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Journal of Clinical Pathology May 1994A 30 year old man with a 20 year history of chronic renal failure who presented with a testicular lesion is described. The lesional pathology, secondary oxalosis, and...
A 30 year old man with a 20 year history of chronic renal failure who presented with a testicular lesion is described. The lesional pathology, secondary oxalosis, and associated sperm granuloma of the epididymis was clinically considered to be an intrascrotal tumour. The oxalate crystal deposition was present within the rete testis, the ductuli efferents, and the epididymis along with sperm granulomata. This seems to be a rare complication of secondary oxalosis associated with chronic renal failure and having both clinical and pathological implications.
Topics: Adult; Calcium Oxalate; Epididymis; Granuloma; Humans; Kidney Failure, Chronic; Male; Spermatozoa; Testicular Diseases
PubMed: 8027405
DOI: 10.1136/jcp.47.5.470 -
Andrology Jan 2014Vasectomy reversal involves either vasovasostomy (VV) or epididymovasostomy (EV), and rates of epididymal obstruction and EV increase with time after vasectomy. However,...
Vasectomy reversal involves either vasovasostomy (VV) or epididymovasostomy (EV), and rates of epididymal obstruction and EV increase with time after vasectomy. However, as older vasectomies may not require EV for successful reversal, we hypothesized that sperm production falls after vasectomy and can protect the system from epididymal blowout. Our objective was to define how the need for EV at reversal changes with time after vasectomy through a retrospective review of consecutive reversals performed by three surgeons over a 10-year period. Vasovasotomy was performed with Silber score 1-3 vasal fluid. EVs were performed with Silber score 4 (sperm fragments; creamy fluid) or 5 (sperm absence) fluid. Reversal procedure type was correlated with vasectomy and patient age. Post-operative patency rates, total spermatozoa and motile sperm counts in younger (<15 years) and older (>15 years) vasectomies were assessed. Simple descriptive statistics determined outcome relevance. Among 1229 patients, 406 had either unilateral (n = 252) or bilateral EV's (n = 154) constituting 33% (406/1229) of reversals. Mean patient age was 41.4±7 years (range 22-72). Median vasectomy interval was 10 years (range 1-38). Overall sperm patency rate after reversal was 84%. The rate of unilateral (EV/VV) or bilateral EV increased linearly in vasectomy intervals of 1-22 years at 3% per year, but plateaued at 72% in vasectomy intervals of 24-38 years. Sperm counts were maintained with increasing time after vasectomy, but motile sperm counts decreased significantly (p < 0.001). Pregnancy, secondary azoospermia, varicocoele and sperm granuloma were not assessed. In conclusion, and contrary to conventional thinking, the need for EV at reversal increases with time after vasectomy, but this relationship is not linear. EV rates plateau 22 years after vasectomy, suggesting that protective mechanisms ameliorate epididymal 'blowout'. Upon reversal, sperm output is maintained with time after vasectomy, but motile sperm counts decrease linearly, suggesting epididymal dysfunction influences semen quality after reversal.
Topics: Adult; Aged; Epididymis; Humans; Male; Middle Aged; Retrospective Studies; Semen Analysis; Sperm Count; Sperm Motility; Spermatozoa; Vas Deferens; Vasectomy; Vasovasostomy; Young Adult
PubMed: 24243789
DOI: 10.1111/j.2047-2927.2013.00143.x -
British Medical Journal Jan 1977
Topics: Antibody Formation; Humans; Male; Spermatozoa; Vasectomy
PubMed: 837080
DOI: 10.1136/bmj.1.6056.290-a -
Fertility and Sterility Apr 1978
Topics: Genital Diseases, Male; Granuloma; Humans; Male; Spermatozoa; Vas Deferens; Vasectomy
PubMed: 648655
DOI: No ID Found -
International Braz J Urol : Official... 2019
Topics: Epididymis; Granuloma; Humans; Male; Middle Aged; Spermatozoa; Testicular Diseases; Ultrasonography
PubMed: 30901170
DOI: 10.1590/S1677-5538.IBJU.2018.0676 -
Journal of Cell Science Mar 2009The epididymis is a highly convoluted tubule that connects the testis with the vas deferens, and in which mammalian sperm acquire the ability to fertilize eggs. The most...
The epididymis is a highly convoluted tubule that connects the testis with the vas deferens, and in which mammalian sperm acquire the ability to fertilize eggs. The most proximal portion of the epididymis, or initial segment, secretes numerous factors that are critical for sperm maturation and storage. One such factor is SED1 (also known as MFG-E8) a bi-motif protein composed of two N-terminal EGF domains, the second of which contains an RGD motif, and two C-terminal discoidin domains (also known as F5/8 type C domains). Previous studies have reported that SED1 is secreted into the epididymal lumen, where it coats sperm and later facilitates sperm-egg binding. Herein, we report that SED1-null males also harbor unexpected epididymal pathologies, including detached epithelia and spermatic granulomas. We therefore examined whether SED1 has a tissue-intrinsic role in the epididymis, in addition to its role in sperm-egg adhesion. Improved fixation protocols revealed that SED1 is found in the basolateral domains of epididymal epithelial cells in vivo, and similarly, SED1 is secreted both apically and basally from polarized epididymal cells in vitro. The basolateral distribution of SED1 suggests that it may play a novel role in epididymal cell adhesion. Consistent with this, in vitro assays showed that SED1 supports epididymal cell adhesion via RGD binding to alphaV integrin receptors on epididymal epithelial cells. Finally, epididymal cells from SED1-null males showed reduced adhesion in vitro, a phenotype that can be rescued with exogenous SED1. These results suggest that SED1 facilitates epididymal cell adhesion, and that its loss leads to breakdown of the epididymal epithelium and consequent development of spermatic granulomas.
