Testicular torsion is a urological emergency that requires prompt diagnosis and treatment,accounting for 10%-15%of cases of acute scrotum.[1]It occurs most frequently during the perinatal period and adolescence and ca...Testicular torsion is a urological emergency that requires prompt diagnosis and treatment,accounting for 10%-15%of cases of acute scrotum.[1]It occurs most frequently during the perinatal period and adolescence and can occur at any age.[2]The incidence of testicular torsion is 1/4,000 in males under 25 years of age and 1/160 in males over 25 years of age.[3]Unilateral torsion is relatively common,with a higher incidence on the left side.Testicular torsion is typically managed through surgical exploration.Necrotic testes,identified by a black appearance,require orchiectomy.[4]展开更多
Testicular tumor is the most common solid malignancy in males under 40 years of age.This malignancy is known to have a negative impact on male fertility.Therefore,several techniques for sperm retrieval have been propo...Testicular tumor is the most common solid malignancy in males under 40 years of age.This malignancy is known to have a negative impact on male fertility.Therefore,several techniques for sperm retrieval have been proposed,including microdissection testicular sperm extraction(mTESE).The objective of this study was to review the literature on the outcomes of oncological(Onco)-mTESE at the time of radical orchiectomy.We conducted a comprehensive literature search through PubMed,Scopus,and Cochrane Central Controlled Register of Trials.Only studies reporting ex vivo mTESE in patients with testicular tumor were considered.Twelve papers met the inclusion criteria and were included in this review.Tumor size was identified as the sole preoperative factor influencing spermatogenesis.The considered studies demonstrated a satisfactory success rate for Onco-mTESE,associated with a similarly valid percentage of live healthy births through assisted reproductive technology.Currently,no comparison has been made between Onco-mTESE and conventional Onco-TESE,hence further assessment is required.In cases where the tumor completely replaces the cancer-bearing testicle,a contralateral micro-TESE may be a viable alternative.However,the surgeon should evaluate associated risks and benefits preoperatively.In conclusion,Onco-mTESE at the time of radical orchiectomy appears to be a promising therapeutic option for young patients with testicular tumors.Nevertheless,additional studies are necessary to achieve a definitive conclusion.展开更多
Oncological microdissection testicular sperm extraction(onco-micro-TESE)represents a significant breakthrough for patients with nonobstructive azoospermia(NOA)and a concomitant in situ testicular tumor,to be managed a...Oncological microdissection testicular sperm extraction(onco-micro-TESE)represents a significant breakthrough for patients with nonobstructive azoospermia(NOA)and a concomitant in situ testicular tumor,to be managed at the time of sperm retrieval.Onco-micro-TESE addresses the dual objectives of treating both infertility and the testicular tumor simultaneously.The technique is intricate,necessitating a comprehensive understanding of testicular anatomy,physiology,tumor biology,and advanced microsurgical methods.It aims to carefully extract viable spermatozoa while minimizing the risk of tumor dissemination.This review encapsulates the procedural intricacies,evaluates success determinants,including tumor pathology and spermatogenic tissue health,and discusses the implementation of imaging techniques for enhanced surgical precision.Ethical considerations are paramount,as the procedure implicates complex decision-making that weighs the potential oncological risks against the profound desire for fatherhood using the male gametes.The review aims to provide a holistic overview of onco-micro-TESE,detailing methodological advances,clinical outcomes,and the ethical landscape,thus offering an indispensable resource for clinicians navigating this multifaceted clinical scenario.展开更多
A 14-year-old presented with an asymptomatic left testicular mass after a brief episode of pain.Examination showed a non-tender left testis that was significantly larger than the right.Ultrasound revealed a 4.5-cm ava...A 14-year-old presented with an asymptomatic left testicular mass after a brief episode of pain.Examination showed a non-tender left testis that was significantly larger than the right.Ultrasound revealed a 4.5-cm avascular mass and an absence of normal testicular parenchyma.Tumor markers were unremarkable.A CT scan demonstrated no lymphadenopathy but identified a prominent left spermatic cord.Due to a suspicion of chronic torsion vs.malignancy,a left radical orchiectomy was performed.Pathology identified a hemorrhagic paratesticular venous malformation without signs of germ cell neoplasia,a rare entity.展开更多
