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Veterinary Medicine and Science Sep 2023Orchiectomy with a vas deferens to pampiniform plexus ligation (VPL) is a novel method, and it is unclear how its short-term outcomes compare with the results of a...
BACKGROUND
Orchiectomy with a vas deferens to pampiniform plexus ligation (VPL) is a novel method, and it is unclear how its short-term outcomes compare with the results of a conventional method, spermatic cord ligation (SCL).
OBJECTIVE
To compare the short-term outcomes of SCL and VPL on inflammation, surgery time, bleeding, pain and surgeon satisfaction during canine open orchiectomy.
METHODS
Thirty male crossbred dogs undergoing open orchiectomy were enrolled the study. Dogs were randomly allocated to one of the SCL or VPL groups, with 15 patients in each. In the SCL group, the spermatic cord was ligated using absorbable sutures. The vas deferens, and pampiniform plexus self-tying were performed in the VPL group. Surgery time, bleeding and surgeon satisfaction scores were recorded. Inflammation at the surgical site was assessed using infrared thermal camera over three days, and pain associated with inflammation was scored on the third day.
RESULTS
On Day 3, the average temperature in the SCL group was significantly higher than that of the VPL group, with a mean difference of 4.63°C (95% CI: 2.34-6.93, p < 0.001). Moreover, the surgery time in the VPL group was significantly longer compared to the SCL group, with a mean difference of 1.7 min (95% CI: 0.28-3.11, p = 0.021). The bleeding score was also significantly higher in the VPL group (p = 0.012). On the other hand, surgeon satisfaction and pain scores were not significantly different between groups.
CONCLUSION
Both SCL and VPL methods are safe and effective for orchiectomy in dogs. VPL is comparable in efficacy and safety and has the additional benefit of less inflammation.
Topics: Dogs; Male; Animals; Spermatic Cord; Vas Deferens; Orchiectomy; Prospective Studies; Inflammation; Pain; Dog Diseases
PubMed: 37466009
DOI: 10.1002/vms3.1208 -
Fertility and Sterility Jan 2017Brown JS, Dubin L, Hotchkiss RS. The varicocele as related to fertility. Fertil Steril 1967;18:46-56. "The fact that some men with varicoceles are fertile should not...
Brown JS, Dubin L, Hotchkiss RS. The varicocele as related to fertility. Fertil Steril 1967;18:46-56. "The fact that some men with varicoceles are fertile should not minimize the potentially detrimental role of this abnormality. It would be reasonable to claim that varicocele is uniformly detrimental. One might postulate that a fertile man with a varicocele would have better semen without this condition."
Topics: Fertility; History, 20th Century; Humans; Infertility, Male; Male; Phlebography; Predictive Value of Tests; Risk Factors; Spermatic Cord; Varicocele; Veins
PubMed: 27842996
DOI: 10.1016/j.fertnstert.2016.10.018 -
BMJ Case Reports Jan 2021Proximal-type epithelioid sarcoma is an ultra-rare, high-grade soft tissue malignancy usually presenting as a deep-seated painless mass in the proximal extremities. Most...
Proximal-type epithelioid sarcoma is an ultra-rare, high-grade soft tissue malignancy usually presenting as a deep-seated painless mass in the proximal extremities. Most patients are diagnosed as young adults, between 20 and 40 years of age. Perineal and genital masses do occur but are extremely rare and represent a challenging tumour to diagnose and treat. Early radical excision is recommended due to its aggressive behaviour and poor prognosis. Median overall survival from initial diagnosis is 30 months. We present the case of a 22-year-old man with a left groin proximal-type epithelioid sarcoma who is sadly deceased 12 months after initial presentation despite early surgical excision, completion of both first-line and palliative chemotherapy, and palliative radiotherapy.
