Testicular function after torsion

A group of 20 patients with torsion was investigated. The study indicated that immediate surgical intervention with a period of torsion of the testis of less than 6 h will prevent impairment of testicle function. The histology of testicular biopsies taken from such patients revealed only interstitial oedema and, at the most, partial necrosis. If torsion time exceeded 6 h testicular histology revealed severe alterations, and surgical correction could not prevent atrophy of the testis. Patients with pathological spermiograms showed FSH values over or at the upper limit of the normal range. As far as can be concluded from one single basal hormone determination, the testosterone secretion remained unaltered. Libido, potency and virilization remained normal.     

Surgical repositioning of the contralateral testicle before irradiation of a paratesticular rhabdomyosarcoma for preservation of hormone production

Little has been published so far about the possibility of preserving an uninvolved testicle by surgically transferring it out of the irradiation field. A then 16-year-old boy developed a right paratesticular embryonal rhabdomyosarcoma in 2003. Initial treatment consisted of orchiectomy and chemotherapy. Prior to local radiotherapy, the contralateral testicle was surgically transferred into the left groin region. Hyperfractionated, accelerated radiation therapy was administered to a total dose of 44.0 Gy. After radiotherapy, the testicle was returned. The patient's testosterone levels are still normal. No clinical abnormalities or signs of tumor had been observed as of June 2006.     

Lymphotropic administration of photosensitizer as a model of target therapy of testicle inflammation: Experimental and clinical data

BackgroundThe existence of zones of humoral skin–subskin tissue linkage with internal organs as well as the possibility of targeted administration of preparation into the affected organs were studied.MethodsAn experimental study of preparation and distribution in the bodies of mice was held by both intravenous and lymphotropic methods of administration. By means of detection with a photosensitizer (as a marker), the study was conducted on healthy mice and mice with testicle inflammation.Based on the experimental results, the study has been implemented into the clinical practice of treatment of acute inflammatory diseases of testicle and its epididymis. Patients were administered antibiotics either by the lymphotropic method, or by traditional methods.ResultsThe concentration of the preparation, administered by the lymphotropic method, maintained in target organs (testicles) at a high level for a longer time, while the intravenous injections provided fast achievement of high concentrations. Moreover there was a lower level of accumulation of the photosensitizer in parenchymal organs after subcutaneous (lymphotropic) administration.ConclusionsThe presence of humoral connection of certain areas of skin and subcutaneous tissue with testicles and their epididymis was proved. It was found that the lymphotropic administration leads to earlier clinical improvement and normalization of laboratory indices, and, thus, to significant reduction in hospital stay. Such results open the possibility of targeted drug delivery to the diseased organs. In perspective, the method may be used in treating patients not only in urology, but also in surgery, as well as for many acute, chronic or cancer diseases.     

Protective effect of α-tocopherol on damage to rat testes by experimental cryptorchidism

It is thought that the degeneration of germ cells associated with an increase in the temperature due to cryptorchidism involves oxidative stress. α-Tocopherol is a powerful antioxidant that prevents oxidation of polyunsaturated fats found in membranes and stabilizes peroxyl radicals. For this reason we were interested in determining the role of α-Tocopherol using experimental cryptorchidism, followed by orchidopexia in neonatal rats. Eighty-four, 10-day-postpartum (dpp) male rats (Wistar strain) were used and divided into 7 groups: healthy control, sham with α-Tocopherol treated with 30 or 100 mg/kg doses, sham vehicle, cryptorchidism treated with α-Tocopherol at 30 or 100 mg/kg doses and cryptorchidism vehicle. Cryptorchidism was surgically induced at 10 dpp. At 25 dpp the animals were treated with α-Tocopherol and the vitamin vehicle. Lipoperoxidation and testicular morphology was determined in half of the animals at 40 dpp (short term). The remaining animals underwent orchidopexia and fertility was determined at 90 dpp. Testicular morphology was determined at 120 dpp (long term) in these animals. A significant reduction of lipoperoxidation was observed in the cryptorchid group treated with α-Tocopherol compared to the untreated cryptorchid group, in addition to short-term histological alterations. At long term, we observed an increase in the area and maturation of the seminiferous epithelium, a decrease in apoptosis and histological alterations and an increase in fertility from α-Tocopherol treatment. α-Tocopherol treatment decreased lipoperoxidation, possibly stabilizing free radicals produced during cryptorchidism, reducing morphological testicular alterations and favoring fertility.     

Torsion of an undescended testis located in the inguinal canal

Background

Torsion of undescended testis located within the inguinal canal is a rare finding in the emergency department (ED). This diagnosis can present as undifferentiated abdominal or groin pain, and a full genitourinary examination is essential to making this diagnosis.

Objectives

We present this case to increase awareness among emergency physicians regarding torsion of undescended testis.

Case Report

A 5-year-old boy presented to the ED with abdominal pain and a mass in his right groin. Physical examination and Doppler ultrasound were used to diagnose torsion of undescended testis.

Conclusions

In a patient with undescended testis, torsion must be considered as a cause of abdominal or groin pain. Full genitourinary examination is essential to making this diagnosis.     