The aim of this study was to investigate the trend in testicular volume changes after orchiopexy in children with cryptorchidism.The clinical data of 854 children with cryptorchidism who underwent orchiopexy between J...The aim of this study was to investigate the trend in testicular volume changes after orchiopexy in children with cryptorchidism.The clinical data of 854 children with cryptorchidism who underwent orchiopexy between January 2013 and December 2016 in Shenzhen Children’s Hospital(Shenzhen,China)were retrospectively analyzed.The mean(standard deviation)age of the patients was 2.8(2.5)years,and the duration of follow-up ranged from 1 year to 5 years.Ultrasonography was conducted preoperatively and postoperatively.The variables analyzed included age at the time of surgery,type of surgical procedure,laterality,preoperative testicular position,preoperative and postoperative testicular volumes,and the testicular volume ratio of them.The average testicular volumes preoperatively and at 1 year,2 years,3 years,and 5 years postoperatively were 0.27 ml,0.38 ml,0.53 ml,0.87 ml,and 1.00 ml,respectively(P<0.001).The corresponding testicular volume ratios were 0.67,0.76,0.80,0.83,and 0.84(P<0.001).The mean volume of the undescended testes was significantly smaller than the mean normative value(P<0.001,lower than the 10th percentile).The postoperative testicular volumes in children with cryptorchidism were generally lower than those in healthy boys but were still greater than the 10th percentile and exhibited an increasing trend.The older the child is at the time of surgery,the larger the gap in volume between the affected and normal testes.Although testicular volume tends to gradually increase after orchiopexy for cryptorchidism,it could not normalizes.Earlier surgery results in affected testicular volumes closer to those of healthy boys.展开更多
Objective:To assess the effects of azoxystrobin on sperm quality,hormone levels and testicular structure in Swiss albino mice.Methods:48 Swiss albino male mice were divided into 7 groups containing 6 mice in each grou...Objective:To assess the effects of azoxystrobin on sperm quality,hormone levels and testicular structure in Swiss albino mice.Methods:48 Swiss albino male mice were divided into 7 groups containing 6 mice in each group except Group桏in which 12 mice were taken.Group栺served as the control group and treated with vehicle(distil water for 30 and 60 days).Azoxystrobin at three different doses(125,250,500 mg/kg body weight)was orally administered to Group栻,栿and桇for 30 days and Group桋,桍and桏for 60 days.After dose completion,sperm parameters,hormonal profile and testis histology were analysed.Half animals of group桏(500 mg/kg body weight)were left untreated for next 30 days to assess the recovery from reproductive toxicity.Results:At azoxystrobin 125 and 250 mg/kg,sperm viability,count,and motility remained largely unaffected,but a significant decline was observed at azoxystrobin 500 mg/kg after 30 days.After 60 days,all dose levels led to a significant decrease in sperm parameters.Morphological abnormalities in sperm,such as globular heads,bent or coiled tails,and headless or tailless sperm,were noted to be increased in a dose dependent manner.Antioxidant parameters,serum level of reproductive hormones and steroidogenic enzymes followed a similar trend with non-significant changes at low and medium doses but a marked decline at the high dose after both 30 and 60 days of exposure.Histopathology of testis also revealed degenerative changes in seminiferous tubules and Leydig cell.Conclusions:Azoxystrobin exposure at high dose(500 mg/kg)affects sperm quality and disrupts testicular function via potentially impairing antioxidant defences,deregulating steroidogenesis in Swiss albino male mice.展开更多
