Relationship between testicular volume and testicular function： comparison of the Prader orchidometric and ultrasonographic measurements in patients with infertility

Aim： To evaluate the relationship between testicular function and testicular volume measured by using Prader orchidometry and ultrasonography （US） to determine the critical testicular volume indicating normal testicular function by each method. Methods： Total testicular volume （right plus left testicular volume） was measured in 794 testes in 397 men with infertility （mean age, 35.6 years） using a Prader orchidometer and also by ultrasonography. Ultrasonographic testicular volumes were calculated as length x width x height x 0.71. To evaluate volume-function relationships, patients were divided into 10 groups representing 5-mL increments of total testicular volume by each method from below 10 mL to 50 mL or more. Results： Mean total testicular volume based on Prader orchidometry and US were 36.8 mL and 26.3 mL, respectively. Semen volume, sperm density, total sperm count, total motile sperm count, and serum FSH, LH, and testosterone all correlated significantly with total testicular volume measured by either method. Mean sperm density was in the oligozoospermic range in patients with total testicular volume below 35 mL by orchidometry or below 20 mL by ultrasonography. Mean total sperm count was subnormal in patients with total testicular volume below 30 mL by orchidometry or under 20 mL by ultrasonography. Conclusion： Testicular volume measured by either ultrasonography or Prader orchidometry correlated significantly with testicular function. However, critical total testicular volume indicating normal or nearly normal testicular function was 30 mL to 35 mL using Prader orchidometer and 20 mL using ultrasonography. Prader orchidometry morphometrically and functionally overestimated the testicular volume in comparison to US. （Asian JAndro12008 Mar; 10： 319-324）

The reliability of ultrasonographic measurements for testicular volume assessment: comparison of three common formulas with true testicular volume

The aim of this study was to determine the correlation of ultrasonographic estimates of testicular volume with true testicular volume and to compare the accuracy and precision of the three most commonly utilized formulas.A total of 15 patients underwent high-resolution ultrasonography(US)analysis for testicular volume before orchiectomy.Testicular volume was calculated using three common formulas:(1)length(L)×width(W)×height(H)×0.52;(2)the empirical formula of Lambert:L×W×H×0.71;and(3)L×W^(2)×0.52.The actual volume of each removed testis was estimated directly by a water displacement method.Thus,four volume measurements were obtained for each of the 30 testes.The obtained data were analyzed by paired t-test and linear regression analysis.All three US formula measurements significantly underestimated the true testicular volume.The largest mean biases were observed with US formula 1,which underestimated the true volume by 3.3 mL(31%).US formula 2 had a smaller mean difference from the true volume,with an underestimation of only 0.6 mL(6%).Regression analysis showed that formulas 1 and 2 had better R^(2) values than formula 3.However,all three US formulas displayed a strong linear relationship with the true volume(R^(2)=0.872−0.977;P<0.001).Among the commonly used US formulas,the empirical formula of Lambert(L×W×H×0.71)provided better accuracy than the other two formulas evaluated,and better precision than formula 3.Therefore,the formula of Lambert is the optimal choice in clinical practice.

Inter/intra investigator variation in orchidometric measurements of testicular volume by ten investigators from five institutions

Aim： To perform quality control studies on testicular volume measurements for a multi-center epidemiological study of male reproductive function. Methods： We constructed a data matrix with a balanced assignment for 2 consecutive days by ten investigators （andrological career： 4-21 years） from five institutions and 12 male volunteers aged 20-26 years. Testicular volume was measured by Prader＇s orchidometer. A skilled technician also performed an ultrasound estimate of testicular volume. Results： A statistically significant inter-investigator variation was found for both testes （P 〈 0.05）. In addition, there was a statistically significant investigator-by-volunteer interaction in testicular volume measurement （P 〈 0.01）. However, there was no statistically significant difference in the two measurements performed on consecutive days for either testis. The testicular volumes for both the right and left testes as estimated by ultrasonography were smaller than results using the orchidometer. However, there was no statistical significance （P 〉 0.05）. The difference in experiences of the investigators did not significantly correlate with accuracy of measurements in either testis. Conclusion： The present study revealed significant differences in the results of estimation of testicular volume among the ten investigators, but intra-investigator variation was not considerable. Improved training and proper standardization of the measurement will be necessary before starting a multi-center study based on an andrological examination.

