Aim： To evaluate the treatment outcome of antegrade internal spermatic vein sclerotherapy in men with non-obstructive azoospermia or severe oligoteratoasthenospermia （OTA） as a result of varicocele. Methods： Betwe...Aim： To evaluate the treatment outcome of antegrade internal spermatic vein sclerotherapy in men with non-obstructive azoospermia or severe oligoteratoasthenospermia （OTA） as a result of varicocele. Methods： Between September 1995 and January 2004, 47 patients （mean age 33.8 ± 6.3 years） underwent antegrade internal spermatic vein sclerotherapy for the treatment of varicocele with azoospermia （14 patients） or severe OTA （33 patients）. Testicular core biopsy was also performed in complete azoospermic patients who provided informed consent. The outcome was assessed in terms of improvement in semen parameters and conception rate. Results： Forty-two （89.4%） of 47 patients had bilateral varicocele. Serum follicle stimulating hormone （FSH） did not differ between patients with azoospermia and severe OTA. After the follow-up of 24.8 ± 9.2 months, significant improvement was noted in mean sperm concentration, motility and morphology in 35 patients （74.5%）. Comparison between groups during the follow-up revealed significantly higher values of sperm concentration, motility and normal morphology in the severe OTA group. Pregnancy was achieved in 14 cases （29.8%）. Testicular histopathology of the azoospermic patients with postoperative induction of spermatogenesis revealed maturation arrest at spermatid stage, Sertoli-cell-only （SCO） with focal spermatogenesis or hypospermatogenesis. None of the patients with pure SCO pattern or maturation arrest at spermatocyte stage achieved spermatogenesis after the treatment. Preoperative serum FSH levels didn＇t relate to treatment outcome. Conclusion： Antegrade internal spermatic vein sclerotherapy is an easy and effective treatment for symptomatic varicocele. It can significantly reverse testicular dysfunction and improve spermatogenesis in men with severe OTA, as well as induce sperm production in men with azoospermia, improving pregnancy rates in subfertile couples.展开更多
Aim:To determine retrospectively the safety and efficacy of extracorporeal shock wave therapy(ESWT)in patients with Peyronie's disease.Methods:Fifty-three patients with stable Peyronie's disease underwent ESWT...Aim:To determine retrospectively the safety and efficacy of extracorporeal shock wave therapy(ESWT)in patients with Peyronie's disease.Methods:Fifty-three patients with stable Peyronie's disease underwent ESWT(group 1). Fifteen patients matched with the baseline characteristic of the patients in group 1,who received no treatment,were used as the control(group 2).The patients'erectile function(International Index of Erectile Function [IIEF-5] score), pain severity(visual analog scale),plaque size and degree of penile angulation were assessed before and after the treatment in group 1 and during the follow-up in group 2.Results:The mean follow-up time was 32 months(range: 6-64 months)in group 1 and 35 months(range:9-48 months)in group 2.All the patients were available for the follow-up.Considering erectile function and plaque size,no significant changes(P>0.05)were observed in group 1 before or after the ESWT.A total of 39 patients(74%)reported a significant effect in pain relief in group 1 after ESWT.However.regarding improvement in pain,IIEF-5 score and plaque size,no significant differences were observed between the two groups.In 21 patients(40%)of group 1,the deviation angle was decreased more than 10° with a mean reduction in all patients of 11°(range:6-20°).No serious complications were noted considering ESWT procedure.Conclusion:ESWT is a minimally mvasive and safe alternative procedure for the treatment of Peyronie's disease.However,the effect of ESWT on penile pain,sexual function and plaque size remains questionable.展开更多
文摘Aim： To evaluate the treatment outcome of antegrade internal spermatic vein sclerotherapy in men with non-obstructive azoospermia or severe oligoteratoasthenospermia （OTA） as a result of varicocele. Methods： Between September 1995 and January 2004, 47 patients （mean age 33.8 ± 6.3 years） underwent antegrade internal spermatic vein sclerotherapy for the treatment of varicocele with azoospermia （14 patients） or severe OTA （33 patients）. Testicular core biopsy was also performed in complete azoospermic patients who provided informed consent. The outcome was assessed in terms of improvement in semen parameters and conception rate. Results： Forty-two （89.4%） of 47 patients had bilateral varicocele. Serum follicle stimulating hormone （FSH） did not differ between patients with azoospermia and severe OTA. After the follow-up of 24.8 ± 9.2 months, significant improvement was noted in mean sperm concentration, motility and morphology in 35 patients （74.5%）. Comparison between groups during the follow-up revealed significantly higher values of sperm concentration, motility and normal morphology in the severe OTA group. Pregnancy was achieved in 14 cases （29.8%）. Testicular histopathology of the azoospermic patients with postoperative induction of spermatogenesis revealed maturation arrest at spermatid stage, Sertoli-cell-only （SCO） with focal spermatogenesis or hypospermatogenesis. None of the patients with pure SCO pattern or maturation arrest at spermatocyte stage achieved spermatogenesis after the treatment. Preoperative serum FSH levels didn＇t relate to treatment outcome. Conclusion： Antegrade internal spermatic vein sclerotherapy is an easy and effective treatment for symptomatic varicocele. It can significantly reverse testicular dysfunction and improve spermatogenesis in men with severe OTA, as well as induce sperm production in men with azoospermia, improving pregnancy rates in subfertile couples.
文摘Aim:To determine retrospectively the safety and efficacy of extracorporeal shock wave therapy(ESWT)in patients with Peyronie's disease.Methods:Fifty-three patients with stable Peyronie's disease underwent ESWT(group 1). Fifteen patients matched with the baseline characteristic of the patients in group 1,who received no treatment,were used as the control(group 2).The patients'erectile function(International Index of Erectile Function [IIEF-5] score), pain severity(visual analog scale),plaque size and degree of penile angulation were assessed before and after the treatment in group 1 and during the follow-up in group 2.Results:The mean follow-up time was 32 months(range: 6-64 months)in group 1 and 35 months(range:9-48 months)in group 2.All the patients were available for the follow-up.Considering erectile function and plaque size,no significant changes(P>0.05)were observed in group 1 before or after the ESWT.A total of 39 patients(74%)reported a significant effect in pain relief in group 1 after ESWT.However.regarding improvement in pain,IIEF-5 score and plaque size,no significant differences were observed between the two groups.In 21 patients(40%)of group 1,the deviation angle was decreased more than 10° with a mean reduction in all patients of 11°(range:6-20°).No serious complications were noted considering ESWT procedure.Conclusion:ESWT is a minimally mvasive and safe alternative procedure for the treatment of Peyronie's disease.However,the effect of ESWT on penile pain,sexual function and plaque size remains questionable.
