Re-establishment of Spermatogenesis by Diethylstilbestrol after 2,5-Hexanedione-induced Irreversible Testicular Atrophy in Rats

To investigate the effects of diethylstilbestrol （DES） in reestablishing spermatogenesis and the mechanism by which estrogen works on spermatogenesis, rats were exposed to 1% 2,5-HD for 5 week. Then 0.1 mL of DES was given （s.c.） at a rate of 0.3 μg/kg, 30 μg/kg, 3 mg/kg every other day for 2 weeks respectively （DES group） while the other rats received ethyldeate only. Plasma testosterone （T） and LH were measured on the 8th week after the treatment. The rats were killed at the 18th week. The left testis was histopathologically examined. In all the rats in the DES groups, spermatogenesis was re-established and the rats in the 30 μg/kg group showed the best results. Serum T was suppressed markedly in rats of 30 μg/kg and 3 mg/kg groups while T was only mildly inhibited in 0.3 μg/kg group, without significant difference found in serum LH. It is concluded that the nearly complete testicular atrophy could be reversed by DES treatment in rats. Estrogen plays an important part in spermatogenesis, and the role of estrogen in spermatogenesis is more than suppressing the hypothalamo-pituitary-testis axis.

The impact of ipsilateral testicular atrophy on semen quality and sperm DNA fragmentation response to varicocele repair

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.

Analysis of trends in testicular atrophy index values with age in patients with unilateral palpable cryptorchidism

Cryptorchidism affects the growth of testicular volume.Testicular volume is associated with reproductive function.The testicular atrophy index evaluates the degree of damage caused by cryptorchidism,but it remains unclear whether changes in testicular atrophy index are related to age.We selected patients who underwent surgery for unilateral palpable cryptorchidism.Testicular volume was measured using ultrasonography.The testicular atrophy indices of the undescended testes were then reviewed,and their correlation with age was analyzed.We studied 228 cases(age range:6–53 months).Scatter plots were constructed,and Loess curves were fitted,revealing a turning point at 24 months of age.The patients were divided into age groups of 6–24 months and 25–53 months.The testicular volume of the cryptorchid side was smaller than that of the normal side in both groups(both P<0.001).In the 6–24-month group,the testicular atrophy index was positively correlated with age,testicular volume on the cryptorchid side was not correlated with age,and testicular volume was positively correlated with age on the normal side.In the 25–53-month group,testicular atrophy index and testicular volumes on either side were not correlated with age.A palpable unilateral cryptorchid testis is smaller than the contralateral testis.The testicular atrophy index increases with age between 6 months and 24 months,but not between 25 months and 53 months.Testicular volume increased with age on the normal side between 6 months and 24 months,but not on the cryptorchid side.Trends in testicular atrophy index with age contribute to the decision of operation time.

Laparoscopic Orchidopexy after 4 Weeks of Testicular Traction with Preservation of Blood Supply: A New Concept for the Treatment of Intra-Abdominal Cryptorchidism: Original Article

Background: Testicular atrophy is recurrent after orchidopexy for intra-abdominal cryptorchidism due to damage to vessels. Fowlers-Stephens and Shehata methods proposed staged orchidopexy, but are still associated to a rate of atrophy greater than 10%. Purpose: We set out to present a new technique that preserves testicular vessels. Our study is aimed at investigating testicular vitality after surgery. Patients and Method: We reviewed files of boys who underwent orchidopexy for 2 years in our department. Those who have been operated for intra-abdominal cryptorchidism with the new technique and aged between 6 months and 14 years old were included in our study. We excluded boys who have been operated before 6 months and after 14 years old and those who did not respect their follow-up plane. Ultrasound (US) outcomes were used to measure testicular volumes and blood flow at each postoperative visit. The Sample population was divided into group A and group B representing testes that were followed respectively for 12 and 24 months. Results: 22 boys with 25 testes were included in our study;11 testes in group A and 14 testes in group B. In each group, we noted a significant difference of UDT volumes from the third month after surgery with respective P-values 0.05. There was no statistical difference between UDT and contra lateral testes volumes 12 months after surgery in group A and 24 months in group B with respective P-values of 0.07 and 0.72. All volume differential indexes were Conclusion: This method offers a new perspective in performing safe orchidopexy for intra abdominal undescended testes.

Urogenital Complications of Groin Hernia Surgery: A Multicentre Study in Guinea

Context and Objective: Groin hernia is a common pathology in visceral surgery (2nd rank after appendicitis), which affects approximately 4.6% of the African population. Restoring the normal anatomy of the groin region is one of the most benign interventions. However, uro-andrological complications are possible. This study aimed to contribute to the improvement of the management of urogenital complications of groin hernia surgery. Patients and Method: We carried out a prospective study of descriptive type with a duration of 6 months from 1 August 2021 to 31 January 2022. The data were collected using a pre-established survey sheet. The study covered several sites (public hospitals and private clinics) in Guinea. Results: The urogenital complications of the surgery of the hernia of the groin represented 15.22% or 14 cases out of 92 patients. The average age was 37.00 years with extremes of 20-69 years. Polygamists occupied the first place. The reason for consultation was dominated by decreased testicular volume (42.86%), followed by a desire to conceive (21.43%). Unilateral testicular atrophy represented 63.64%, bilateral 27.27%. We performed a left orchidectomy in one patient and a cystorraphy in another simple operative follow-up. The other cases consisting of testicular atrophy, due to lack of a suitable technical platform, did not benefit from any specific therapeutic treatment. Conclusion: Urogenital complications of groin hernia surgery are relatively common. Testicular atrophy was the main clinical complication. The left orchidectomy and cystorraphy were the therapeutic procedures performed.

Management of the Torsion of Spermatic Cord in the Urology-Andrology Department of the Ignace Deen National Hospital in Conakry

Introduction: Torsion of the spermatic cord is an emergency whose delay in treatment conditions the functional prognosis of the testicle. The aim of this study was to analyze the management of spermatic cord torsion in the Urology Andrology Department of the Ignace Deen National Hospital in Conakry. Material and methods: This was a ten-year retrospective descriptive study from January 1, 2012 to December 31, 2021. It involved all patients admitted for torsion of the spermatic cord, confirmed at surgical exploration. Results: We identified 21 cases of torsion of the spermatic cord. The mean age of the patients was 17.9 ± 4.4 years. The average consultation time was 19.2 ± 21.4 hours with extremes of [2 h and 98 h]. Only 6 patients (28.6%) consulted before the sixth hour. All patients presented with scrotal swelling. At scrototomy, all torsions were intravaginal with two turns of spiral in 13 cases and three turns in 8 cases. Orchiectomy followed by contralateral orchidopexy was performed in 6 cases. In the other cases, bilateral orchidopexy was performed after detorsion. The average hospital stay was 4.5 days. We recorded 4 cases of testicular atrophy after orchidopexy. Conclusion: Spermatic cord torsion is an infrequent emergency in our department. The delay in consultation remains the main predictive factor of testicular necrosis. Emergency exploratory scrotomy should be the rule.