Testicular histology based on testicular biopsy is an important factor for determining appropriate testicular sperm extraction surgery and predicting sperm retrieval outcomes in patients with azoospermia.Therefore,we ...Testicular histology based on testicular biopsy is an important factor for determining appropriate testicular sperm extraction surgery and predicting sperm retrieval outcomes in patients with azoospermia.Therefore,we developed a deep learning(DL)model to establish the associations between testicular grayscale ultrasound images and testicular histology.We retrospectively included two-dimensional testicular grayscale ultrasound from patients with azoospermia(353 men with 4357 images between July 2017 and December 2021 in The First Affiliated Hospital of Sun Yat-sen University,Guangzhou,China)to develop a DL model.We obtained testicular histology during conventional testicular sperm extraction.Our DL model was trained based on ultrasound images or fusion data(ultrasound images fused with the corresponding testicular volume)to distinguish spermatozoa presence in pathology(SPP)and spermatozoa absence in pathology(SAP)and to classify maturation arrest(MA)and Sertoli cell-only syndrome(SCOS)in patients with SAP.Areas under the receiver operating characteristic curve(AUCs),accuracy,sensitivity,and specificity were used to analyze model performance.DL based on images achieved an AUC of 0.922(95%confidence interval[CI]:0.908-0.935),a sensitivity of 80.9%,a specificity of 84.6%,and an accuracy of 83.5%in predicting SPP(including normal spermatogenesis and hypospermatogenesis)and SAP(including MA and SCOS).In the identification of SCOS and MA,DL on fusion data yielded better diagnostic performance with an AUC of 0.979(95%CI:0.969-0.989),a sensitivity of 89.7%,a specificity of 97.1%,and an accuracy of 92.1%.Our study provides a noninvasive method to predict testicular histology for patients with azoospermia,which would avoid unnecessary testicular biopsy.展开更多
Polyorchidism is a rare anomaly of the male urogenital tract characterized by the presence of one or more extra testes.Supernumerary testes can often present with coexistent conditions,including cryptorchidism,inguina...Polyorchidism is a rare anomaly of the male urogenital tract characterized by the presence of one or more extra testes.Supernumerary testes can often present with coexistent conditions,including cryptorchidism,inguinal hernia,and torsion.We report a case of a pediatric patient with initial concern for intra-scrotal left testicular torsion on ultrasonography who was ultimately found to have torsion of an intra-abdominal supernumerary testis.He underwent scrotal exploration with bilateral orchiopexy and laparoscopic excision of the torsed gonad.This case highlights a unique presentation of polyorchidism with incongruent descent of an ipsilateral supernumerary testis.展开更多
Infertility,defined as the inability to conceive after 1 year of regular unprotected intercourse,impacts 10%–20%of couples globally.Both male and female factors contribute equally to this condition.Azoospermia,partic...Infertility,defined as the inability to conceive after 1 year of regular unprotected intercourse,impacts 10%–20%of couples globally.Both male and female factors contribute equally to this condition.Azoospermia,particularly nonobstructive azoospermia(NOA),which affects 10%–15%of infertile men,represents a significant challenge in male infertility.The advent of assisted reproductive technology(ART),specifically microdissection testicular sperm extraction(micro-TESE)followed by intracytoplasmic sperm injection(ICSI),offers a possibility for men with NOA to father biological children.Recent studies have focused on the predictors of sperm retrieval in NOA patients,such as age,testicular volume,and follicle-stimulating hormone(FSH)level.This review aims to explore the limited data on the anatomical characteristics of NOA patients and provide surgical considerations for micro-TESE,thereby enhancing understanding and improving outcomes for this challenging condition.展开更多
BACKGROUND Primary testicular lymphoma(PTL)is a rare,aggressive malignancy,representing a small fraction of testicular tumors and non-Hodgkin lymphomas,yet it is the most common testicular malignancy in older men.Diff...BACKGROUND Primary testicular lymphoma(PTL)is a rare,aggressive malignancy,representing a small fraction of testicular tumors and non-Hodgkin lymphomas,yet it is the most common testicular malignancy in older men.Diffuse large B-cell lymphoma(DLBCL),which is typically the aggressive subtype,dominates PTL and shows diffuse B-cell infiltration.Venous tumor thrombus,uncommon in lymphomas,is uniquely reported in this case of testicular DLBCL with gonadal vein involvement.CASE SUMMARY A 62-year-old man presented with a two-month history of painless left testicular swelling and stiffness.Diagnostic imaging[ultrasonography,computed tomography(CT),and 