Inter/intra investigator variation in orchidometric measure-ments of testicular volume by ten investigators from five insti-tutions

Aim:To perform quality control studies on testicular volume measurements for a multi-center epidemiological study of male reproductive function.Methods:We constructed a data matrix with a balanced assignment for 2 consecutive days by ten investigators(andrological career:4-21 years)from five institutions and 12 male volunteers aged 20-26 years.Testicular volume was measured by Prader's orchidometer.A skilled technician also perfornled an ultrasound estimate of testicular volume.Results:A statistically significant inter-investigator variation was found *'or both testes (P<0.05).In addition,there was a statistically significant investigator-by-volunteer interaction in testicular volume measurement(P<0.01).However,there was no statistically significant difference in the two measurements performed on consecutive days for either testis.The testicular volumes for both the right and left testes as estimated by ultrasonog- raphy were smaller than results using the orchidometer.However,there was no statistical significance(P>0.05).The difference in experiences of the investigators did not significantly correlate with accuracy of measurements in either testis.Conclusion:The present study revealed significant differences in the results of estimation of testicular volume among the ten investigators,but intra-investigator variation was not considerable.Improved training and proper standardization of the measurement will be necessary before starting a multi-center study based on an andrological examination,

Testicular volume is a noninvasive predictor of sperm retrieval failure in idiopathic nonobstructive azoospermia

We investigated the prognostic importance of noninvasive factors in predicting sperm retrieval failure in idiopathic nonobstructive azoospermia(iNOA).We studied 193 patients with nonobstructive azoospermia who underwent microsurgical testicular sperm extraction.The Chi-square test and Mann–Whitney U tests for clinical parameters and seminiferous tubule distribution were used for between-group comparisons.A logistic regression analysis was conducted to identify predictors of retrieval failure.Area under the receiver operating characteristic curve for each variable was evaluated,and the net clinical benefit was calculated using a clinical decision curve.Patients with iNOA had a lower sperm retrieval rate than those with known causes.Moreover,testicular volume was an independent factor affecting sperm extraction outcomes(odds ratio=0.79,P<0.05).The testicular volume cut-off value was 6.5 ml(area under the curve:0.694).The patients with iNOA were categorized into two groups on the basis of the distribution of seminiferous tubules observed.The sperm retrieval rate and testicular volume were significantly different between the groups with a uniform or heterogeneous tubule distribution.There was also a significant association between a uniform tubule distribution and testicular volume.In conclusion,a testicular volume of more than 6.5 ml effectively predicts microsurgical testicular sperm extraction failure due to a uniform tubule distribution in patients with iNOA.

Clinical characteristics of testicular torsion and factors influencing testicular salvage in children:A 12-year study in tertiary center

BACKGROUND Testicular torsion is the most common acute scrotum worldwide and mainly occurs in children and adolescents.Studies have demonstrated that the duration of symptoms and torsion grade lead to different outcomes in children diagnosed with testicular torsion.AIM To predict the possibility of testicular salvage(TS)in patients with testicular torsion in a tertiary center.METHODS We reviewed the charts of 75 pediatric patients with acute testicular torsion during a 12-year period from November 2011 to July 2023 at the Suzhou Hospital of Anhui Medical University.Univariate and multivariate logistic regression analyses were used to determine independent predictors of testicular torsion.The data included clinical findings,physical examinations,laboratory data,color Doppler ultrasound findings,operating results,age,presenting institution status,and follow-up results.RESULTS Our study included 75 patients.TS was possible in 57.3%of all patients;testicular torsion occurred mostly in winter,and teenagers aged 11-15 years old accounted for 60%.Univariate logistic regression analyses revealed that younger age(P=0.09),body mass index(P=0.004),torsion angle(P=0.013),red blood cell count(P=0.03),neutrophil-to-lymphocyte ratio(P=0.009),and initial presenting institution(P<0.001)were associated with orchiectomy.In multivariate analysis,only the initial presenting institution predicted TS(P<0.05).CONCLUSION The initial presenting institution has a predictive value for predicting TS in patients with testicular torsion.Children with scrotal pain should be admitted to a tertiary hospital as soon as possible.

