Minimal invasiveness and effectivity of subinguinal microscopic varicocelectomy: a comparative study with retroperitoneal high and laparoscopic approaches

Watanabe, Masami; Nagai, Atsushi; Kusumi, Norihiro; Tsuboi, Hiromu; Nasu, Ya Sutomo; Kumon, Hiromi

doi:10.1111/j.1442-2042.2005.01142.x

Cited by 89 publications

(69 citation statements)

References 36 publications

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“…A future randomized study including the quantitative evaluation of the therapeutic physical changes is planned to further elucidate the dose-dependency between the three dosing groups. The average testosterone levels in the treatment groups reached around 700 ng/dL, which is comparable to the testosterone levels in normal males [9,10].…”

Section: Desired Clinical Effectssupporting

confidence: 52%

Dose-response analysis of testosterone replacement therapy in patients with female to male gender identity disorder

et al. 2013

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Gender identity disorder (GID) is a condition where an individual experiences significant gender dysphoria or discontent due to the divergence between their biological sex and their actually perceived sex. The concept of GID was introduced in the 20 th century [1], and the affected patients usually indicate an apparently normal somatic sexual differentiation and hope to live as the member of the opposite gender to their innate one. The number of patients diagnosed with the condition has been increasing in the past decade. Currently, a broad approach toward to treatment of GID is conducted from various aspects of law, sociology, psychol- Abstract. Gender identity disorder (GID) is a conflict between a person's actual physical gender and the one they identify him or herself with. Testosterone is the key agent in the medical treatment of female to male GID patients. We conducted a dose-response analysis of testosterone replacement therapy (TRT) in 138 patients to determine the onset of the therapeutic effects. The TRT consisted of intramuscular injection of testosterone enanthate and patients were divided into three groups; 250 mg every two weeks, 250 mg every three weeks and 125 mg every two weeks. The onset of deepening of voice, increase in facial hair and cessation of menses was evaluated in each group. At one month after the start of TRT, the onset of these physical changes was more prevalent in the group receiving the higher dose of testosterone, and there were dosedependent effects observed between the three treatment groups. On the other hand, at six months after the start of TRT, most of the patients had achieved treatment responses and there were no dose-dependent effects with regard to the percentage of patients with therapeutic effects. No significant side effects were observed in any of the treatment groups. We demonstrated that the early onset of the treatment effects of TRT is dose-dependent, but within six months of starting TRT, all three doses were highly effective. Current study provides useful information to determine the initial dose of TRT and to suggest possible changes that should be made in the continuous dosage for long term TRT.Key words: Gender identity disorder, Testosterone, Female to male, Dose response analysis, Estradiol ogy and medicine to effectively manage the disorder.The aim of the treatment for GID patients is to provide relief from the dichotomy between body habitus and sex identity by the induction of desired mental changes and maintenance of an acceptable physical state of the opposite sex. With regard to the history of the medical approach towards GID, surgical intervention was first conducted in 1907, and hormone therapy using testosterone replacement in female to male GID was started from 1935 after the discovery of testosterone [2]. Currently, the treatment for GID consists of psychotherapy, hormone replacement therapy and sex reassignment surgery. The therapeutic strategy is often determined, and therapies are started, by incorporating the patient's preferences or base...

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Section: Desired Clinical Effectssupporting

confidence: 52%

Dose-response analysis of testosterone replacement therapy in patients with female to male gender identity disorder

et al. 2013

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“…The standard management of varicocele repair is the subject of ongoing controversy. In a comparative study of three surgical methods of varicocele treatment Watanabe and colleagues (Watanabe et al, 2005) compared various minimally invasive method. They compared retroperitoneal high ligation under lumbar anesthesia, laparoscopic ligation under general anesthesia, and subinguinal microscopic ligation under local anesthesia.…”

Section: Varicocelectomymentioning

confidence: 99%

Urological Surgical Procedures Under Local Anesthesia

Ather¹,

Mushtaq²,

Sulaiman³

2012

Clinical Use of Local Anesthetics

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“…3,4 Other recent studies have shown that the prevalence of malfunction of one-way valves in the ISV increases by 10-15% for each decade of life. 5 Varicocele arises exclusively in humans, whose erect posture predisposes the valves to high gravitational forces. Quadrupeds do not require valves in their ISV to assist venous return.…”

Section: Editorial Comment To Umbilical Laparoendoscopic Single Site mentioning

confidence: 99%

“…1,2 However, a comparative study showed no superiority of laparoscopic varicocele ligation over the standard open subinguinal varicocelectomy with respect to operative time, postoperative pain, cost-effectiveness and complications. [5][6][7] Laparoendoscopic single site surgery (LESS) was introduced several years ago. LESS has been carried out successfully for laparoscopic nephrectomies, cholecystectomies and appendectomies.…”

Section: Introductionmentioning

confidence: 99%

Umbilical laparoendoscopic single site surgery versus inguinal varicocelectomy for bilateral varicocele: A comparative study

et al. 2011

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Abstract:We aimed to determine the efficacy of umbilical laparoendoscopic single site surgery (LESS) bilateral varicocelectomy on the basis of a comparative study versus open inguinal bilateral varicocelectomy. We enrolled 39 patients who underwent bilateral varicocelectomy with predetermined surgical indications at two hospitals with either the LESS (n = 19) or the open inguinal approach (n = 20). Operative time, operation-related pain (10-point visual analog pain scale), catch-up growth of the testes, semen parameters, and complications after surgery between the LESS group and the open group at 3 months after surgery were compared. Operative times were 46.8 and 72.8 min (P < 0.001) in the LESS and open surgery groups, respectively. Patients in the LESS group reported lower surgery-related pain than those in the open surgery group at 3 months (2.5 vs 1.2, P = 0.029). A significant improvement in terms of semen concentration, motility, catch-up growth of the bilateral testes was observed in both groups, although no significant differences were detected between the groups. Postoperative complications were also similar between the two groups. LESS varicocelectomy required a shorter operative time than inguinal varicocelectomy for bilateral cases. In addition, the LESS procedure showed less postoperative pain and cosmetic benefits with similar seminal outcomes. Thus, LESS for patients undergoing bilateral varicocelectomy represents a promising surgical approach.

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Minimal invasiveness and effectivity of subinguinal microscopic varicocelectomy: a comparative study with retroperitoneal high and laparoscopic approaches

Cited by 89 publications

References 36 publications

Dose-response analysis of testosterone replacement therapy in patients with female to male gender identity disorder

Dose-response analysis of testosterone replacement therapy in patients with female to male gender identity disorder

Urological Surgical Procedures Under Local Anesthesia

Umbilical laparoendoscopic single site surgery versus inguinal varicocelectomy for bilateral varicocele: A comparative study

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