[Management of testicular lesions in a population of infertile patients]. / Prise en charge des nodules testiculaires dans une population de patients infertiles.

INTRODUCTION: Testicular parenchyma abnormalities and testis cancers are more frequent in infertile men, hence the guidelines recommending a systematic scrotal ultrasound. METHODS: A retrospective review of all patients treated with total or partial orchidectomy, from January, 2000 to July, 2010, for a testicular lesion discovered during an infertility evaluation work-up. Physical, examination data, type of surgery and pathological results were reported. RESULTS: Forty-five patients were treated. The majority of tumors (80%) were non palpable, and incidentally discovered with scrotal ultrasonography. Eight cases were partial orchidectomies, and 37 cases were radical orchidectomies. A frozen section examination was performed in 13 cases, and led to two radical orchidectomies. Standard histological examination revealed 33 (73.3%) benign lesions (11 Leydig cell hyperplasias, 17 Leydig cell tumors, five Sertoli cell tumors) and 10 (22.2%) malignant lesions (nine seminomas and one teratoma). Ten patients had a Klinefelter syndrome, for whom all the lesions were benign. CONCLUSION: The majority of non-palpable testicular lesions, discovered by ultrasonography in a population of infertile men were benign tumors. Conservative management in this context appears to be an option, to preserve the endocrine function and the fertility of these patients, while being ontologically safe.

[Pregnancy in women with atrioventricular block. 13 cases]. / La grossesse chez les femmes ayant un bloc auriculo-ventriculaire. 13 observations

Thirteen women aged between 18 and 37 years and suffering from atrio-ventricular block had 36 pregnancies. Foetal prognosis was excellent and the pregnancy quite unaffected by the block in 9 cases. In 4 women, Stokes-Adams attacks occurred. In one case from some time ago therapeutic abortion was necessary. Temporary pacing at the time of delivery was used in one case and a permanent pacemaker in one patient. The problems posed by the insertion of a pacemaker in a woman of childbearing age are discussed.