Outcomes of surgical correction of Peyronie’s disease with plaque excision and grafting: Comparison of testicular tunica vaginalis graft versus bovine pericardium graft

Objective:Peyronie’s disease(PD)is an abnormal wound healing in the penile tunica albuginea.After fibrotic plaque excision,different graft materials have been used to repair the defects,but the optimal graft remains unknown.This study aimed to compare the functional outcomes of testicular tunica vaginalis grafts and bovine pericardium grafts in patients with severe PD.Methods:A retrospective comparative study was conducted on 33 PD patients undergoing partial plaque excision and grafting from September 2015 to May 2021.The patients were divided into two groups depending on the type of graft used.For 15 patients in Group B,testicular tunica vaginalis grafts were used to repair the defect,while for 18 patients in Group A,bovine pericardium grafts were used.Data of the patient’s age,comorbidities,sexual function,penile curvature,postoperative complications,need for further treatment,change in penile length,and satisfaction were gathered and compared between the groups.Sexual function was evaluated using the 5-item version of the International Index of Erectile Function(IIEF-5),and a functional less than 20-degree penile curvature after surgery was considered a successful intervention.Results:There was no difference in age,comorbidities,degree of curvature,perioperative IIEF-5,operative time,plaque size,or complication rates.After surgery,a statistically significant improvement in curvature degree(p<0.05)and satisfactory penile appearance(p<0.05)were seen in both groups without any superiority between the two groups(p=0.423 and p=0.840,respectively).With a 30-month follow-up,the IIEF-5 was consistent in both groups,with no statistical significance between the groups(p=0.492).The main change in penile length during the operation was increased and still positive in the last follow-up in both groups without statistical significance(p=0.255 and p=0.101,respectively).Conclusion:Partial plaque excision and corporoplasty with both testicular tunica vaginalis or bovine pericardium grafts are equally effective in treating males with clinically significant PD.

Robotic-assisted retroperitoneal lymph node dissection for stage II testicular cancer

Objective:To evaluate the perioperative as well as early oncological outcomes of patients undergoing robotic retroperitoneal lymph node dissection for treatment of testicular cancer.Methods:We conducted a prospective consecutive case series of patients undergoing robotic assisted retroperitoneal lymph node dissection for metastatic testicular cancer between May 2018 and July 2021 at our institution.Data were collected on patient and tumour characteristics,intraoperative and postoperative parameters,and functional and oncological outcomes.Descriptive statistics are presented.Results:Nineteen patients were identified;18(94.7%)completed the procedure robotically and one was converted to open surgery;78.9%of patients had stage≥IIB and 12(63.2%)patients had undergone prior chemotherapy.The median operative time was 300(interquartile range[IQR]240-315)min.Median blood loss was 100(IQR 50-175)mL.Median length of stay was 2(range 1-11)days.All robotically completed patients commenced diet and passed flatus on Day 1 and were discharged by Day 3.The median lymph node yield was 40.5(IQR 38-51)nodes.All patients undergoing nerve-sparing procedures recovered antegrade ejaculatory function.One patient had a Clavien-Dindo III complication(chylous ascites requiring drainage).At a median follow-up of 22.3(IQR 16.3-24.9)months,one patient developed retroperitoneal recurrence,which was successfully treated with second-line chemotherapy;no other patients have had recurrences.Conclusion:Robotic retroperitoneal lymph node dissection is a safe and feasible alternative to open surgery in appropriately selected patients,offering low morbidity.Early oncological outcomes are promising.Larger cohorts and longer follow-ups are required to validate our institution's findings.

