scholarly journals Recurrent varicocele

2021 ◽  
Vol 9 (2) ◽  
pp. 132-141
Author(s):  
S. V. Kotov ◽  
N. D. Korochkin ◽  
A. A. Klimenko
Keyword(s):  
Male Infertility ◽  
Treatment Option ◽  
Reproductive Medicine ◽  
Primary Treatment ◽  
Male Population ◽  
Pathophysiological Mechanisms ◽  
General Male Population ◽  
Endovascular Methods ◽  
Common Problems ◽  
Methods Of Treatment

Varicocele is one of the most common problems in modern reproductive medicine. The incidence of varicocele in the structure of the general male population is 15%, 40% of which have problems with fertility. Among the causes of male infertility, varicocele ranks second after idiopathic, thus being the most common curable cause of male infertility. While researching the pathophysiological mechanisms of infertility in varicocele, the question of the reasons for the varicocele relapses, both after surgical and endovascular methods of treatment remains open, as well as the tactics of managing such patients. The review aimed to systematize knowledge about the problem of recurrent varicocele, to analyze the frequency and etiology of relapses after various methods of primary treatment, as well as to select the optimal diagnostic and treatment option for varicocele recurrence.

scholarly journals Male Infertility Diagnosis: Improvement of Genetic Analysis Performance by the Introduction of Pre-Diagnostic Genes in a Next-Generation Sequencing Custom-Made Panel

2021 ◽  
Vol 11 ◽  
Author(s):  
Vincenza Precone ◽  
Rossella Cannarella ◽  
Stefano Paolacci ◽  
Gian Maria Busetto ◽  
Tommaso Beccari ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Male Infertility ◽  
Next Generation ◽  
Male Population ◽  
Pathogenic Variants ◽  
Custom Made ◽  
Number Of Genes ◽  
General Male Population ◽  
Generation Sequencing ◽  
Spermatogenic Failure

BackgroundInfertility affects about 7% of the general male population. The underlying cause of male infertility is undefined in about 50% of cases (idiopathic infertility). The number of genes involved in human spermatogenesis is over two thousand. Therefore, it is essential to analyze a large number of genes that may be involved in male infertility. This study aimed to test idiopathic male infertile patients negative for a validated panel of “diagnostic” genes, for a wide panel of genes that we have defined as “pre-diagnostic.”MethodsWe developed a next-generation sequencing (NGS) gene panel including 65 pre-diagnostic genes that were used in 12 patients who were negative to a diagnostic genetic test for male infertility disorders, including primary spermatogenic failure and central hypogonadism, consisting of 110 genes.ResultsAfter NGS sequencing, variants in pre-diagnostic genes were identified in 10/12 patients who were negative to a diagnostic test for primary spermatogenic failure (n = 9) or central hypogonadism (n = 1) due to mutations of single genes. Two pathogenic variants of DNAH5 and CFTR genes and three uncertain significance variants of DNAI1, DNAH11, and CCDC40 genes were found. Moreover, three variants with high impact were found in AMELY, CATSPER 2, and ADCY10 genes.ConclusionThis study suggests that searching for pre-diagnostic genes may be of relevance to find the cause of infertility in patients with apparently idiopathic primary spermatogenic failure due to mutations of single genes and central hypogonadism.

scholarly journals Effect of Intermittent Hypoxia on Metabolic Syndrome and Insulin Resistance in the General Male Population

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 668
Author(s):  
Jung-Yup Lee ◽  
Chan-Won Kim ◽  
Kyung-Chul Lee ◽  
Jae-Hyuk Lee ◽  
Sung-Hun Kang ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Density Lipoprotein ◽  
Resistance Index ◽  
Health Examination ◽  
Male Population ◽  
Incident Type ◽  
Obstructive Sleep ◽  
General Male Population ◽  
Group 5

Background and objectives: Obstructive sleep apnea (OSA) is closely associated with insulin resistance (IR) and is an independent risk factor for incident type 2 diabetes mellitus (T2DM). Most studies evaluate the correlation between OSA and IR in only obese or T2DM patients. Therefore, we tried to investigate the effect of OSA on metabolic syndrome and IR in the general healthy male population. Materials and Methods: 184 subjects who visited a preventive health examination program were recruited for this study. All subjects received overnight polysomnography by a portable device (Watch-PAT 200). We examined several metabolic parameters and a homeostasis model of assessment for insulin resistance index (HOMA-IR). The subjects were divided into three groups by AHI (Apnea-hyponea index): normal group (AHI < 5), mild OSA group (5 ≤ AHI < 15), and moderate-severe OSA group (AHI ≥ 15). They were also divided into two groups according to minimum oxygen saturation: low group, Min-SpO2 < 88%; and high group, Min-SpO2 ≥ 88%. Results: Parameters of metabolic syndrome, including waist circumference, systolic and diastolic blood pressure, triglyceride, and high-density lipoprotein cholesterol showed significant differences among the AHI groups. Furthermore, HOMA-IR showed significant differences among the AHI groups. Those parameters, including metabolic syndrome and HOMA-IR, also showed differences between Min-SpO2 groups. Conclusions: In summary, this study helps confirm that AHI is associated with HOMA-IR in the general male population. Furthermore, the severity of AHI correlated with the parameters of metabolic syndrome. Therefore, AHI might be an indicator for evaluating both T2DM and metabolic syndrome, even in the general male population.