18F-fluorodeoxyglucose positron emission tomography/CT(18FFDG-PET/CT)]revealed bilateral testicular masses and a gonadal vein tumor thrombus(SUVmax 16.5).Left orchiectomy confirmed DLBCL with CD20,Bcl-2,and MUM1 positivity(Ki-67:approximately 80%).The disease was staged as Ann Arbor stage IVA(International Prognostic Index score 3,high-intermediate risk).The patient received Rituximab,Polatuzumab Vedotin,Cyclophosphamide,Epirubicin,and Prednisolone chemotherapy,completing the first cycle with good tolerability.No adverse events were reported,and follow-up is ongoing to assess long-term outcomes.This case highlights the diagnostic utility of 18F-FDGPET/CT and the importance of multidisciplinary management in rare PTL presentations with tumor thrombus.CONCLUSION This case demonstrates the diagnostic complexities of PTL with gonadal vein tumor thrombus,underscoring the importance of considering lymphoma in elderly patients with testicular masses and venous involvement.A multi-disciplinary team including urologists,hematologists,and radiation oncologists is needed to ensure appropriate therapy.展开更多
Testicular biopsy was considered the cornerstone of male infertility diagnosis for many years in men with unexplained infertility and azoospermia. Recent guidelines for male infertility have limited the indications fo...Testicular biopsy was considered the cornerstone of male infertility diagnosis for many years in men with unexplained infertility and azoospermia. Recent guidelines for male infertility have limited the indications for a diagnostic testicular biopsy to the confirmation of obstructive azoospermia in men with normal size testes and normal reproductive hormones. Nowadays, testicular biopsies are mainly performed for sperm harvesting in men with non-obstructive azoospermia, to be used for intracytoplasmic sperm injection. Testicular biopsy is also performed in men with risk factors for testicular malignancy. In a subgroup of infertile men, there is an increased risk for carcinoma in situ of the testis, especially in men with a history of cryptorchidism and testicular malignancy and in men with testicular atrophy. Ultrasonographic abnormalities, such as testicular microlithiasis, inhomogeneous parenchyma and lesions of the testes, further increase the risk of carcinoma in situ （CIS） in these men. For an accurate histological classification, proper tissue handling, fixation, preparation of the specimen and evaluation are needed. A standardized approach to testicular biopsy is recommended. In addition, approaches to the detection of CIS of the testis testicular immunohistochemistry are mandatory. In this mini-review, we describe the current indications for testicular biopsies in the diagnosis and management of male infertility.展开更多
Objective To observe the clinical efficacy of thunder-fire moxibustion on pediatric testicular hydrocele. Methods Thunder-fire moxa was used for suspending moxibus on on Shu？dào（水道 ST 28） and Guānyuán...Objective To observe the clinical efficacy of thunder-fire moxibustion on pediatric testicular hydrocele. Methods Thunder-fire moxa was used for suspending moxibus on on Shu？dào（水道 ST 28） and Guānyuán（关元 CV 4） on both sides for 10 children with tes cular hydrocele,the moxa s ck was kept 2–3 cm above from the skin and the moxibustion was carried out until the skin become red and hot for about 15–20 min. The treatments were carried out once a day and ten mes were considered as a treatment course,and the therapeutic efficacy was subjected to statistics after two treatment courses. Results Eight cases were cured,and eff ec ve in 2 cases; the cured rate was 80% and the effective rate was 100%. Conclusion Thunder-fire moxibustion has rela vely good clinical effi cacy in trea ng tes cular hydrocele in children.展开更多
Introduction: Testicular cancer accounts for 5% of urological tumors, predominantly affecting young men. The aim of our study was to report the diagnostic and evolutionary aspects of testicular cancer cases treated in...Introduction: Testicular cancer accounts for 5% of urological tumors, predominantly affecting young men. The aim of our study was to report the diagnostic and evolutionary aspects of testicular cancer cases treated in our center. Patients and Methods: A retrospective study conducted over a 15-year period involving 12 patients treated for testicular cancer at the University Hospital of Brazzaville. Results: The median age was 31 years (range 11 to 49 years), with a median consultation delay of 10.6 months (range 3 to 27 