Awareness, Practice and Intention to Practice Testicular Self-Examination among Professional Working Males in Ghana

Background: The aetiology of Testicular Cancer (TC) is still unknown to researchers but many of the associated risk factors have been identified. These include family history, age, racial origin, cryptorchidism, urogenital malformations, testicular atrophy, and infertility. Given the lack of scientific data on the causes of the disease, it has been asserted in previous studies that the promotion of awareness and early detection are prerequisites to mitigating risks of metastasis as well as improving survival. This study is to assess the awareness, practice, and intention to practice testicular self-examination among professional working males in Accra. Methods: A quantitative cross-sectional design with a structured research instrument was used to collect data from respondants. The purposive and convenience sampling techniques were used to collect data from 300 men at Accra in Ghana. The study was conducted at two (2) Universities and a Senior High school at Accra in Ghana. The data was then analysed using descriptive statistics, logistic regression, multiple linear regression, and structural equation modeling. Results: From the study findings, 37% of male participants rated their knowledge of testicular self-examination and related symptoms as good, 28% of participants practised testicular self-examination monthly, while 65% of respondents expressed their intention to practice monthly testicular self-examination. The findings from logistic regression demonstrated that level of education, age, and marital status of participants had a significant influence on testicular self-examination. Additionally, the multiple linear regression results revealed knowledge and self-efficacy significantly predict testicular self-examination intention. The path coefficient results from the structural equation model are consistent with results from the regression models. Conclusion: This research is the first to investigate testicular self-examination among men in Ghana. The findings revealed awareness and practice of TSE are low among participants. Therefore, the research findings would improve the expertise of physicians and nurses in providing counsel, intervention, and support for patients at risk of testicular cancer.

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.

Exploring the effect and mechanisms of Epimedium on diabetic testicular injury using network pharmacology,molecular docking,and cell experiments

Background:Studying the potential targets and mechanisms of Epimedium for anti-diabetic testicular injury using network pharmacology,molecular docking,and cell experiments.Methods:Acquisition of major components and targets of Epimedium was based on TCMSP,TCMID,and Symmap databases and retrieval of diabetic testicular injury targets by OMIM,GeneCards,Pharmgkb,and Drugbank databases.Intersecting targets were obtained from the Venny 2.1.0 database and input SRTING data to construct a protein-protein interaction(PPI)network,and key targets were screened in Cytoscape 3.8.0 software.Then the Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses of intersecting targets were conducted through the DAVID database.Further,AutoDock software was used to verify docking between the main components and the core target proteins.In addition,a Cell Counting Kit-8(CCK-8)assay was used to determine the survival effect of quercetin,the main component of Epimedium,on TM4 sertoli-like cells exposed to palmitic acid(PA).Results:Quercetin,kaempferol and luteolin in epimedium were identified as the main components in the treatment of diabetic testicular injury.It has core target proteins including MMP9,AKT1,and TNF.The biological process mainly involves the regulation of the apoptotic signaling pathway.The key pathways of KEGG are the AGE-RAGE signaling pathway in diabetic complications,PI3K-Akt and MAPK signaling pathway.Molecular docking results showed that quercetin had the strongest binding ability to MMP9.Also,PA-challenged cells had a lower survival rate,which was alleviated by the administration of quercetin.Conclusion:Our findings suggest that Epimedium attenuates diabetes mellitus(DM)-induced testicular injury through AGE-RAGE,PI3K-Akt and MAPK signaling pathway.These insights offer a potential therapeutic strategy for managing DM-induced testicular injury,will be the basis for future clinical research.

Management of Testicular Cancers in Brazzaville

Introduction: Testicular cancer accounts for 5% of urological tumors, predominantly affecting young men. The aim of our study was to report the diagnostic and evolutionary aspects of testicular cancer cases treated in our center. Patients and Methods: A retrospective study conducted over a 15-year period involving 12 patients treated for testicular cancer at the University Hospital of Brazzaville. Results: The median age was 31 years (range 11 to 49 years), with a median consultation delay of 10.6 months (range 3 to 27 months). Scrotal mass was the most common reason for consultation. Cancer was bilateral in two patients. Two patients were admitted with metastatic disease. Histopathological examination favored germ cell tumors in 7 cases, two cases of non-Hodgkin’s malignant lymphoma, and one case of epididymo-testicular adenocarcinoma. Adjuvant chemotherapy resulted in complete remission in patients with germ cell tumors. However, neoadjuvant chemotherapy was not effective in patients admitted with advanced-stage disease. Conclusion: Testicular cancer is a rare condition that is curable in the majority of cases, but its management is often complicated in our setting due to delayed diagnosis caused by taboos surrounding genital organ pathologies.