Topics: Animals; Antibodies, Blocking; Cell Adhesion; Cell Polarity; Epididymis; Epithelial Cells; Granuloma; Integrin alphaV; Integrin beta Chains; Male; Membrane Proteins; Mice; Models, Biological; Oligopeptides; Protein Subunits; Recombinant Proteins; Seminiferous Tubules; Spermatic Cord
PubMed: 19240116
DOI: 10.1242/jcs.041731 -
Journal of the American Veterinary... May 2018
Topics: Animals; Breeding; Cattle; Cattle Diseases; Diagnosis, Differential; Granuloma; Lameness, Animal; Male; Orchiectomy; Sperm Count; Testicular Neoplasms; Ultrasonography
PubMed: 29701522
DOI: 10.2460/javma.252.10.1217 -
Journal of the American Association For... Nov 2023Sterility in male NHP has long been achieved through surgical castration or vasectomy. However, these techniques are irreversible, require a surgical procedure, and have...
Sterility in male NHP has long been achieved through surgical castration or vasectomy. However, these techniques are irreversible, require a surgical procedure, and have potential consequences such as sperm granulomas and long recovery time. Deslorelin is a gonadotropin-releasing hormone agonist that temporarily and reversibly suppresses sex hormone secretion. Our goal in this study was to investigate the effects of deslorelin on testosterone secretion and testicular volume in male rhesus macaques (). Male macaques ( = 4) each received two, 4.7-mg deslorelin implants subcutaneously in the interscapular region. Serum testosterone and testicular volume were then monitored at specific time points until 10 mo after treatment. Testosterone suppression was defined as testosterone levels lower than 0.6 ng/mL for a sustained period of at least 30 d. After implantation, mean testicular volume was significantly reduced by day 121. Testosterone suppression was observed in all subjects. However, the time from implantation to testosterone suppression and duration of suppression varied. Two macaques were hormonally suppressed by day 26 after implantation and remained suppressed for at least 6 mo. The other 2 macaques were hormonally suppressed by 2 mo after implantation; of these two, one remained suppressed for 70 days while the other was suppressed for at least 245 days. We conclude that deslorelin can safely suppress testosterone secretion in male rhesus macaques, but individual variation in onset and duration of action should be considered when establishing reimplantation time points and potential return to reproductive activity.
Topics: Male; Animals; Testis; Gonadotropin-Releasing Hormone; Macaca mulatta; Testosterone; Semen; Drug Implants; Triptorelin Pamoate
PubMed: 37844997
DOI: 10.30802/AALAS-JAALAS-22-000116 -
Fertility and Sterility Feb 1978
Review
Topics: Animals; Antibodies; Epididymis; Female; Fertility; Granuloma; Humans; Male; Microsurgery; Pregnancy; Prospective Studies; Sperm Transport; Spermatogenesis; Spermatozoa; Sterilization Reversal; Testis; Vasectomy
PubMed: 342283
DOI: 10.1016/s0015-0282(16)43088-8 -
Canadian Urological Association Journal... Nov 2007Advances in surgical techniques have improved the outcome of microsurgical vasovasostomy (VV). We performed a retrospective analysis of surgical procedures to determine...
OBJECTIVES
Advances in surgical techniques have improved the outcome of microsurgical vasovasostomy (VV). We performed a retrospective analysis of surgical procedures to determine outcomes and predictors of VV success, to develop Kaplan-Meier Curves for predicting VV outcomes and to evaluate the use of alpha-glucosidase (AG) to predict outcomes.
PATIENTS AND METHODS
We undertook a retrospective analysis of 747 modified 1-layer microsurgical VV procedures performed between 1984 and 2000. Obstructive interval, partner status, social status preoperatively and method of vasal obstruction, vasal fluid quality and sperm granuloma intraoperatively were compared with outcome results. Parameters evaluated at follow-up included semen analysis, AG concentration in ejaculate fluid and pregnancy rates.
RESULTS
The overall patency rate was 86% and pregnancy rates were 33% and 53% at 1 and 2 years after primary VV, respectively. Preoperative factors associated with successful outcome and pregnancy included shorter obstructive interval and same female partner (p < 0.05). Intraoperative factors predicting success included the use of surgical clips instead of suture at vasectomy, the presence of a sperm granuloma, the presence and quality of vasal fluid, and the presence and quality of sperm in vasal fluid. Further, increased AG in the postoperative semen predicted improved patency and pregnancy outcomes.
CONCLUSION
This study confirms the effectiveness of VV for vasectomized men who wish to father children. It also demonstrates that preoperative and intraoperative factors are predictive of the VV outcome. Postoperative AG is also a useful marker of patency and it appears to predict pregnancy outcome.
PubMed: 18542824
DOI: 10.5489/cuaj.454