncture (EAc) on oxidative stress and inflammation in testis torsion/detorsion (T/D) model in rats. METHODS: Thirty male Wistar rats were randomized into five groups. G1 Group (Sham) served as control. The remaining groups were submitted to spermatic cord torsion (720°) for 3 hours, followed by detorsion and reperfusion for 4 hours. Before detorsion G3, G4 and G5 rats were treated with Ac, EAc 2Hz and EAc 10 Hz, respectively, applied to acupoint Gulai (S-29) bilaterally under anesthesia for 5 minutes. Next, the testes were detorsioned and reperfused for 4 hours. Afterwards, blood samples and the right testis were collected for biochemical assays: reduced Glutathione (GSH), Malonaldehyde (MDA), Myeloperoxidase (MPO). RESULTS: EAc stimulation (2 and 10 Hz) promoted significant increase in concentrations of GSH in plasma and testis of G4-G5 rats, compared with G1. There was significant increase of tissue MDA in groups G4-G5 and plasma MDA in all groups, compared with G1. There was a significant reduction in MPO activity in groups G4-G5 compared with G1. CONCLUSION: Electroacupuncture stimulation (2 and 10 Hz) attenuates oxidative stress and inflammatory response in rats subjected to testicular torsion/detorsion. .


Subject(s)
Animals , Male , Acupuncture Points , Electroacupuncture/methods , Oxidative Stress , Spermatic Cord Torsion/therapy , Glutathione/blood , Lipid Peroxidation , Malondialdehyde/blood , Peroxidase/blood , Random Allocation , Rats, Wistar , Reproducibility of Results , Reperfusion Injury/therapy , Spermatic Cord Torsion/metabolism , Time Factors , Treatment Outcome , Testis/blood supply , Testis/metabolism
19.
Int. braz. j. urol ; 40(1): 109-117, Jan-Feb/2014. tab, graf
Article in English | LILACS | ID: lil-704178

ABSTRACT

Objective: To analyze the oxidative damage and histopathological alterations caused by ischemia-reperfusion (I/R) injury and ameliorative effects of carvedilol (CVD) in the rat testis. Materials and Methods: Twenty-one male rats were randomized into 3 groups as follows: Group I (n = 7); control (sham) group, Group II (n = 7); I/R group, in which I/R injury was performed by torsing the left testis 720º clockwise for 2 hours and detorsing for 2 hours. Group III (n = 7); CVD treatment group; in addition to I/R process, one-dose of CVD was administered (2mg/kg, i.p) 30 min. before detorsion. Levels of antioxidant enzymes, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) and levels of malondialdehyde (MDA) and protein carbonyl (PC) were determined in testicular tissues and serum of rats. Testicular tissues were also examined histopathologically and Johnsen scores were determined. Results: Activities of SOD and GSH-Px in serum and testicular tissues were increased by I/R, but administration of CVD decreased these levels (p < 0.001 and p = 0.001). Significantly increased MDA levels in serum and testicular tissues were decreased by CVD treatment (p < 0.001 and p = 0.001). Concerning PC levels in serum and testicular tissues, there was no statistically significant difference between the groups (p = 0.989 and p = 0.428). There was not a statistically significant difference in terms of mean Johnsen scores between the groups (p = 0.161). Conclusions: Administration of CVD decreased oxidative damage biochemically in the rat testis caused by I/R injury, but histopathologically no change was observed between all of the groups. .


Subject(s)
Animals , Male , Rats , Carbazoles/pharmacology , Oxidative Stress/drug effects , Propanolamines/pharmacology , Reperfusion Injury/drug therapy , Testis/blood supply , Testis/pathology , Vasodilator Agents/pharmacology , Antioxidants/pharmacology , Carbazoles/therapeutic use , Disease Models, Animal , Glutathione Peroxidase/blood , Malondialdehyde/blood , Necrosis , Propanolamines/therapeutic use , Protein Carbonylation/drug effects , Random Allocation , Rats, Wistar , Reproducibility of Results , Spermatic Cord Torsion/complications , Spermatic Cord Torsion/drug therapy , Superoxide Dismutase/blood , Time Factors , Treatment Outcome , Vasodilator Agents/therapeutic use
20.
Int. braz. j. urol ; 40(1): 62-66, Jan-Feb/2014. tab, graf
Article in English | LILACS | ID: lil-704179

ABSTRACT

Purpose: To study the effect of high grade varicocele treatment in infertile patients. Materials and Methods: Seventy-five patients were selected by the following criteria: infertility persisting for more than 1 year; abnormal semen parameters; no other infertility-related disease; no obvious causes of infertility in the subject’s partner; basal eco-color Doppler ultrasound demonstrating continuous reflux in the spermatic vein. All patients considered for the study had at least a six months period from the diagnosis to the surgery due to waiting list, choice of the patient or time needed to complete diagnostic evaluation of the couple. The surgical procedure was performed through an inguinal approach. All enrolled patients were counseled to have unprotected intercourse during the ovulation period in order to maximize the probability of pregnancy within the 6-month preoperative period. The achievement of pregnancy and semen parameters were recorded during the preoperative and postoperative period. Results: Two of the seventy-five patients were excluded because of persistent varicocele after surgery. The preoperative pregnancy rate was 1.3% (1 couple). The postoperative pregnancy rate was 42.5%. The stratification of pregnancies by semester showed a significantly higher rate in the first postoperative period (p = 0.0012). Mean time to conception was 13.5 months. Mean preoperative sperm count was 17.6x10 6 /mL compared to 19.7x10 6 /mL in the postoperative period (p < 0.0001). Mean percentage of progressive sperm motility was 13.7%, compared to 17.6% in the postoperative period (p < 0.0001). Mean percentage of normal sperm morphology was 7.6%, compared to 15.2% postoperatively (p < 0.0001). Conclusion: Surgical treatment of high grade varicocele proved to effectively treat associated infertility by improving seminal parameters and pregnancy rate in our patient cohort. .


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Pregnancy , Young Adult , Infertility, Male/surgery , Testis/blood supply , Varicocele/surgery , Chi-Square Distribution , Ligation/methods , Postoperative Period , Pregnancy Rate , Reproducibility of Results , Sperm Count , Sperm Motility , Treatment Outcome , Veins/surgery
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