Open Scrotal Trauma Complicated by Testicular Evisceration: An Unusual Injury after a Brawl in 2 Cases

Background: Scrotal trauma is a rare injury, and can compromise reproductive function. If in closed trauma, a morphological assessment of the lesion is usually necessary before treatment, in open trauma otherwise, namely in the case of testicular evisceration, surgical exploration is the rule. Objective: To present the management of open scrotal trauma. Case Presentation: These were two adults aged 42 and 63, admitted for post-traumatic testicular evisceration. One of the patients presented with signs of infection due to a diagnosis delay. Management consisted on surgical exploration, with scrotal debridement and testicular reintegration. The evolution was favourable. Conclusion: Open scrotal trauma is a rare lesion that can cause testicular evisceration. It requires surgical exploration, which should be systematic.

Normozoospermic versus teratozoospermic domestic cats： differential testicular volume, sperm morphometry, and subpopulation structure during epididymal maturation

Teratozoospermia （〈40% morphologically normal spermatozoa/ejaculate） is a frequent phenomenon in feline species. This research was carried out to study the possible differences in testicular volume, differential sperm morphometric traits, and potential differences regarding the sperm subpopulational structure during epididymal sperm maturation in teratozoospermic feline donors. Epididymal sperm samples were collected from the caput （R1）, corpus （R2）, and cauda （R3） epididymidis in two donor groups （N： normozoospermic; T： teratozoospermic）. Aliquots were assessed for concentration, viability, motility, and acrosomal integrity. Sperm morphometric descriptors from CASA-Morph analysis were analyzed by the Principal Component Analysis （PCA） and clustering analyses. Irrespective of the group analyzed, PCA revealed two Principal Components （PCs） for each epididymal region explaining more than the 93% of the variance. Surprisingly, the number of subpopulations remained constant in regions R1-R2-R3 irrespective of the donor group analyzed. However, the distribution of these subpopulations was found to be structurally different and strongly influenced by the epididymal region and the donor group. In conclusion, testicular morphometry and the sperm subpopulation structure were different in N and T donors. The alterations in subpopulations during epididymal maturation could be used as a potential clinical indicator of teratozoospermic individuals since an important influence of teratozoospermia on sperm subpopulation structure has been demonstrated.

Testicular volume in infertile versus fertile white-European men: a case-control investigation in the real-life setting

Testicular volume(TV)is considered a good clinical marker of hormonal and spermatogenic function.Accurate reference values for TV measures in infertile and fertile men are lacking.We aimed to assess references values for TV in white-European infertile men and fertile controls.We analyzed clinical and laboratory data from 1940(95.0%)infertile men and 102(5.0%)fertile controls.Groups were matched by age using propensity score weighting.TV was assessed using a Prader orchidometer(PO).Circulating hormones and semen parameters were investigated in every male.Descriptive statistics,Spearman's correlation,and logistic regression models tested potential associations between PO-estimated TV values and clinical variables.Receiver operating characteristic(ROC)curves were used to find TV value cutoffs for oligoasthenoteratozoospermia(OAT)and nonobstructive azoospermia(NOA)status in infertile men.The median testicular volume was smaller in infertile than that of fertile men(15.0 ml vs 22.5 ml;P<0.001).TV positively correlated with total testosterone,sperm concentration,and progressive sperm motility(all P≤0.001)in infertile men.At multivariable logistic regression analysis,infertile status(P<0.001)and the presence of left varicocele(P<0.001)were associated with TV<15 ml.Testicular volume thresholds of 15 ml and 12 ml had a good predictive ability for detecting OAT and NOA status,respectively.In conclusion,infertile men have smaller testicular volume than fertile controls.TV positively correlated with total testosterone,sperm concentration,and progressive motility in infertile men,which was not the case in the age-matched fertile counterparts.

