Highlights d Cities possess a consistent ''core'' set of non-human microbes d Urban microbiomes echo important features of cities and city-life d Antimicrobial resistance genes are widespread in cities d Cities contain many novel bacterial and viral species
Varicoceles adversely impact semen quality and sperm DNA fragmentation, which typically improve with surgical repair. Some men with varicoceles have ipsilateral testicular atrophy due to damage from the varicocele. This study assessed semen quality and the sperm DNA fragmentation index (DFI) response to varicocele repair in men with ipsilateral testicular atrophy (TA) versus men with no testicular atrophy (NTA). Semen parameter values and DFI in both groups were compared preoperatively and postoperatively. The Mann–Whitney U test and the Wilcoxon signed-rank test were used where appropriate. There were 20 men in the TA group and 121 men in the NTA group with no difference in age, varicocele grade, or preoperative semen parameter values between the two groups. The NTA group had a higher preoperative DFI than the TA group. Both groups showed improvement in semen quality postoperatively, only the TA group showed a significant improvement in DFI, whereas the NTA group showed significant improvements in several parameter values and DFI. The change from preoperative to postoperative parameter values when comparing the two groups revealed a difference in total sperm motile count and DFI, with a larger mean improvement in the NTA group than in the TA group. Both TA and NTA groups showed improved semen quality and DFI after varicocele repair, but the NTA group had more improvement than the TA group. However, only total motile count (TMC) and DFI had a significantly greater mean change in preoperative to postoperative response in the NTA group than in the TA group.
procedure is intra-abdominal bleeding. Hospitalization is reported to be needed with an incidence between 0.06% and 0.35%. According to the literature, the rate of cases requiring abdominal surgery with severe haematoperitoneum (SHP) is very different, between 40% to 70% in large series. The aims of the study were to compare single clinician's complication rate for SHP caused by ovarian bleeding after TVOR with literature and to compare the outcome of treatment strategies.DESIGN: This retrospective cohort study includesa total of 8332 consecutive TVOR procedures performed by a single clinician (65.2%) among a total of 12776 TVORs, between June 2014 and March 2019 and in one IVF center. All the suspected SHP cases who were hospitalized were enrolled in the study group. This ''complication'' group was categorized according to the need for a conservative or surgical treatment. General SHP rates and the treatment approaches were compared with the literature.MATERIALS AND METHODS: The complications of SHP included in the study were grouped into two: Group I included patients in whom conservative treatment with or without red blood cell (RBC) transfusion was performed; Group II consisted of patients who were indicated for surgical treatment. Patients with non-ovarian bleedings were excluded. Number of RBC units for transfusion, duration of hospitalization of SHP patients, general body mass index (BMI) and women ages in TVOR were considered.RESULTS: A total number of 79097 oocytes (8832 TVOR) were retrieved by the same clinician between June 2014 and March 2019. The mean female age was 35.04AE5.67, the mean body mass index was 24.92AE4.49, the mean number of retrieved oocytes and metaphase II oocytes was 9.50AE8.35 and 7.92AE6.97 respectively. The number of SHP related ovarian bleeding complications during TVOR was 17 out of 8332 (%0.2). The mean duration of hospitalization was 1.76 days/patient. The mean RBC units administered was 1.65 U/patient. Whereas 15 patients (88.23%) needed only conservative treatment, only two (11.77%) needed a laparoscopic intervention. None of the patients (17) had severe infections such as pelvic abscess or sepsis after the treatment.CONCLUSIONS: The real complication rates of SHP after TVORand especially their treatment methods are variable in the literature. Difficulties of origin of intra-abdominal bleeding after TVOR and diagnosis of severity of haematoperitenium also make the therapeutic approaches more complicated in IVF patients. We report here a very low complication rate (0.2%) of SHP in a large series performed by a single clinician in nearly five years. Our data showed that most of the ovarian bleeding related SHP after TVOR could be managed without adverse outcome by conservative treatment (88.23%) not by surgery in contrast to the published data.Reference: No. SUPPORT: No.
SA, including morphology defects. When morphology defects were excluded, approximately 3/4 (73.3%) of men with an initial abnormal SA had persistently abnormal results on a second test, while the remaining 26.7% had a normal second SA. Among patients with at least two initial defects, only 8.1% had a normal second SA; when morphology defects were excluded, this figure increased to 16.4%.CONCLUSIONS: The majority of men with abnormal semen analyses on initial testing have persistent abnormalities on repeat testing that warrant referral to Urology. Less than than 1 in 10 men with two or more defects on initial testing had a normal second SA. These results suggest that referral to a Urologist may be considered after a single abnormal SA to expedite male-factor infertility workup and treatment.
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