scholarly journals Prediction of coronary heart disease incidence in a general male population by circulating non-coding small RNA sRNY1-5p in a nested case–control study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Vera L. Costa ◽  
Jean-Bernard Ruidavets ◽  
Vanina Bongard ◽  
Bertrand Perret ◽  
Emanuela Repetto ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Small Rna ◽  
Case Control Study ◽  
Disease Incidence ◽  
Case Control ◽  
Male Population ◽  
General Male Population ◽  
Nested Case Control ◽  
Control Study

AbstractDuring the development of atherosclerotic lesion, s-RNYs (small RNAs of about 24/34 nucleotides) are derived by the processing of long Ro-associated non-coding RNAs (RNYs) in macrophages. The levels of serum s-RNYs have been found significantly upregulated in patients with coronary heart disease (CHD) compared to age-matched CHD-free individuals. The present study aimed to examine the predictive value of serum s-RNYs for CHD events in the general male population. Within the frame of nested-case–control study, the GENES study, we measured the absolute expression of a RNY-derived small RNA, the s-RNY1-5p, in the serum of individuals (without CHD at baseline) who encountered a CHD event within 12 years of follow-up (n = 30) (Cases) and compared them to individuals who remained event-free (Controls) (n = 30). The expression of s-RNY1-5p in serum was significantly upregulated in Cases compared to Controls (p = 0.027). The proportion of CHD event-free was significantly higher among individuals with serum s-RNY1-5p below the median value (631 molecules/mL). In a multivariable model adjusted for age, smoking, hypertension, diabetes and dyslipidemia, the risk of CHD events increased more than fourfold in individuals with serum s-RNY1-5p above the median value (HR, 4.36; 95% CI 1.22–15.60). A positive association with CHD events was also observed when considering s-RNY1-5p as a continuous variable (p = 0.022). Based on our results, we conclude that serum s-RNY1-5p is an independent predictor of CHD events in a general male population and might be a relevant biomarker for early detection of cardiovascular diseases.

scholarly journals Endoscopic transsphenoidal pituitary surgery: a good and safe primary treatment option for Cushing's disease, even in case of macroadenomas or invasive adenomas

2013 ◽  
Vol 169 (3) ◽  
pp. 329-337 ◽  
Author(s):  
M A E M Wagenmakers ◽  
H D Boogaarts ◽  
S H P P Roerink ◽  
H J L M Timmers ◽  
N M M L Stikkelbroeck ◽  
...  
Keyword(s):  
Treatment Option ◽  
Cushing’S Disease ◽  
Remission Rate ◽  
Pituitary Surgery ◽  
Primary Treatment ◽  
Endoscopic Technique ◽  
Cushing's Disease ◽  
Recurrence Rates ◽  
Transsphenoidal Pituitary Surgery

ContextAlthough the endoscopic technique of transsphenoidal pituitary surgery (TS) has been widely adopted, reports on its results in Cushing's disease (CD) are still scarce and no studies have investigated long-term recurrence rates. This is the largest endoscopic series published till now.ObjectiveTo gain insight into the role of endoscopic TS as a primary treatment option for CD, especially in patients with magnetic resonance imaging (MRI)-negative CD and (invasive) macroadenomas.DesignRetrospective cohort study.Patients and methodsThe medical records of 86 patients with CD who underwent endoscopic TS were examined. Data on preoperative and postoperative evaluation, perioperative complications, and follow-up were collected. Remission was defined as disappearance of clinical symptoms with a fasting plasma cortisol level ≤50 nmol/l either basal or after 1 mg dexamethasone.ResultsThe remission rate in different adenoma subclasses varied significantly: 60% in MRI-negative CD (n=20), 83% in microadenomas (n=35), 94% in noninvasive macroadenomas (n=16), and 40% in macroadenomas that invaded the cavernous sinus (n=15). The recurrence rate was 16% after 71±39 months of follow-up (mean±s.d., range 10–165 months).ConclusionsEndoscopic TS is a safe and effective treatment for all patients with CD. Recurrence rates after endoscopic TS are comparable with those reported for microscopic TS. Our data suggest that in patients with noninvasive and invasive macroadenomas, the endoscopic technique of TS should be the treatment of choice as remission rates seem to be higher than those reported for microscopic TS, although no comparative study has been performed.