Topics: Genital Neoplasms, Male; Humans; Male; Sarcoma; Spermatic Cord; Young Adult
PubMed: 33414109
DOI: 10.1136/bcr-2019-232385 -
Korean Journal of Urology Jan 2015Scrotal pain is a common complaint in a urological practice. Its diagnosis can prove challenging in both acute and chronic forms and requires a thorough and complete... (Review)
Review
Scrotal pain is a common complaint in a urological practice. Its diagnosis can prove challenging in both acute and chronic forms and requires a thorough and complete history and physical examination. This article discusses the evaluation and management of several entities of scrotal pain, including testicular torsion, epididymitis, postvasectomy pain, varicocele, and chronic orchialgia.
Topics: Diagnosis, Differential; Epididymitis; Humans; Male; Pain; Pain Management; Pain, Postoperative; Physical Examination; Scrotum; Spermatic Cord Torsion; Testis; Varicocele; Vasectomy
PubMed: 25598931
DOI: 10.4111/kju.2015.56.1.3 -
Asian Journal of Andrology Jan 2013The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop... (Review)
Review
The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation (for chronic orchialgia) and robotic assisted microsurgical testicular sperm extraction (microTESE).
Topics: Andrology; Denervation; Humans; Male; Microsurgery; Pain; Robotics; Sperm Retrieval; Spermatic Cord; Surgery, Computer-Assisted; Testicular Diseases; Urologic Surgical Procedures, Male; Varicocele; Vasovasostomy
PubMed: 23241637
DOI: 10.1038/aja.2012.131 -
Annals of the Royal College of Surgeons... Jul 1984Subfertility has recently been shown to follow unilateral torsion of the spermatic cord in more than half the patients studied. Since the anatomical anomaly that...
Subfertility has recently been shown to follow unilateral torsion of the spermatic cord in more than half the patients studied. Since the anatomical anomaly that predisposes to torsion (a high investment of the tunica vaginalis) is commonly bilateral, there could be an associated congenital defect in spermatogenesis on each side. Alternatively, autoantigens escaping from the ischaemic or 'exciting' testis could trigger an immunological response which damages the contralateral or 'sympathising' testis. Demonstration of an autoallergic (sympathetic) orchidopathia, analogous to sympathetic ophthalmia, would fundamentally alter the management of testicular torsion.
Topics: Animals; Antibody Formation; Autoantigens; Child; Humans; Infertility, Male; Male; Ophthalmia, Sympathetic; Rats; Sperm Count; Spermatic Cord Torsion; Spermatozoa
PubMed: 6742739
DOI: No ID Found -
Asian Journal of Andrology 2016Post-vasectomy pain syndrome remains one of the more challenging urological problems to manage. This can be a frustrating process for both the patient and clinician as... (Review)
Review
Post-vasectomy pain syndrome remains one of the more challenging urological problems to manage. This can be a frustrating process for both the patient and clinician as there is no well-recognized diagnostic regimen or reliable effective treatment. Many of these patients will end up seeing physicians across many disciplines, further frustrating them. The etiology of post-vasectomy pain syndrome is not clearly delineated. Postulations include damage to the scrotal and spermatic cord nerve structures via inflammatory effects of the immune system, back pressure effects in the obstructed vas and epididymis, vascular stasis, nerve impingement, or perineural fibrosis. Post-vasectomy pain syndrome is defined as at least 3 months of chronic or intermittent scrotal content pain. This article reviews the current understanding of post-vasectomy pain syndrome, theories behind its pathophysiology, evaluation pathways, and treatment options.
