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Asian Journal of Andrology Nov 2023Vasectomy damage is a common complication of open nonmesh hernia repair. This study was a retrospective analysis of the characteristics and possible causes of vas...
Vasectomy damage is a common complication of open nonmesh hernia repair. This study was a retrospective analysis of the characteristics and possible causes of vas deferens injuries in patients exhibiting unilateral or bilateral vasal obstruction caused by open nonmesh inguinal herniorrhaphy. The site of the obstructed vas deferens was intraoperatively confirmed. Data, surgical methods, and patient outcomes were examined. The Anderson-Darling test was applied to test for Gaussian distribution of data. Fisher's exact test or Mann-Whitney U test and unpaired t-test were used for statistical analyses. The mean age at operation was 7.23 (standard deviation [s.d.]: 2.09) years and the mean obstructive interval was 17.72 (s.d.: 2.73) years. Crossed (n = 1) and inguinal ( n = 42) vasovasostomies were performed. The overall patency rate was 85.3% (29/34). Among the 43 enrolled patients (mean age: 24.95 [s.d.: 2.20] years), 73 sides of their inguinal regions were explored. The disconnected end of the vas deferens was found in the internal ring on 54 sides (74.0%), was found in the inguinal canal on 16 sides (21.9%), and was found in the pelvic cavity on 3 sides (4.1%). Location of the vas deferens injury did not significantly differ according to age at the time of hernia surgery ( ≥ 12 years or <12 years) or obstructive interval (≥15 years or <15 years). These results underscore that high ligation of the hernial sac warrants extra caution by surgeons during open nonmesh inguinal herniorrhaphy.
Topics: Male; Humans; Young Adult; Adult; Child; Vas Deferens; Herniorrhaphy; Retrospective Studies; Hernia, Inguinal; Iatrogenic Disease; Laparoscopy
PubMed: 37147939
DOI: 10.4103/aja202312 -
BMC Infectious Diseases Jan 2024To assess the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of tuberous vas deferens tuberculosis (VD TB) and improve the positive diagnostic rate of VD...
BACKGROUND
To assess the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of tuberous vas deferens tuberculosis (VD TB) and improve the positive diagnostic rate of VD TB.
METHODS
CEUS and routine ultrasound (US) images of 17 patients with tuberous VD TB confirmed by surgery, pathology, or laboratory semen examination were retrospectively analyzed and summarized, and the positive rates of both imaging techniques were compared.
RESULTS
The 19 VD lesions of the 17 patients were divided into two types according to the CEUS findings: Type I and Type II, and type II was divided into Types IIa, IIb, and IIc. Of the nodules with transverse diameters > 1 cm, 100% presented as type II. Of the nodules with transverse diameters < 1 cm, 37.5% (3/8) presented as type I and 62.5% (5/8) presented as type II. The sonographic manifestations of tuberous VD TB were hypoechoic and mixed echoic. The positive diagnostic rate was 89.5% for CEUS and 68.4% for US, but the difference was not significant (χ = 2.533; P = 0.111).
CONCLUSIONS
CEUS was able to show the blood supply characteristics of tuberous VD TB, the internal necrosis of nodules was more easily observed by CEUS than by routine US, which is helpful for the diagnosis of tuberous VD TB.
Topics: Male; Humans; Vas Deferens; Retrospective Studies; Contrast Media; Ultrasonography; Necrosis
PubMed: 38166757
DOI: 10.1186/s12879-023-08886-6 -
International Journal of Molecular... Jan 2024The increasing incidence of male infertility in humans and animals creates the need to search for new factors that significantly affect the course of reproductive...