months). Scrotal mass was the most common reason for consultation. Cancer was bilateral in two patients. Two patients were admitted with metastatic disease. Histopathological examination favored germ cell tumors in 7 cases, two cases of non-Hodgkin’s malignant lymphoma, and one case of epididymo-testicular adenocarcinoma. Adjuvant chemotherapy resulted in complete remission in patients with germ cell tumors. However, neoadjuvant chemotherapy was not effective in patients admitted with advanced-stage disease. Conclusion: Testicular cancer is a rare condition that is curable in the majority of cases, but its management is often complicated in our setting due to delayed diagnosis caused by taboos surrounding genital organ pathologies.展开更多
Aim： To evaluate the relationship between testicular function and testicular volume measured by using Prader orchidometry and ultrasonography （US） to determine the critical testicular volume indicating normal testi...Aim： To evaluate the relationship between testicular function and testicular volume measured by using Prader orchidometry and ultrasonography （US） to determine the critical testicular volume indicating normal testicular function by each method. Methods： Total testicular volume （right plus left testicular volume） was measured in 794 testes in 397 men with infertility （mean age, 35.6 years） using a Prader orchidometer and also by ultrasonography. Ultrasonographic testicular volumes were calculated as length x width x height x 0.71. To evaluate volume-function relationships, patients were divided into 10 groups representing 5-mL increments of total testicular volume by each method from below 10 mL to 50 mL or more. Results： Mean total testicular volume based on Prader orchidometry and US were 36.8 mL and 26.3 mL, respectively. Semen volume, sperm density, total sperm count, total motile sperm count, and serum FSH, LH, and testosterone all correlated significantly with total testicular volume measured by either method. Mean sperm density was in the oligozoospermic range in patients with total testicular volume below 35 mL by orchidometry or below 20 mL by ultrasonography. Mean total sperm count was subnormal in patients with total testicular volume below 30 mL by orchidometry or under 20 mL by ultrasonography. Conclusion： Testicular volume measured by either ultrasonography or Prader orchidometry correlated significantly with testicular function. However, critical total testicular volume indicating normal or nearly normal testicular function was 30 mL to 35 mL using Prader orchidometer and 20 mL using ultrasonography. Prader orchidometry morphometrically and functionally overestimated the testicular volume in comparison to US. （Asian JAndro12008 Mar; 10： 319-324）展开更多
Testicular microlithiasis （TM） is one of the symptoms of testicular dysgenesis syndrome （TDS）. TM is particularly interesting as an informative marker of testicular germ cell tumors （TGCTs）. KIT ligand gene （KI...Testicular microlithiasis （TM） is one of the symptoms of testicular dysgenesis syndrome （TDS）. TM is particularly interesting as an informative marker of testicular germ cell tumors （TGCTs）. KIT ligand gene （KITLG）, BCL2 antagonist/killer 1 （BAK1）, and sprouty RTK signaling antagonist 4 （SPRY4） genes are associated with a high risk of TGCTs, whereas bone morphogenetic protein 7 gene （BMP7）, transforming growth factor beta receptor 3 gene （TGFBR3）, and homeobox D cluster genes （HOXD） are related to TDS. Using polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP） analysis, we investigated allele and genotype frequencies for KITLG （rs995030, rs1508595）, SPRY4 （rs4624820, rs6897876）, BAK1 （rs210138）, BMP7 （rs388286）, TGFBR3 （rs12082710）, and HOXD （rs17198432） in 142 TGCT patients, 137 TM patients, and 153 fertile men （control group）. We found significant differences in the KITLG GG_rs995030 genotype in TM （P= 0.01） and TGCT patients （P = 0.0005） compared with the control. We also revealed strong associations between KITLGrs1508595 and TM （G allele, P = 0.003; GG genotype, P= 0.01） and between KITLG_rs1508595 and TGCTs （G allele, P-- 0.0001; GG genotype, P = 0.0007）. Moreover, there was a significant difference in BMP7_rs388286 between the TGCT group and the control （T allele, P = 0.00004; TT genotype, P = 0.00006） and between the TM group and the control （T allele, P= 0.04）. HOXDalso demonstrated a strong association with TGCTs （rs17198432 A allele, P = 0.0001; AA genotype, P = 0.001）. Furthermore, significant differences were found between the TGCT group and the control in the BAK1_rs210138 G allele （P= 0.03） and the GG genotype （P= 0.01）. KITLG and BMP7genes, associated with the development of TGCTs, may also be related to TM. In summary, the KITLG GG_rs995030, GG_rs1508595, BMP7 TT_rs388286, HOXD AA_rs17198432, and BAK1 GG_rs210138 genotypes were associated with a high risk of TGCT development.展开更多
