Abstract:
OBJECTIVES:Epididymovasostomy is commonly performed at the most distal site of the epididymis where whole sperm are present within the lumen, regardless of their motility status. Although more fresh and motile sperm can be found more proximally within the epididymis, it is believed that the outcome of epididymovasostomy is better more distally. Because the current results of epididymovasostomy are far from perfect, it would be ideal to be able to harvest motile sperm for cryopreservation at the time of surgery in case the patient remains azoospermic postoperatively. The objective of this study was to determine the effect of the level of epididymal anastomosis and quality of sperm on the outcome of surgery. METHODS:An end-to-side epididymovasostomy was performed on 131 azoospermic men with a mean age of 39 years and a mean obstructive interval of 18 years. The etiology of obstruction was vasectomy in 48%, infectious in 19%, congenital in 20%, and unknown in 13%. The average duration of follow-up was 32 months. The overall patency rate was 67% and pregnancy rate was 27%. Subgroups of patients with an anastomosis to the same level of the epididymis on all functional sides were identified as follows: caput (56), corpus (28), and cauda (13). These groups were compared in regard to the presence of motile sperm within the epididymal lumen at the time of surgery, patency rates, postoperative semen quality, and pregnancy rates. RESULTS:Motile sperm were present more often in both the caput (54%) and corpus (61%) than in the cauda epididymis (25%) (P < 0.05). The patency rates for the three subgroups were not significantly different. The postoperative total motile sperm count and pregnancy rate for the corpus epididymis (13 x 10(6) and 45%) was significantly (P < 0.05) better than for the caput (4.4 x 10(6) and 22%) but no different than that of the cauda (10 x 10(6) and 23%). The patency and pregnancy rates for anastomoses performed at levels demonstrating motile sperm were not significantly better than at sites with nonmotile sperm, but the postoperative total motile sperm count was better (P < 0.05). CONCLUSIONS:The results of this study suggest that the outcomes of epididymovasostomy to the corpus and cauda epididymis are roughly equivalent and superior to the caput. Therefore, it may be reasonable to move more proximally from the cauda to corpus in the search for motile sperm for cryopreservation during an end-to-side epididymovasostomy. In contrast, moving from the corpus to the caput epididymis has a significant adverse effect upon outcome; it is, therefore, not worthwhile to search for viable sperm for cryopreservation in this clinical setting.
journal_name
Urologyjournal_title
Urologyauthors
Jarow JP,Oates RD,Buch JP,Shaban SF,Sigman Mdoi
10.1016/s0090-4295(97)80001-5subject
Has Abstractpub_date
1997-04-01 00:00:00pages
590-5issue
4eissn
0090-4295issn
1527-9995pii
S0090-4295(97)80001-5journal_volume
49pub_type
临床试验,杂志文章相关文献
UROLOGY文献大全abstract::Of 293 patients with transitional cell carcinoma of the bladder seen at our institution between April 1977 and December 1987, 9 patients were found to have brain metastasis. Seven of 9 patients were found to have a solitary brain lesion, and in 4 of these, no other site of metastatic disease was identified. Five patie...
journal_title:Urology
pub_type: 杂志文章,评审
doi:10.1016/0090-4295(92)90034-t
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVES:To determine whether pretreatment serum prostate-specific antigen (PSA) levels in newly diagnosed prostate cancer patients can identify a group with a low probability of osseous metastasis and safely eliminate the need for a bone scan as a routine part of the staging evaluation. METHODS:We retrospectively r...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/s0090-4295(96)80016-1
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVE:To highlight the feasibility and technical details of performing simultaneous ipsilateral pyeloplasty and ureteric re-implantation for simultaneous proximal and distal obstruction of the ureter. METHODS:Two patients with preoperative diagnosis of proximal and distal ureteric obstruction underwent robot-assis...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2020.01.020
更新日期:2020-05-01 00:00:00
abstract::The efficacy of Sacks solution for hypothermic preservation of dog kidneys was determined. Complete ischemia was produced in one kidney for thirty minutes by clamping the renal pedicle in situ, followed by excision and immediate washout with the cold preservation fluid. Kidneys were stored in Sacks solution at 2 degre...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/0090-4295(75)90502-6
更新日期:1975-11-01 00:00:00
abstract:OBJECTIVE:To identify risk factors for recurrent urinary tract infection (UTI) in patients who perform clean intermittent catheterization (CIC). METHODS:A 6-year retrospective chart review of patients with spina bifida or tethered cord who perform clean intermittent catheterization (8 months to 58 years) was conducted...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2016.12.049
更新日期:2017-04-01 00:00:00
abstract::We present our experience with inferior vena cava (IVC) reconstruction in patients undergoing post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) due to metastatic germ cell tumor. Four patients underwent IVC reconstruction with a prosthetic graft. Early postoperative leg edema was prevented in all 4. L...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2008.02.054
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To compare pathological characteristics, treatment patterns, and survival in patients with ductal adenocarcinoma (DC) compared to those with acinar adenocarcinoma (AC). MATERIALS AND METHODS:Using the National Cancer Database, we identified patients diagnosed with clinically localized (cN0, cM0) pure DC (n =...