The increasing incidence of male infertility in humans and animals creates the need to search for new factors that significantly affect the course of reproductive processes. Therefore, the aim of this study was to determine the temporospatial expression of aquaglyceroporins (AQP3, AQP7 and AQP9) in the bovine () reproductive system using immunohistochemistry and Western blotting. The study also included morphological analysis and identification of GATA-4. In brief, in immature individuals, AQP3 and AQP7 were found in gonocytes. In reproductive bulls, AQP3 was observed in spermatocytes and spermatogonia, while AQP7 was visible in all germ cells and the Sertoli cells. AQP7 and AQP9 were detected in the Leydig cells. Along the entire epididymis of reproductive bulls, aquaglyceroporins were visible, among others, in basal cells (AQP3 and AQP7), in epididymal sperm (AQP7) and in the stereocilia of the principal cells (AQP9). In males of all ages, aquaglyceroporins were identified in the principal and basal cells of the vas deferens. An increase in the expression of AQP3 in the testis and cauda epididymis and a decrease in the abundance of AQP7 in the vas deferens with age were found. In conclusion, age-related changes in the expression and/or distribution patterns of AQP3, AQP7 and AQP9 indicate the involvement of these proteins in the normal development and course of male reproductive processes in cattle.
Topics: Humans; Cattle; Male; Animals; Aquaporin 3; Aquaporins; Semen; Epididymis; Aquaglyceroporins
PubMed: 38338845
DOI: 10.3390/ijms25031567 -
BMC Zoology Aug 2023Chrysopa pallens is one of the most beneficial and effective natural predators, and is famous for its extensive distribution, wide prey spectrum, and excellent...
BACKGROUND
Chrysopa pallens is one of the most beneficial and effective natural predators, and is famous for its extensive distribution, wide prey spectrum, and excellent reproductive performance. This study examined the anatomy and fine structure of the C. pallens reproductive system and spermatogenesis.
RESULTS
The male reproductive system of C. pallens comprises a pair of testes, a vas deferens, seminal vesicles, accessory glands, and short ejaculatory ducts. The testes were already mature on the day of emergence, but the accessory glands did not mature until 5 days post-emergence. In early spermatids, the flagellum had an axoneme on one side of the two mitochondrial derivatives. The nucleus was surrounded by parallel crystalline and paracrystalline materials. The spermatid envelope extends towards the paracrystalline material in a tail-shaped wing. In mature spermatids, the axoneme is located between the two accessory bodies and mitochondrial derivative sets. The parallel-crystalline and paracrystalline materials disappeared. In the testes, the wall of seminal cysts consists of a layer of epithelium, a muscular-connective sheath, and several vesicles of different sizes. The mature seminal cysts contained 128 spermatozoa. The accessory gland is composed of six parts: ventral papilla-like protuberance, anterior glandular lobe, lateral glandular lobe, seminal cyst, posterior kidney-shaped lobe, and posterior papilla-like protuberance. Muscle fibers and secretory granules are extensive.
CONCLUSIONS
This study provides information on the reproductive system of C. pallens and offers a resource for taxonomy and reproductive biology.
PubMed: 37641154
DOI: 10.1186/s40850-023-00175-8 -
Deep Learning Model for Real‑time Semantic Segmentation During Intraoperative Robotic Prostatectomy.European Urology Open Science Apr 2024Recently, deep learning algorithms, including convolutional neural networks (CNNs), have shown remarkable progress in medical imaging analysis. Semantic segmentation,...
BACKGROUND AND OBJECTIVE
Recently, deep learning algorithms, including convolutional neural networks (CNNs), have shown remarkable progress in medical imaging analysis. Semantic segmentation, which segments an unknown image into different parts and objects, has potential applications in robotic surgery in areas where artificial intelligence (AI) can be applied, such as in AI-assisted surgery, surgeon training, and skill assessment. We aimed to investigate the performance of a CNN-based deep learning model in real-time segmentation in robot-assisted radical prostatectomy (RALP).
METHODS
Intraoperative videos of RALP procedures were obtained. The reinforcement U-Net model was used for segmentation. Segmentation of the images of instruments, bladder, prostate, and seminal vesicle-vas deferens was performed. The dataset was preprocessed and split randomly into training, validation, and test data in a 7:2:1 ratio. Dice coefficient, intersection over union (IoU), and accuracy by class, which are commonly used in medical image segmentation, were calculated to evaluate the performance of the model.
