Fifty-five patients were followed up for their state of fertility at a time varying in length after testicular torsion. In addition to the spermiogram they were screened for sperm antibodies. Biopsy samples were collected from the contralateral (not contorted) testis in 34 patients at the time of torsion or immediately afterwards. Two to 8 years after torsion only 7 out of 55 patients had a normal spermiogram. Nineteen had an OAT syndrome, 10 had asthenospermia and 19 had teratospermia. Sperm antibodies occurred very rarely at the time of torsion (2/36) or at the time of a further checkup (2/36). Immunological damage to the noncontorted testis by the contorted one seems therefore rather unlikely. Histology of the contralateral testis, the samples of which were taken at the time of torsion (30) or up to 4 months later (4), showed pathological conditions in 30/34 cases (desquamation of the germinative epithelium, atrophy of the Leydig cells, malformation of spermatoblasts) and normal spermiogenesis in 4 cases only. Hence, a preexistent congenital testicular dysplasia must be assumed to be the cause of the observed disturbance of spermiogenesis and reduced fertility.

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Die bisherigen experimentellen und klinischen Untersuchungen über immunbiologische Probleme bei Fertilitätsstörungen des Mannes sind in ein Stadium getreten, in dem sie auch für die praktische Abklärung von Fertilitäts- und Sterilitätsfragen eine gewisse Bedeutung erlangt haben. In der vorliegenden Arbeit wurden die wichtigsten bisher bekannten Untersuchungsergebnisse auf diesem Gebiet angeführt. In eigenen Untersuchungen über die antigenen Eigenschaften von menschlichem Samenplasma, Spermatozoen und kochsalzlöslichen Extrakten aus menschlicher Pro-stata, Samenblasen, Nebenhoden und Hoden wurde der immunologische Aufbau des Samenplasmas geprüft. Er entspricht insofern der biochemischen Zusammensetzung, als die Sekrete von Nebenhoden, Samenblasen und Prostata Antigenfraktionen an das Samenplasma abgeben. Ein Teil dieser Antigenfraktionen wird an die Oberfläche der Samenfäden auf ihrem Weg durch den Genitaltrakt angelagert. An Hand des eigenen Krankengutes konnte auf die Bedeutung entzündlicher und traumatischer Veränderungen im Bereich des männlichen Genitaltraktes für die Entstehung autoimmunologischer Reaktionen gegen den eigenen Samen hingewiesen werden. Die wichtigsten Untersuchungsmethoden zur experimentellen und praktischen Abklärung immunologischer Sterilitätsprobleme wurden besprochen. Die bisher geringen Erfahrungen bezüglich der Therapie der immunologisch induzierten Sterilität und Subfertilität wurden aufgezeigt. Auf Grund eigener Erfahrungen bestehen aber bereits Hinweise auf erfolgversprechende konservative und chirurgische Maβnahmen in der Behandlung immunologisch bedingter Fertilitätsstörungen des Mannes.

The study reports cytological findings in 63 cases of radio- and/or oestrogen-treated carcinoma of the prostate. The different effects of therapy on the tumor cells in the cytological smear are described and discussed. An evaluation of the results, depending on the type of therapy, showed, that radio-treated tumors, due to the rapid and strong sclerosis of connective tissue, were less suitable for aspiration biopsy than hormone-treated tumors. Further, we were able to show that the effect of therapy in well-differentiated tumors is better than in poorly differentiated tumors. Cytological examination of treated prostate carcinoma is a simple method, quickly carried out, repeatable several times, and of high diagnostic value. Aspiration biopsy is most of all indicated for follow-up of the less well-differentiated and the hormone-treated carcinomas.

Free carnitine in human semen originates predominantly in the epididymis. The role of carnitine in the evaluation of different forms of obstructive azoospermia was studied in 42 patients. In 14 of the men, a bilateral vasectomy had been performed. In the remaining 28 patients, the occlusion was located within the epididymis. In postvasectomy cases and where the occlusion was located in the cauda epididymidis, carnitine concentrations were low, with mean values of 115.57 mumol/l and 121.28 mumol/l, respectively. When the occlusion was located in the corpus epididymidis, the mean value increased to 194.72 mumol/l. In patients having obstruction of the caput epididymidis or of the rete testis, the mean value of free carnitine was 416.0 mumol/l. After vasovasostomy, a return of free carnitine concentration to the normal range was observed in 10 of 12 cases. The results indicate that there is a significant correlation in patients with obstructive azoospermia between the concentration of free carnitine and the anatomic site of the obstruction. These findings may lead to important conclusions concerning therapy and prognosis for patients presenting with this condition.

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