journal_title:Urology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.urology.2015.07.009
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:To compare the results of retroperitoneal laparoscopic versus open nephrectomy for benign renal diseases in children. METHODS:From January 1999 to February 2003, retroperitoneal nephrectomy or nephroureterectomy was performed in 23 consecutive children (7 girls and 16 boys). The median patient age was 4 yea...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2003.11.040
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVES:To investigate the long-term outcome of an organ-saving approach for renal cell carcinoma (RCC) with a normal opposite kidney (elective indication). METHODS:Since 1979, 180 patients have undergone nephron-sparing surgery at our institution for RCC in the presence of a normal contralateral kidney. The mean a...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/s0090-4295(00)00656-7
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:To assess the morbidity, mortality, and impact on quality of life and renal function after laparoscopic cystectomy and ileal conduit in patients with multiple sclerosis with lower urinary tract symptom refractory to conservative management. MATERIALS AND METHODS:A prospective study was conducted between Febr...
journal_title:Urology
pub_type: 临床试验,杂志文章
doi:10.1016/j.urology.2012.06.039
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:To evaluate the effectiveness and safety of retroperitoneal laparoscopic adrenalectomy for pheochromocytoma and report our experience in adrenalectomy without previous control of the adrenal vein. METHODS:From January 2000 to December 2005, 56 patients underwent 58 retroperitoneal laparoscopic adrenalectomy...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2007.01.078
更新日期:2007-05-01 00:00:00
abstract::To evaluate the effect of prostaglandin inhibition on the renal blood flow of the ischemic kidney, we administered indomethacin to 10 anesthetized dogs with renal artery stenosis and contralateral nephrectomy. Following the operation to produce renal ischemia, there was an increase of blood pressure associated with an...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/0090-4295(79)90495-3
更新日期:1979-09-01 00:00:00
abstract:OBJECTIVE:To report a new technique to reconstruct the abdominal wall at the site of the hernia with 2 separate layers of human acellular dermal matrix (hADM). Parastomal hernia is the most commonly encountered complication of ileal conduit urinary diversion, occurring at a rate of 5%-25%. Multiple methods of parastoma...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2010.05.003
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:To study the combination of thermal magnetic resonance imaging (MRI) and novel hypothermic cooling, via an endorectal cooling balloon (ECB), to assess the effective dispersion and temperature drop in pelvic tissue to potentially reduce inflammatory cascade in surgical applications. METHODS:Three male subject...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2017.07.006
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:To report the functional results of continent cutaneous ileal urinary diversion using modified W-pouch with non-isolated extra limb for continence. PATIENTS AND METHODS:From January 2013 to January 2016, 21 patients with muscle-invasive bladder cancer with median (interquartile range) of 59 (56.5-62.5) years...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2017.04.006
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:To present a novel surgical concept using preoperative imaging to estimate length needed for ileal segment. This enables robotic ileal interposition to be completed with only 1 position change during surgery. MATERIALS AND METHODS:The index patient is a 69-year-old woman with a history of stage IIIB cervical...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2017.02.033
更新日期:2017-06-01 00:00:00
abstract::Renal angiomyolipoma has traditionally been considered a benign tumor. Recently, a variety of epithelioid angiomyolipomas with malignant potential have been described. We report an adrenal recurrence in a patient who had a cellular angiomyolipoma removed 4 years earlier. ...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/s0090-4295(02)02584-0
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVES:To evaluate the anticancer effects of a lipophilic macromolecular anticancer agent, poly(styrene-co-maleic acid)-conjugated neocarzinostatin (SMANCS), dissolved in a lipid contrast medium (Lipiodol) given via the renal artery to patients with renal cell carcinoma. METHODS:Among 467 patients with renal cell ...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/s0090-4295(99)00537-3