Balloon inflation-created subdartos pouch during orchiopexy: a new simplified technique

Purpose  Creation of subdartos pouch is an integral part of orchidopexy. The objective of this study was to describe and evaluate the results that can be achieved by using a new simplified technique (creation of subdartos pouch by balloon inflation of small sized Foley’s or Fogarty catheter during orchiopexy). Materials and methods  Seventy-five boys with undescended testicle had been operated upon at King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia in the period from April 2007 to April 2008. The technique will be described in detail. All patients were followed up for 12 months on average, range (2–12) months. Results  They were 75 boys with undescended testicle, 53(71%) palpable cases [48(64%) unilateral, 5(7%) bilateral] and 22(29%) impalpable cases [20(26%) unilateral, 2(3%) bilateral]. Mean age of 13 ± 1.47 months (range, 9–36 months). The mean operative time was 11.5 ± 1.12 min. (range, 10–15 min) for each orchiopexy; whereas, the mean operative time for creation of subdartos pouch was 23.7 ± 1.12 s (range, 20–30 s). There were no intraoperative or early postoperative complications (hematoma or infection). There was no evidence of testicular atrophy by testicular ultrasound among cases of palpable testes. Only two testes among the cases of impalpable testes became smaller in size but viable after 12 months. However, almost all families were happy with good esthetic appearance of the scrotum. Conclusion  The new technique of balloon inflation-created subdartos pouch during orchiopexy is an easy, safe bloodless and quick technique with good cosmetic outcome.     

不同测量方法对睾丸体积测量的准确性研究

目的评价三维超声、二维超声及睾丸体积测量器对睾丸体积测量的准确性。方法测量20位拟行去势手术的晚期前列腺癌患者40枚睾丸,术前使用Prader睾丸体积测量器估测睾丸体积;二维超声测量睾丸长、宽、高(前后径)三个径线,椭球体公式计算睾丸体积;三维超声自动测量程序测出睾丸容积。术后使用排水法测量睾丸的实际体积。结果3种测量方法所测睾丸体积与实际体积均高度相关,但Prader测量器所测睾丸体积的相关系数要小于两种超声测量方法,所测数值较实际体积偏大(P<0.05);二维超声测值较实际体积偏小(P<0.05);三维超声所测体积与实际体积的差别没有统计学意义(P>0.05)。三种测量方法与实际体积的误差之间具有统计学意义(P<0.05)。结论三维超声对睾丸体积测量的准确性要优于二维超声和Prader测量器,所测数值能更好的代表睾丸实际体积。     

构建带内支撑组织工程睾丸假体的实验研究

目的探讨以医用多孔高密度聚乙烯(high-density polyethylene,HDPE,商品名为Medpor)为内支撑,外裹聚羟基乙酸(polyglycolic acid,PGA)的支架,接种软骨细胞后,于裸鼠体内构建组织工程睾丸假体的可行性及特点。方法取新生雌性长枫杂交仔猪1只,取四肢大关节表面软骨,制备密度为5×107/ml的软骨细胞悬液。将其接种于长短半径分别为6mm和4mm的Medpor,外裹2mm PGA的支架,体外培养2周。取4周龄BALB/C裸鼠10只,随机分为两组(n=5)。实验组:采用制备的细胞-支架复合物植入裸鼠背部皮下;对照组:采用Medpor-PGA复合支架植入裸鼠皮下。8周后处死裸鼠取材,行大体观察、组织学及免疫组织化学观察。结果大体观察:实验组标本形状与体积未发生变化,色泽及弹性与正常软骨相似,软骨与Medpor接合紧密;对照组无软骨形成,外包裹纤维样组织。实验组:HE染色见软骨内存在大量成熟的软骨陷窝,无血管长入,部分PGA尚未降解完全;甲苯胺蓝染色示细胞外基质具有异染特性;藏红花染色示基质中大量蛋白聚糖沉积;型胶原免疫组织化学染色呈强阳性表达。对照组:Medpor被大量富含血管的纤维组织包裹。结论利用Medpor与PGA复合的支架,接种软骨细胞后,可于体内构建出具有预构睾丸形态且组织学良好的Medpor-软骨复合体。     

褪黑素主动免疫对雄兔睾丸发育的影响

目的:研究褪黑素(melatonin,Mel)与雄兔睾丸发育之间的关系.方法:30只未达初情期的雄性新西兰大耳兔,随机分成2组,每组15只.实验组采用皮内多点多次注射Mel与牛血清白蛋白偶联制备的完全抗原进行主动免疫,对照组相应注射等量的蒸馏水.实验期间,用RIA法检测兔血清睾酮及促黄体生成激素含量,并在实验结束时测定兔睾丸、附睾质量及精子数.结果:进入发情期后,实验组兔血清睾酮及促黄体生成激素含量均明显低于对照组(P<0.01),睾丸、附睾质量及精子数亦显著低于对照组(P<0.01).结论:通过Mel主动免疫可以延缓兔睾丸发育.     

Anatomy and microanatomy of the venous system of scrotal organs and spermatic cord

Three structural and hemodynamic variants of venous angioarchitectonics of the epididymis were detected: direct testicular outflow (direct outflow into veins of the plexus pampiniformis), indirect testicular outflow (outflow into veins of the plexus pampiniformis with involvement of the communicant veins), and mixed outflow (combination of indirect testicular outflow with the outflow into vas deference veins). Anastomosis of caudal veins of the epididymis and the initial compartment of veins of the vas deference forming the “testicular venous arch” plays an important role in collateral venous blood-flow system; the arch anastomosing with the source of cremasteric vein forms a three-system anastomosis, the “testicular venous plexus” at the site of the epididymis tail transition into the vas deference. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 143, No. 1, pp. 106–111, January, 2007