KEY FINDINGS AND LIMITATIONS
From 120 patient videos, 2400 images were selected for RALP procedures. The mean Dice scores for the identification of the instruments, bladder, prostate, and seminal vesicle-vas deferens were 0.96, 0.74, 0.85, and 0.84, respectively. Overall, when applied to the test data, the model had a mean Dice coefficient value of 0.85, IoU of 0.77, and accuracy of 0.85. Limitations included the sample size, lack of diversity in the methods of surgery, incomplete surgical processes, and lack of external validation.
CONCLUSIONS AND CLINICAL IMPLICATIONS
The CNN-based segmentation provides accurate real-time recognition of surgical instruments and anatomy in RALP. Deep learning algorithms can be used to identify anatomy within the surgical field and could potentially be used to provide real-time guidance in robotic surgery.
PATIENT SUMMARY
We demonstrate the potential effectiveness of deep learning segmentation in robotic prostatectomy procedures. Deep learning algorithms could be used to identify anatomical structures within the surgical field and may provide real-time guidance in robotic surgery.
PubMed: 38585210
DOI: 10.1016/j.euros.2024.02.005 -
Frontiers in Pediatrics 2024Zinner syndrome (ZS) is the association of seminal vesicle cysts, ipsilateral ejaculatory duct obstruction, and ipsilateral renal agenesis. This condition is very rare...
INTRODUCTION
Zinner syndrome (ZS) is the association of seminal vesicle cysts, ipsilateral ejaculatory duct obstruction, and ipsilateral renal agenesis. This condition is very rare in children and both diagnosis and treatment may be challenging. We reviewed the clinical presentation and treatment describing our experience with a series of three patients.
METHODS
From January 2016 to January 2021, three patients (patients 1, 2, and 3) with symptomatic ZS, aged 2, 15, and 17 years, respectively, were diagnosed and treated. All three patients were symptomatic, manifesting pelvic pain and dysuria. The diagnosis was made by physical examination, ultrasonography, and abdominopelvic MRI. Patient 1 underwent open surgery, while for patients 2 and 3, laparoscopic excision was performed.
RESULTS
The renal agenesis regarded the left side in patients 1 and 3, and the right side in patient 2. In all cases, the cystic complex was excised. The mean operating time was 4 h and the mean hospitalization time was 5 days (range 4-6 days). The mean follow-up period was 5 years (range 2-5 years). Patients 1 and 3 showed a complete resolution of the symptoms during postoperative follow-up. In patient 2, clinical symptoms relapsed because of the persistence of a 9 mm cyst requiring a redo laparoscopic excision.
CONCLUSIONS
Seminal vesicle cyst with ipsilateral renal agenesis, even if rare in pediatric age, should be suspected in young male patients presenting with pelvic cystic masses, pelvic pain, dysuria, and ipsilateral renal absence. Conservative management should be reversed to asymptomatic patients. Surgical treatment is mandatory in symptomatic cases and the preferred approach is minimally invasive surgery to magnify the operating field to spare anatomical structures, primarily the contralateral vas deferens. Radicality is crucial to avoid the persistence of symptoms and the need for reintervention.
PubMed: 38328345
DOI: 10.3389/fped.2024.1353960 -
Case - Vas deferens injury after herniorrhaphy leading to epididymal blowout in a pediatric patient.Canadian Urological Association Journal... Sep 2023
PubMed: 37458743
DOI: 10.5489/cuaj.8316 -
Urology Annals 2023Inflammation of the vas deferens or what known as acute vasitis is an under-reported condition that usually presents with scrotal or inguinal pain and swelling which can...
Inflammation of the vas deferens or what known as acute vasitis is an under-reported condition that usually presents with scrotal or inguinal pain and swelling which can be misdiagnosed and treated as many other conditions. Here, we present one of the first cases to be reported in the literature with bilateral manifestation. A 28-year-old male patient presented complaining of bilateral testicular and inguinal pain associated with inguinal swelling for 3 days. Initially, the patient was being evaluated as a case of incarcerated bilateral inguinal hernia, but with the aid of radiological imaging, the patient was diagnosed correctly and the unnecessary surgical intervention was prevented.