Topics: Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Anticonvulsants; Antidepressive Agents, Tricyclic; Chronic Pain; Denervation; Disease Management; Epididymis; Humans; Male; Microsurgery; Orchiectomy; Pain, Postoperative; Pelvic Floor; Physical Therapy Modalities; Spermatic Cord; Testicular Diseases; Vasectomy; Vasovasostomy
PubMed: 26952956
DOI: 10.4103/1008-682X.175090 -
Romanian Journal of Morphology and... 2015Spermatic cord liposarcoma is a rare medical condition and liposarcomas are most commonly found in the retroperitoneum, in the extremities and less often in the head and... (Review)
Review
Spermatic cord liposarcoma is a rare medical condition and liposarcomas are most commonly found in the retroperitoneum, in the extremities and less often in the head and the neck area. The spermatic cord is a rare site of origin, accounting for about 3-7% of all liposarcomas. We report a case of liposarcoma of spermatic cord. A 62-year-old male patient presented with a painless right inguinal mass. MRI (magnetic resonance imaging) showed a fatty mass in the right inguinoscrotal region, and was interpreted as an inguinal hernia containing omentum protruding into scrotum. The mass was removed with right testis and spermatic cord. The surgical margins were negative. Histopathological examination and immunohistochemistry revealed a well-differentiated liposarcoma. In this article, we discuss the clinical behavior of the spermatic cord liposarcoma and currently recommended treatment of the spermatic cord liposarcoma by reviewing the literature. In conclusion, spermatic cord liposarcoma are rare neoplasm that present as firm, slow-growing palpable paratesticular masses and the surgical treatment should include a wide resection around the inguinal canal, with removal of the spermatic cord and the surrounding soft tissue deep to the internal inguinal ring.
Topics: Cell Shape; Humans; Liposarcoma; Magnetic Resonance Imaging; Male; Middle Aged; Spermatic Cord; Stromal Cells; Testicular Neoplasms
PubMed: 26662152
DOI: No ID Found -
JPMA. the Journal of the Pakistan... Jan 2023Spermatic cord Leiomyosarcoma is an extremely rare intrascrotal tumour. Owing to its rarity, no definitive management guidelines have been formulated as yet. The... (Review)
Review
Spermatic cord Leiomyosarcoma is an extremely rare intrascrotal tumour. Owing to its rarity, no definitive management guidelines have been formulated as yet. The majority of published literature comprises of case reports or case series and show varying outcomes depending upon multiple patient- and disease-related factors. Almost all cases are older adults with majority in the sixth or seventh decades of life. It is commonly labelled as an indolent curable tumour if treated Spermatic cord Leiomyosarcoma is an extremely rare intrascrotal tumour. Owing to its rarity, no definitive management guidelines have been formulated as yet. The majority of published literature comprises of case reports or case series and show varying outcomes depending upon multiple patient- and disease-related factors. Almost all cases are older adults with majority in the sixth or seventh decades of life. It is commonly labelled as an indolent curable tumour if treated early by radical orchiectomy. The role of lymphadenectomy, adjuvant radiotherapy or chemotherapy is unclear. This case report concerns a young 38-year-old man who suffered from a painless firm left hemiscrotal mass for the past two years. Ultrasonography showed an intrascrotal paratesticular mass. Metastatic workup was negative. Left radical orchiectomy was performed and histopathology of the surgical specimen revealed leiomyosarcoma of the spermatic cord. The patient is on post-surgery follow-up and disease-free for six months. A literature review is also presented.
Topics: Humans; Male; Aged; Adult; Genital Neoplasms, Male; Spermatic Cord; Leiomyosarcoma; Radiotherapy, Adjuvant; Orchiectomy
PubMed: 36842031
DOI: 10.47391/JPMA.4137 -
Asian Journal of Andrology 2016Varicoceles had been recognized in clinical practice for over a century. Originally, these procedures were utilized for the management of pain but, since 1952, the... (Review)
Review
Varicoceles had been recognized in clinical practice for over a century. Originally, these procedures were utilized for the management of pain but, since 1952, the repairs had been mostly for the treatment of male infertility. However, the diagnosis and treatment of varicoceles were controversial, because the pathophysiology was not clear, the entry criteria of the studies varied among centers, and there were few randomized clinical trials. Nevertheless, clinicians continued developing techniques for the correction of varicoceles, basic scientists continued investigations on the pathophysiology of varicoceles, and new outcome data from prospective randomized trials have appeared in the world's literature. Therefore, this special edition of the Asian Journal of Andrology was proposed to report much of the new information related to varicoceles and, as a specific part of this project, the present article was developed as a comprehensive review of the evolution and refinements of the corrective procedures.
Topics: History, 20th Century; Humans; Male; Microsurgery; Spermatic Cord; Varicocele
PubMed: 26732111
DOI: 10.4103/1008-682X.170866