Testicular volume and clinical correlates of hypothalamic–pituitary–testicular function:A cross-sectional study in obese men

The aim of this study was to determine whether testicular volume is correlated with clinical and biochemical markers of hypothalamic–pituitary–testicular(HPT)axis function.This was a cross-sectional substudy of a larger randomized controlled trial including obese men,body mass index(BMI)≥30 kg m−2,with a total testosterone level<12 nmol l−1.Testicular volume was measured by orchidometer,testosterone by liquid chromatography/tandem mass spectrometry,and body composition by dual-energy X-ray absorptiometry.Men completed the Aging Males'Symptoms(AMS)score,International Index of Erectile Function-5(IIEF-5),physical function,and handgrip dynamometer testing.Eighty-nine men participated with a median(interquartile range[IQR])age of 53.1(47.6,59.2)years,BMI of 37.0(34.6,40.5)kg m−2,and a total testosterone of 7.0(6.1,7.9)nmol l−1.Median testicular volume was 18(IQR:10,20)ml.Testicular volume was negatively correlated with BMI(τ=−0.1952,P=0.010)and total fat mass(τ=−0.2115,P=0.005)independent of age and testosterone.When BMI,testosterone,sex hormone-binding globulin(SHBG),and luteinizing hormone(LH)were present in a multivariable model,only BMI(-0.38 ml change in testicular volume per 1 kg m-2BMI;95%CI:−0.74,−0.02;P=0.04)and LH(-0.92 ml change in testicular volume per 1 IU l-1 LH;95%CI:−1.75,−0.095;P=0.03)remained independent significant predictors of testicular volume.Testicular volume was positively correlated with IIEF-5(τ=0.2092,P=0.021),but not related to handgrip strength,physical function tests,or AMS.In obese men,testicular volume is inversely and independently associated with measures of adiposity,but not with most clinical or biochemical markers of HPT axis action.From a clinical perspective,this suggests that obesity might compromise the reliability of reduced testicular volume as a sign of androgen deficiency in men.

Effects of percutaneous varicocele repair on testicular volume:results from a 12-month follow-up

Varicocele is a comm on fin ding in men. Varicocele correcti on has bee n advocated for young patients with testicular hypotrophy, but there is a lack of morphofunctional follow-up data. We assessed whether percutaneous treatment of left varicocele is associated with testicular "catch-up growth" in the following 12 months by retrospectively reviewing data from an electronic database of 10 656 patients followed up in our clinic between 2006 and 2016. We selected all young adults (<35 years) with left varicocele who un derwe nt percuta neous treatment, had a minimum of 12 mon ths' ultraso und imagi ng follow-up, and had no other con ditions affecting testicular volume. One hundred and fourteen men (mean±standard deviation [s.d.] of age: 22.8 ± 5.4 years) met the inclusion and exclusion criteria. Left testicular hypotrophy (LTH), defined as a >20% difference between left and right testicular volume at baseline, was observed in 26 (22.8%) men. Participants with LTH (mean±s.d.: 14.5 ± 2.7 ml) had lower baseline testicular volume compared to those without LTH (mean±s.d.: 15.7 ± 3.8 ml;P= 0.032). Repeated measures mixed models showed a sign ifica nt in teraction betwee n LTH and time posttreatme nt when correcting for baseli ne left testicular volume (β= 0.114, 95% confidence interval [Cl]: 0.018-0.210, P=0.020), resulting in a catch-up growth of up to 1.37 ml per year (95% Cl: 0.221- 2.516). Age at intervention was also associated with reduced testicular volume (-0.072 ml per year, 95% Cl:-0.135--0.009;P = 0.024). Percutaneous treatment of left varicocele in young adults with LTH can result in catch-up growth over 1 year of follow-up. The reproductive and psychological implicati ons of these findings n eed to be confirmed in Ion ger and larger prospective studies.

