Minimal access surgery to stage early ovarian cancer (EOC) is still regarded as an investigation among many gynecologic oncologists. This is a case of comprehensive laparoscopic surgical stage of an ovarian dysgermino...Minimal access surgery to stage early ovarian cancer (EOC) is still regarded as an investigation among many gynecologic oncologists. This is a case of comprehensive laparoscopic surgical stage of an ovarian dysgerminoma in a 10-year-old girl described. This patient was referred to the gynecology oncology unit status post left salpingo-oophorectomy through a midline incision when the histopathology showed pure dysgerminoma. We then performed the laparoscopic stage including peritoneal washing;resection of the left infundibulopelvic ligament;systematic pelvic, common iliac, and infrarenal bilateral paraaortic lymphadenectomy;and omentectomy. The uterus and right adnexum were spared to preserve future fertility. The final histopathology showed no metastatic disease (stage ovarian dysgerminoma), and patient has no evidence of recurrence after 52 months follow up. Conclusion: This is the youngest patient reported in the literature with a comprehensive laparoscopic surgical stage for ovarian neoplasm. A full laparoscopic staging for ovarian cancer in a 10-year-old girl is safe and might be considered as an alternative to the stander of care.展开更多
Patients with azoospermia show a prevalence of varicocele of 10.9%and a 14.8%contribution to male infertility.Patients with azoospermia are thought to produce high-quality semen following varicocele treatment.Advising...Patients with azoospermia show a prevalence of varicocele of 10.9%and a 14.8%contribution to male infertility.Patients with azoospermia are thought to produce high-quality semen following varicocele treatment.Advising varicocelectomy prior to sperm retrieval in a reproductive program is still debated.This study reviewed the impact of varicocele repair on male infertility using several factors.A literature search was conducted using Scopus,PubMed,Embase,the Wiley Online Library,and Cochrane databases.Sperm concentration,sperm progression,overall sperm motility,sperm morphology,and follicle-stimulating hormone(FSH)and luteinizing hormone(LH)levels were also compared.Outcomes were compared between those who received treatment for varicocele and those who did not.The data from the pooled analysis were presented as standardized mean difference(SMD)along with a 95%confidence interval(CI).Heterogeneity was evaluated using I2.Additionally,we conducted analyses for publication bias,sensitivity,and subgroup analysis as appropriate.Nine studies were included after screening relevant literature.Statistical analysis revealed a significant improvement in sperm concentration(SMD:1.81,95%CI:0.84–2.77,P<0.001),progressive sperm motility(SMD:4.28,95%CI:2.34–6.22,P<0.001),and sperm morphology(SMD:3.59,95%CI:2.27–4.92,P<0.001).Total sperm motility showed no significant difference following varicocele repair(SMD:0.81,95%CI:−0.61–2.22,P=0.26).No significant differences were seen in serum FSH(SMD:0.01,95%CI:−0.16–0.19,P=0.87)and LH(SMD:0.19,95%CI:−0.01–0.40,P=0.07)levels as well.This study supports varicocele repair in infertile men with clinical varicocele,as reflected by the improvement in sperm parameters after varicocelectomy compared with no treatment.There were no significant improvements in serum FSH and LH levels.展开更多
文摘Minimal access surgery to stage early ovarian cancer (EOC) is still regarded as an investigation among many gynecologic oncologists. This is a case of comprehensive laparoscopic surgical stage of an ovarian dysgerminoma in a 10-year-old girl described. This patient was referred to the gynecology oncology unit status post left salpingo-oophorectomy through a midline incision when the histopathology showed pure dysgerminoma. We then performed the laparoscopic stage including peritoneal washing;resection of the left infundibulopelvic ligament;systematic pelvic, common iliac, and infrarenal bilateral paraaortic lymphadenectomy;and omentectomy. The uterus and right adnexum were spared to preserve future fertility. The final histopathology showed no metastatic disease (stage ovarian dysgerminoma), and patient has no evidence of recurrence after 52 months follow up. Conclusion: This is the youngest patient reported in the literature with a comprehensive laparoscopic surgical stage for ovarian neoplasm. A full laparoscopic staging for ovarian cancer in a 10-year-old girl is safe and might be considered as an alternative to the stander of care.
文摘Patients with azoospermia show a prevalence of varicocele of 10.9%and a 14.8%contribution to male infertility.Patients with azoospermia are thought to produce high-quality semen following varicocele treatment.Advising varicocelectomy prior to sperm retrieval in a reproductive program is still debated.This study reviewed the impact of varicocele repair on male infertility using several factors.A literature search was conducted using Scopus,PubMed,Embase,the Wiley Online Library,and Cochrane databases.Sperm concentration,sperm progression,overall sperm motility,sperm morphology,and follicle-stimulating hormone(FSH)and luteinizing hormone(LH)levels were also compared.Outcomes were compared between those who received treatment for varicocele and those who did not.The data from the pooled analysis were presented as standardized mean difference(SMD)along with a 95%confidence interval(CI).Heterogeneity was evaluated using I2.Additionally,we conducted analyses for publication bias,sensitivity,and subgroup analysis as appropriate.Nine studies were included after screening relevant literature.Statistical analysis revealed a significant improvement in sperm concentration(SMD:1.81,95%CI:0.84–2.77,P<0.001),progressive sperm motility(SMD:4.28,95%CI:2.34–6.22,P<0.001),and sperm morphology(SMD:3.59,95%CI:2.27–4.92,P<0.001).Total sperm motility showed no significant difference following varicocele repair(SMD:0.81,95%CI:−0.61–2.22,P=0.26).No significant differences were seen in serum FSH(SMD:0.01,95%CI:−0.16–0.19,P=0.87)and LH(SMD:0.19,95%CI:−0.01–0.40,P=0.07)levels as well.This study supports varicocele repair in infertile men with clinical varicocele,as reflected by the improvement in sperm parameters after varicocelectomy compared with no treatment.There were no significant improvements in serum FSH and LH levels.
