[Aging of the human testis]. / Fonctions testiculaires du sujet âgé

The morphological and histological changes related to testicular aging are: volume decrease, arteriolar sclerosis, degeneration of Leydig cells and Sertoli, depletion of germ cells and thickening of the tunica albuginea testis. The participation in testicular androgen decline in aging is related to the decrease in the number of Leydig cells associated with alterations in the functioning of the hypothalamic-pituitary axis Sperm volume, concentration and total number, motility and morphology of sperm decrease with aging male. The interindividual variability of sperm parameters, the variability of methodologies for data collection and selection of patients must be careful in interpreting the published results. Overall, the quality of sperm decreases progressively with age, without any age limit that can be individualized. Alterations of spermatogenesis do not seem significantly compromising fertility in the elderly. The clinical impact of testicular aging implies androgen production decrease and diseases associated with aging.

Clinicopathological characteristics of incidental prostate cancer discovered from radical cystoprostatectomy specimen: a multicenter French study.

PURPOSE: The present study assessed the incidence and histopathological features of incidentally diagnosed prostate cancer (PCa) in specimens from radical cystoprostatectomy (RCP) for bladder cancer. The patient outcomes also were evaluated. METHODS: We retrospectively reviewed the histopathological features and survival data of 4,299 male patients who underwent a RCP for bladder cancer at 25 French centers between January 1996 and June 2012. No patients had preoperative clinical or biological suspicion of PCa. RESULTS: Among the 4,299 RCP specimens, PCa was diagnosed in 931 patients (21.7%). Most tumors (90.1%) were organ-confined (pT2), whereas 9.9% of them were diagnosed at a locally advanced stage (≥pT3). Gleason score was <6 in 129 cases (13.9%), 6 in 575 cases (61.7%), 7 (3 + 4) in 149 cases (16.0%), 7 (4 + 3) in 38 cases (4.1%), and >7 in 40 cases (4.3%). After a median follow-up of 25.5 months (interquartile range 14.2-47.4), 35.4% of patients had bladder cancer recurrence and 23.8% died of bladder cancer. Only 16 patients (1.9%) experienced PCa biochemical recurrence during follow-up, and no preoperative predictive factor was identified. No patients died from PCa. CONCLUSIONS: The rate of incidentally diagnosed PCa in RCP specimens was 21.7%. The majority of these PCas were organ-confined. PCa recurrence occurred in only 1.9% of cases during follow-up.

Removal of pelvic schwannoma using a retroperitoneoscopic and open double approach: description of an effective novel technique.

INTRODUCTION: Schwannomas are rare tumors and are exceptionally retroperitoneal. In the event of clinical signs or uncertainty in the diagnosis, their removal is justified. A risk of neoplastic transformation exists. PATIENTS AND METHODS: Three patients had a retroperitoneal schwannoma located next to or under the sacral promontory. A double approach using an initial retroperitoneoscopy and an iliac abdominal incision had been decided preoperatively. This approach has not been described previously in the medical literature. RESULTS: The double approach enabled the complete removal of tumors in all patients. The iliac incision, described within, enabled the removal of the tumors despite major attachments and difficulties in exposure, due to the tumors' distal situations. CONCLUSION: A double approach by retroperitoneoscopy and laparotomy can enable removal of difficult low-seated retroperitoneal schwannomas without increasing intraoperative risk or perioperative morbidity.

Leiomyosarcoma of the corpus cavernosum mimicking a Peyronie's plaque.

Peyronie's disease is relatively frequent and can cause pain and penile induration. Penile soft tissue tumors, however, are exceptional, with fewer than 45 cases reported since 1930. Some clinical and imagery elements could lead to earlier diagnosis through biopsy, enabling more extensive resections and, ultimately, better prognosis.