Testicular pain originating from lumbar disc degeneration:A case report

BACKGROUND Testicular pain caused by lumbar disease is uncommon in the clinic.Here we reported a case of discogenic low back pain with testicular pain that was successfully cured.CASE SUMMARY A 23-year-old male patient presented to our department with chronic low back pain.Based on his clinical symptoms,signs and imaging,he was diagnosed with discogenic low back pain.Since conservative treatment for more than half a year did not significantly improve his low back pain,we decided to treat it with intradiscal methylene blue injection.During the course of surgery,we again identified the low back pain as originating from the degenerated lumbar disc by analgesic discography.Interestingly,the patient’s low back pain disappeared along with the testicular pain that had been present for more than 3 mo.After the operation,the patient’s low back pain improved,and the testicular pain did not reappear.CONCLUSION Intradiscal methylene blue injection is a convenient and effective surgical intervention for the treatment of discogenic low back pain.Lumbar disc degeneration may also be a possible clinical cause of testicular pain.Methylene blue injection in the diseased disc improved the low back pain,and the accom-panying testicular pain was successfully managed.

Plantain-based diet modulates atrazine-induced testicular toxicities in rats

Objective:To assess the potential of plantain-based diet in modulating testicular toxicities in rats exposed to atrazine.Methods:The plantain-based diet at 50%,25% and 12.5% were prepared from the basal diet by substituting the corn starch with plantain fruit pulp flour at different percentages.Wistar rats were fed plantain-based diet in varying concentrations ranging from 12.5% to 50% of the basal diet for 21 days before or after atrazine treatment in a two-phase experiment:preventive and therapeutic phases.The therapeutic model(n=35)had seven groups with 5 rats each,including the control,atrazine,atrazine recovery,atrazine plus plantain-based diet 50%,25%,12.5%,and atrazine plus quercetin groups.The preventive model(n=30)had six groups of 5 rats,consisting of the control,atrazine,50%,25%,12.5% plantain-based diet plus atrazine,and quercetin plus atrazine groups.Gonadal hormones(testosterone,luteinizing hormone and follicle-stimulating hormone),sperm parameters(sperm motility,viability,morphology and concentration),and testicular function indices(protein,cholesterol,glycogen,acid phosphatase,alkaline phosphatase and lactate dehydrogenase)were measured.Results:The gonadal hormones,sperm characteristics,and testicular function indices of the rat testis decreased significantly in the atrazine group alongside degeneration of the histoarchitecture.However,plantain-based diet restored the gonadal hormone concentrations,semen parameters,and testicular function indices in both the preventive and therapeutic models.Conclusions:Treatment with plantain-based diet protects against rat testicular toxicity caused by atrazine via the modulation of gonadal hormones,sperm quality,testicular function index as well as histoarchitecture of rat testes.

Transcatheter embolization for hemorrhage from aberrant testicular artery after partial nephrectomy:A case report

BACKGROUND Arterial bleeding typically involves the renal artery following partial nephrectomy;in this study,we present a case of bleeding originating from the testicular artery that has not been reported in previous studies.CASE SUMMARY A 52-year-old man suffered hemorrhage from a perinephric branch of the aberrant left testicular artery after an open nephron-sparing surgery for renal cell carcinoma.Clinical signs of bleeding were manifested by the patient,such as fresh blood drainage from the catheter,decreased hemoglobin levels,and significant vital sign changes.Since computed tomography did not show evidence of active bleeding,transcatheter angiography was conducted to identify the bleeding site.Fluoroscopic spot images confirmed bleeding derived from a perinephric branch of the testicular artery originating from the segmental artery of the left renal artery.Using n-butyl-2-cyanoacrylate,successful transcatheter arterial embolization of the affected branch was performed.Immediately after the embolization procedure,the bleeding ceased,and the patient experienced complete recovery devoid of complications.CONCLUSION In patients with postoperative arterial hemorrhage after partial nephrectomy,the testicular artery can be a rare but notable source of bleeding.Accurate bleeding site localization via angiographic evaluation,followed by transcatheter arterial embolization,can be instrumental for safe,prompt,and effective hemostasis.