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVES:To report the long-term results in 7 patients (including the 5-year results in 3 patients) after high-intensity focused ultrasonography (HIFU) combined with irradiation to treat testicular tumors in a solitary testis. METHODS:Transcutaneous HIFU ablation of testicular tumors is based on a technique using a ...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2005.12.001
更新日期:2006-06-01 00:00:00
abstract::A 40-year-old male with presented to the clinic with the chief complaint of right inguinal pain radiating to his right testicle and right thigh with no history of trauma, fever, chills, dysuria, hematuria, or unprotected sexual activity. Physical exam revealed right testicular tenderness with no palpable abnormality o...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2020.05.046
更新日期:2020-09-01 00:00:00
abstract::Several articles describing the natural history of Peyronie disease have shown that untreated patients seem to have spontaneous improvement. It has been suggested that this could be the reason for the success of so many different methods. A review of the literature and of our previous experience has been done, trying ...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/0090-4295(80)90320-9
更新日期:1980-07-01 00:00:00
abstract::A subfertile male with a history of left cryptorchism underwent scrotal ultrasound that revealed stippled calcifications, without associated mass, in the right testicle. Six months later, while on a regimen of clomiphene citrate, a testicular tumor became palpable. This was sonographically confirmed to be surrounding ...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/0090-4295(90)80202-x
更新日期:1990-12-01 00:00:00
abstract:OBJECTIVES:To examine, after psychometric evaluation and validation of the translated National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the practical value of this questionnaire in a routine diagnostic prostatitis setup for patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPP...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2004.02.002
更新日期:2004-06-01 00:00:00
abstract::A case report of a solitary metastasis to the urethra from previously resected renal cell carcinoma is reported. The patient presented with total gross painless hematuria. We believe this is the first such case to be reported. ...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/0090-4295(90)80164-i
更新日期:1990-04-01 00:00:00
abstract::To study the effects of incontinence surgery on detrusor contractility, a group of 24 women who preoperatively voided without a detrusor contraction during voiding urethrocystometry were re-evaluated for detrusor contractility three months after surgery for stress urinary incontinence. Twelve women regained detrusor c...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/0090-4295(88)90101-x
更新日期:1988-04-01 00:00:00
abstract:OBJECTIVE:We describe our experience with single and 4-layer small intestine submucosa in the repair of proximal hypospadias and severe chordee. METHODS:Between 2000 and 2004, 15 boys with proximal hypospadias and/or severe ventral chordee underwent SIS grafting to correct the curvature. Single layer and 4-layer small...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/j.urology.2008.08.489
更新日期:2009-02-01 00:00:00
abstract::A case of bladder perforation secondary to simulated intercourse with a cucumber is presented. Treatment by primary vaginal repair was successful. ...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/0090-4295(87)90251-2
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVES:To report on our 2-year experience in teaching transurethral resection (TUR) of bladder tumors to five trainees. We analyzed their problems, as well as those of the teachers, and present our solutions. METHODS:Between April 2000 and March 2002, five residents and three members of the staff took part in a tr...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/s0090-4295(03)00128-6
更新日期:2003-07-01 00:00:00
abstract::A patient with a durable, complete, local and pulmonary remission of a metastatic sarcomatoid carcinoma of the bladder treated with gemcitabine and cisplatin is presented. Sarcomatoid carcinoma arising in the bladder is a rare and notoriously aggressive variant of urothelial carcinoma for which an effective systemic t...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/s0090-4295(01)01343-7
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVES:To determine serum levels of prostate-specific antigen (PSA) in men born with bladder exstrophy and to investigate the clinical utility of this test in the bladder exstrophy population. METHODS:Ten men aged 19 to 45 years with a history of bladder exstrophy underwent digital rectal examination and free and ...
journal_title:Urology
pub_type: 杂志文章
doi:10.1016/S0090-4295(96)00438-4
更新日期:1997-02-01 00:00:00