PubMed: 38074184
DOI: 10.4103/ua.ua_104_22 -
Physiological Reports May 2024The epithelial cells that line the kidneys and lower urinary tract are exposed to mechanical forces including shear stress and wall tension; however, the mechanosensors...
The epithelial cells that line the kidneys and lower urinary tract are exposed to mechanical forces including shear stress and wall tension; however, the mechanosensors that detect and respond to these stimuli remain obscure. Candidates include the OSCA/TMEM63 family of ion channels, which can function as mechanosensors and osmosensors. Using Tmem63b reporter mice, we assessed the localization of HA-tagged-TMEM63B within the urinary tract by immunofluorescence coupled with confocal microscopy. In the kidneys, HA-TMEM63B was expressed by proximal tubule epithelial cells, by the intercalated cells of the collecting duct, and by the epithelial cells lining the thick ascending limb of the medulla. In the urinary tract, HA-TMEM63B was expressed by the urothelium lining the renal pelvis, ureters, bladder, and urethra. HA-TMEM63B was also expressed in closely allied organs including the epithelial cells lining the seminal vesicles, vas deferens, and lateral prostate glands of male mice and the vaginal epithelium of female mice. Our studies reveal that TMEM63B is expressed by subsets of kidney and lower urinary tract epithelial cells, which we hypothesize are sites of TMEM63B mechanosensation or osmosensation, or both.
Topics: Animals; Female; Male; Mice; Calcium Channels; Epithelial Cells; Mechanotransduction, Cellular; Mice, Inbred C57BL; Urinary Tract; Urothelium
PubMed: 38724885
DOI: 10.14814/phy2.16043 -
Molecular Genetics & Genomic Medicine Nov 2023Isolated congenital bilateral absence of vas deferens (iCBAVD) in men results in obstructive azoospermia and is mainly caused by pathogenic variants in cystic fibrosis...
Compound heterozygous variants in CFTR with potentially reducing ATP-binding ability identified in Chinese infertile brothers with isolated congenital bilateral absence of vas deferens.
BACKGROUND
Isolated congenital bilateral absence of vas deferens (iCBAVD) in men results in obstructive azoospermia and is mainly caused by pathogenic variants in cystic fibrosis transmembrane conductance regulator (CFTR) or adhesion G protein-coupled receptor G2 (ADGRG2).
METHODS
The next-generation sequencing (NGS) was used to screen the mutations in the proband, and Sanger sequencings were performed to validate the compound heterozygous variant of CFTR in his family members. Protein structure simulation was performed to discover the potential pathological mechanism.
RESULTS
This study reported novel compound heterozygous CFTR mutations (NM:000492.4, Intron: 5T; c.3965_3969dupTTGGG: p.R1325Gfs*5) in two brothers with obstructive azoospermia. The compound heterozygous CFTR mutations were first screened out by NGS in an infertile male patient who exhibited iCBAVD from a nonconsanguineous Chinese family. Histological analysis of the testicular biopsy from this patient revealed normal spermatogenesis and mature spermatozoa were observed in the seminiferous tubules. Surprisingly, the same compound heterozygous CFTR mutations were also observed in his brothers who also exhibited iCBAVD, with their parents being a heterozygous carrier for the mutations, as verified by Sanger sequencing. Protein structure simulation revealed that these mutations potentially led to impaired ATP-binding ability of CFTR.
CONCLUSION
We identified novel compound heterozygous CFTR mutations in two brothers and summarized the literature regarding CFTR mutation and male infertility. Our study may contribute to the genetic diagnosis of iCBAVD and future genetic counseling.
Topics: Humans; Male; Azoospermia; Siblings; Cystic Fibrosis Transmembrane Conductance Regulator; East Asian People; Adenosine Triphosphate
PubMed: 37489040
DOI: 10.1002/mgg3.2249