Aim： To evaluate the outcome of repetitive micro-surgical testicular sperm extraction （mTESE） attempts in non-obstructive azoospermia （NOA） cases, in relation to patients＇ initial testicular histology results. M...Aim： To evaluate the outcome of repetitive micro-surgical testicular sperm extraction （mTESE） attempts in non-obstructive azoospermia （NOA） cases, in relation to patients＇ initial testicular histology results. Methods： A total of 68 patients with NOA in whom mTESE had been performed in previous intracytoplasmic sperm injection （ICSI） attempts were reviewed. Results： Among the 68 patients with NOA, the first mTESE yielded mature sperm for ICSI in 44 （64%） （Sp^＋）, and failed in the remaining 24 （36%） （Sp^-）. Following their first trial, 24 patients decided to undergo a second mTESE. Of these 24 patients, no spermatozoa were obtained in 5 patients, and Sp^＋ but no fertilization/pregnancy were achieved in 19. In these 24 cases, mTESE was successively repeated for two （n = 24）, three （n = 4） and four （n = 1） times. The second attempt yielded mature sperm in 3/5 patients from the Sp group and 16/19 patients from the Sp^＋ group. At the third and fourth trials, 4/4 and 1/1 of the original Sp^＋ patients were Sp^＋ again, respectively. Distribution of main testicular histology included Sertoli cell-only syndrome （16%）, maturation arrest （22%）, hypospermatogenesis （21%） and focal spermatogenesis （41%）. Overall, in repetitive mTESE, 24/29 （82%） of the attempts were finally Sp^＋. Conclusion： Repeated mTESE in patients with NOA is a feasible option, yielding considerably high sperm recovery rate. In patients with NOA, mTESE may safely be repeated one or more times to increase sperm retrieval rate, as well as to increase the chance of retrieving fresh spermatozoa to enable ICSI.展开更多
Cryptorchidism affects the growth of testicular volume.Testicular volume is associated with reproductive function.The testicular atrophy index evaluates the degree of damage caused by cryptorchidism,but it remains unc...Cryptorchidism affects the growth of testicular volume.Testicular volume is associated with reproductive function.The testicular atrophy index evaluates the degree of damage caused by cryptorchidism,but it remains unclear whether changes in testicular atrophy index are related to age.We selected patients who underwent surgery for unilateral palpable cryptorchidism.Testicular volume was measured using ultrasonography.The testicular atrophy indices of the undescended testes were then reviewed,and their correlation with age was analyzed.We studied 228 cases(age range:6–53 months).Scatter plots were constructed,and Loess curves were fitted,revealing a turning point at 24 months of age.The patients were divided into age groups of 6–24 months and 25–53 months.The testicular volume of the cryptorchid side was smaller than that of the normal side in both groups(both P<0.001).In the 6–24-month group,the testicular atrophy index was positively correlated with age,testicular volume on the cryptorchid side was not correlated with age,and testicular volume was positively correlated with age on the normal side.In the 25–53-month group,testicular atrophy index and testicular volumes on either side were not correlated with age.A palpable unilateral cryptorchid testis is smaller than the contralateral testis.The testicular atrophy index increases with age between 6 months and 24 months,but not between 25 months and 53 months.Testicular volume increased with age on the normal side between 6 months and 24 months,but not on the cryptorchid side.Trends in testicular atrophy index with age contribute to the decision of operation time.展开更多