Kasai Procedure in Patients Older Than 90 Days: Worth a Cut

2021 ◽  
Author(s):  
Marie Uecker ◽  
Joachim F. Kuebler ◽  
Nagoud Schukfeh ◽  
Eva-Doreen Pfister ◽  
Ulrich Baumann ◽  
...  
Keyword(s):  
Treatment Option ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Primary Treatment ◽  
Inclusion Criteria ◽  
Bridge To Transplant ◽  
Kasai Procedure ◽  
Native Liver ◽  
Native Liver Survival

Abstract Introduction Age at Kasai portoenterostomy (KPE) has been identified as a predictive factor for native-liver survival in patients with biliary atresia (BA). Outcomes of pediatric liver transplantation (LT) have improved over recent years. It has been proposed to consider primary LT as a treatment option for late-presenting BA infants instead of attempting KPE. We present our experience with patients older than 90 days undergoing KPE. Materials and Methods A retrospective chart review of patients with BA undergoing KPE at our institution between January 2010 and December 2020 was performed. Patients 90 days and older at the time of surgery were included. Patients' characteristics, perioperative data, and follow-up results were collected. Eleven patients matched the inclusion criteria. Mean age at KPE was 108 days (range: 90–133 days). Results Postoperative jaundice clearance (bilirubin < 2 mg/dL) at 2-year follow-up was achieved in three patients (27%). Eight patients (73%) received a liver transplant at a mean of 626 days (range: 57–2,109 days) after KPE. Four patients (36%) were transplanted within 12 months post-KPE. Two patients died 237 and 139 days after KPE due to disease-related complications. One patient is still alive with his native liver, currently 10 years old. Conclusion Even when performed at an advanced age, KPE can help prolong native-liver survival in BA patients and offers an important bridge to transplant. In our opinion, it continues to represent a viable primary treatment option for late-presenting infants with BA.

scholarly journals Sauna Bathing and Risk of Psychotic Disorders: A Prospective Cohort Study

2018 ◽  
Vol 27 (6) ◽  
pp. 562-569 ◽  
Author(s):  
Tanjaniina Laukkanen ◽  
Jari A. Laukkanen ◽  
Setor K. Kunutsor
Keyword(s):  
Psychotic Disorders ◽  
Cox Regression ◽  
Well Being ◽  
Population Based ◽  
Hazard Ratio ◽  
Male Population ◽  
Cox Regression Analysis ◽  
Sauna Bathing ◽  
General Male Population ◽  
Independent Association

Objective: Sauna bathing has been suggested to promote mental well-being and relaxation, but the evidence is uncertain with respect to mental disorders. We aimed to assess the association of frequency of sauna bathing with risk of psychosis in the Kuopio Ischemic Heart Disease prospective population-based study. Subjects and Methods: Baseline sauna bathing habits were assessed in 2,138 men aged 42–61 years who had no history of psychotic disorders. Participants were classified into three groups based on the frequency of sauna bathing (once, 2–3, and 4–7 times per week). Results: During a median follow-up of 24.9 years, 203 psychotic disorders were recorded. A total of 537, 1,417, and 184 participants reported having a sauna bath once a week, 2–3 times, and 4–7 times per week, respectively. In Cox regression analysis adjusted for age, compared to men who had 1 sauna session per week, the hazard ratio (95% confidence intervals) of psychosis for 4–7 sauna sessions per week was 0.23 (0.09–0.58). In a multivariable model adjusted for several risk factors and other potential confounders, the corresponding hazard ratio was 0.21 (0.08–0.52). The association was similar after further adjustment for total energy intake, socioeconomic status, physical activity, and C-reactive protein (0.22 [0.09–0.54]) and was unchanged on additional adjustment for duration of a sauna session and temperature of the sauna bath (0.23 [0.09–0.57]). Conclusion: Our study suggests a strong inverse and independent association between frequent sauna bathing and the future risk of psychotic disorders in a general male population.

scholarly journals Diagnostics and Treatment of Cervical Causes of Infertility

2019 ◽  
Vol 12 (1) ◽  
pp. 33-39
Author(s):  
Aleksandar K. Kunev
Keyword(s):  
Intrauterine Insemination ◽  
Treatment Options ◽  
Cervical Canal ◽  
Male Factor ◽  
Gynaecological Examination ◽  
The Common ◽  
Common Problems ◽  
Cervical Diseases ◽  
And Function ◽  
Methods Of Treatment

