The aim of this prospective study was to assess longterm functional results (spermiograms) in subjects who underwent laparoscopic varicocelectomy via either of 2 procedures (ligation or preservation of testicular artery). A total of 122 patients underwent laparoscopic varicocelectomy performed via either of the 2 different procedures: complete ligation of the spermatic vessels or preservation of the spermatic artery. After surgery when patients achieved 18 years, they were asked to undergo semen analysis. Spermiogram results were divided into 2 subgroups: ''normal'' and ''abnormal.'' We analyzed volume, sperm count per mL, percentage of motile spermatozoa, percentage of normal spermatozoa, and percentage of vitality for each group. Both groups showed the same results in terms of ''normal'' and ''abnormal'' spermiograms (World Health Organization criteria), but analysis showed higher sperm concentration per mL, sperm motility, volume, vitality, and rate of morphologically normal sperm for the group with arteries preserved and ''normal'' spermiograms (P , .01). Analysis of data from the spermiograms showed that preservation of the testicular artery was the best possible option in terms of semen quality. Therefore, we believe that surgical treatment of varicocele should be carried out using procedures involving artery preservation.
The proportion of children with subclinical varicocele progressing to a clinically detectable form of the condition was 28% (95% CI 14 to 45) during a 4-year period. We suggest that children with subclinical varicocele require long-term followup.
Phimosis has been defined as unretractable foreskin without adherences and/or a circular band of tight prepuce preventing full retraction. The aim of this study is to evaluate the efficacy (response rate) of topical steroids for the treatment of tight phimosis at different age stages. After using the same medication with different dosage schemes, a retrospective analysis was carried out to assess the efficacy of topical steroids in the treatment of tight phimosis. Patients were divided into three groups: group A (betamethasone scheme A), group B (betamethasone scheme B) and group C (control group). Remission of phimosis, with a complete exposure and without a narrowing behind the glans, was considered a complete response to treatment. The outcomes were then related to dosage scheme and patient's age. The dosage for group A was more effective than the dosage for groups B and C (control group). Phimosis resolved in 90% (group A), 72% (group B) and 56% (group C) of cases. A successful treatment was closely related to the age of patients at the beginning of steroid application. The results showed that treatment with topical steroids, which in general gives good results, proved to be much more successful in patients aged between 4 and 8 years, suggesting the efficacy of an early beginning of the treatment.
Background: Idiopathic varicocele is one of the causes of potentially correctable male subfertility. The mechanisms causing spermatogenesis impairment have yet to be clarified. The aim of this study is to analyze the effects of renal and adrenal metabolite reflux on testicular exocrine function in a rat experimental model. Materials and Methods: In the study, 45 male Lewis Stock adult rats, each weighing 300 g, were used. The rats were subdivided into three groups of 15 rats. In group A (control group) testicular volume and basal follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone levels were measured at the beginning of the study and after 9 months. In group B, varicocele was induced by means of rings introduced in the left renal vein in order to cause a renospermatic reflux. In group C, similarly to group B, varicocele was induced after removal of left adrenal gland. The effects of varicocele on testicular function were then analyzed 3, 6 and 9 months after surgery. After 9 months, all rats underwent testicular biopsy. Results: Both groups B and C showed a reduction in testicular volume, an increase in FSH and a decrease in testosterone levels. These levels were higher in group B. Testicular histological assessment showed important structural abnormalities in group B rats. Conclusions: These data support the hypothesis that renal and adrenal metabolites enhance varicocele-induced testicular damage. This theory is supported both by hormonal impairment and testicular histological analysis.
Rhabdomyosarcoma (RMS) is the most common tumour of the biliary tree in childhood. In children, it is a rare lesion, accounting for about 1% of all RMS. Hepatobiliary botryoid RMS is a disease affecting young children at a median age of about 3 years. In literature, the radiological findings of hepatobiliary RMS have been described in small series and some case reports. In this case report, we present a rare case of RMS of the extrahepatic biliary tree initially diagnosed as a choledochal cyst.
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