Summary Nowadays, infertility is a problem that affects an increasing number of people. The causes of infertility in a couple may be due to a variety of factors – female, male or unexplained. One of the common problems associated with infertility in women is related to uterine cervical diseases. The cervix is an essential part of the sperm passage, so various disorders in the cervix structure and function may be the cause of infertility. The study aimed to identify the leading cervical causes of female infertility, methods of treatment and their success. The most common problems of cervical origin are cervical polyps and stenosis of the cervical canal. They are easily diagnosed with a routine gynaecological examination and ultrasound examination. Polyps are removed through polypectomy, and after that, a natural pregnancy can be achieved. In the case of stenosis of the cervical canal, there are two treatment options – dilation or intrauterine insemination (IUI). In younger patients and lack of male factor in the couple, dilation is performed. Dilation is mechanical with classic Hegar dilatiors or with synthetic hygroscopic dilatiors (Dilapan). If, in addition to the stenosis of the cervical canal in a woman, there is a male factor, treatment with IUI is preferred. Methods for cervical factor treatment vary in their success rate but are generally characterised by good results.

scholarly journals Effects of Environmental and Pathological Hypoxia on Male Fertility

2021 ◽  
Vol 9 ◽  
Author(s):  
Zhibin Li ◽  
Sumin Wang ◽  
Chunli Gong ◽  
Yiyang Hu ◽  
Jiao Liu ◽  
...  
Keyword(s):  
Male Infertility ◽  
Animal Studies ◽  
Sperm Quality ◽  
Reproductive Toxicity ◽  
Causative Factor ◽  
Reproductive Hormones ◽  
Epigenetic Changes ◽  
Causal Association ◽  
Spermatogenic Cells ◽  
Male Population

Male infertility is a widespread health problem affecting approximately 6%–8% of the male population, and hypoxia may be a causative factor. In mammals, two types of hypoxia are known, including environmental and pathological hypoxia. Studies looking at the effects of hypoxia on male infertility have linked both types of hypoxia to poor sperm quality and pregnancy outcomes. Hypoxia damages testicular seminiferous tubule directly, leading to the disorder of seminiferous epithelium and shedding of spermatogenic cells. Hypoxia can also disrupt the balance between oxidative phosphorylation and glycolysis of spermatogenic cells, resulting in impaired self-renewal and differentiation of spermatogonia, and failure of meiosis. In addition, hypoxia disrupts the secretion of reproductive hormones, causing spermatogenic arrest and erectile dysfunction. The possible mechanisms involved in hypoxia on male reproductive toxicity mainly include excessive ROS mediated oxidative stress, HIF-1α mediated germ cell apoptosis and proliferation inhibition, systematic inflammation and epigenetic changes. In this review, we discuss the correlations between hypoxia and male infertility based on epidemiological, clinical and animal studies and enumerate the hypoxic factors causing male infertility in detail. Demonstration of the causal association between hypoxia and male infertility will provide more options for the treatment of male infertility

scholarly journals Successful Primary Treatment of a Hydatidiform Mole with Methotrexate and EMA/CO

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
M. De Vos ◽  
M. Leunen ◽  
C. Fontaine ◽  
Ph. De Sutter
Keyword(s):  
Surgical Treatment ◽  
Complete Remission ◽  
Treatment Option ◽  
Hydatidiform Mole ◽  
Uterine Fibroids ◽  
Treatment Method ◽  
Primary Treatment ◽  
Molar Pregnancy ◽  
Complete Hydatidiform Mole ◽  
Hydatidiform Moles

Background. The preferred treatment method of most hydatidiform moles is suction aspiration. In rare circumstances uterine abnormalities may preclude surgical treatment.Case. We report a case of complete molar pregnancy successfully treated with methotrexate followed by EMA/CO. A 38-year-old woman with a complete hydatidiform mole and multiple uterine fibroids underwent a failed attempt at suction aspiration. Following treatment with methotrexate, a nonmetastatic persistent trophoblastic tumour developed. Six cycles of EMA/CO led to complete remission.Conclusion. We propose that primary treatment of molar pregnancies with chemotherapy is a useful treatment option in cases where uterine abnormalities interfere with suction aspiration.

Obstructions

2011 ◽  
pp. 1428-1429
Author(s):  
Franco Dondero ◽  
Francesco Lombardo
Keyword(s):  
Recent Progress ◽  
Diagnosis And Treatment ◽  
Obstructive Azoospermia ◽  
Male Population ◽  
Infertile Men ◽  
General Male Population ◽  
Normal Spermatogenesis ◽  
Clinical Conditions ◽  
Secretory Azoospermia

Azoospermia, the absence of sperm, is the most challenging of clinical conditions despite recent progress in diagnosis and treatment. The prevalence of azoospermia is less than 1% among all men, and approximately 10–15% among infertile men. Its incidence in the general male population is 2–3% (1). Testicular (secretory) azoospermia is untreatable in most cases, and even when a cure can be attempted, success is usually low. Obstructive azoospermia, in contrast, is characterized by normal spermatogenesis and is therefore potentially treatable. Accordingly, this condition has always been the focus of physicians’ interest and attention.

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