Advances in the oncology field have led to improved survival rates.Consequently,quality of life after remission is anticipated,which includes the possibility to conceive children.Since cancer treatments are potentiall...Advances in the oncology field have led to improved survival rates.Consequently,quality of life after remission is anticipated,which includes the possibility to conceive children.Since cancer treatments are potentially gonadotoxic,fertility preservation must be proposed.Male fertility preservation is mainly based on ejaculated sperm cryopreservation.When this is not possible,testicular sperm extraction(TESE)may be planned.To identify situations in which TESE has been beneficial,a systematic review was conducted.The search was carried out on the PubMed,Scopus,Google Scholar,and CISMeF databases from 1 January 2000 to 19 March 2020.Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)recommendations were followed in selecting items of interest.Thirty-four articles were included in the systematic review,including 15 articles on oncological testicular sperm extraction(oncoTESE),18 articles on postgonadotoxic treatment TESE and 1 article on both oncoTESE and postgonadotoxic treatment TESE.Testicular sperm freezing was possible for 42.9%to 57.7%of patients before gonadotoxic treatment and for 32.4%to 75.5%of patients after gonadotoxic treatment,depending on the type of malignant disease.Although no formal conclusion could be drawn about the chances to obtain sperm in specific situations,our results suggest that TESE can be proposed before and after gonadotoxic treatment.Before treatment,TESE is more often proposed for men with testicular cancer presenting with azoospermia since TESE can be performed simultaneously with tumor removal or orchiectomy.After chemotherapy,TESE may be planned if the patient presents with persistent azoospermia.展开更多
Male reproductive infections are known to shape the immunological homeostasis of the testes,leading to male infertility.However,the specific pathogenesis of these changes remains poorly understood.Exosomes released in...Male reproductive infections are known to shape the immunological homeostasis of the testes,leading to male infertility.However,the specific pathogenesis of these changes remains poorly understood.Exosomes released in the inflammatory microenvironment are important in communication between the local microenvironment and recipient cells.Here,we aim to identify the immunomodulatory properties of inflammatory testes-derived exosomes(IT-exos)and explore their underlying mechanisms in orchitis.IT-exos were isolated using a uropathogenic Escherichia coli(UPEC)-induced orchitis model and confirmed that IT-exos promoted proinflammatory M1 activation with increasing expression of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and interleukin-6(IL-6)in vitro.We further used small RNA sequencing to identify the differential miRNA profiles in exosomes and primary testicular macrophages(TMs)from normal and UPEC-infected testes,respectively,and identified that miR-155-5p was highly enriched in IT-exos and TMs from inflammatory testes.Further study of bone marrow derived macrophages(BMDMs)transfected with miR-155-5p mimic showed that macrophages polarized to proinflammatory phenotype.In addition,the mice that were administrated IT-exos showed remarkable activation of TM1-like macrophages;however,IT-exos with silencing miR-155-5p showed a decrease in proinflammatory responses.Overall,we demonstrate that miR-155-5p delivered by IT-exos plays an important role in the activation of TM1 in UPEC-induced orchitis.Our study provides a new perspective on the immunological mechanisms underlying inflammation-related male infertility.展开更多
Background： Ketoconazole （KET）, an antifungal drug, has adverse effects on the male reproductive system. Pre-treatments with antioxidant plant against testicular damage induced by KET are required. The flowers of C...Background： Ketoconazole （KET）, an antifungal drug, has adverse effects on the male reproductive system. Pre-treatments with antioxidant plant against testicular damage induced by KET are required. The flowers of Clitoria tematea （CT） are proven to have hepatoprotective potential. However, the protective effect on KET-induced testicular damage has not been reported. Objective： To investigate the protective effect of CT flower extracts with antioxidant activity on male reproductive parameters including sperm concentration, serum testosterone level, histopathology of the testis, and testicular tyrosine phosphorylation levels in rats induced with KET. Methods： The antioxidant activity of CT flower extracts was determined using 2,2-diphenyl-1-picrylhydrazyl （DPPH） and ferric reducing antioxidant power （FRAP） assays. Male rats were treated with CT flower extracts （10, 50, or 100 mg/kg BW） or distilled water via a gastric tube for 28 d （preventive period： Days 1-21） and induced by KET （100 mg/kg BW） via intraperitoneal injection for 7 d （induction period： Days 22-28）. After the experiment, all animals were examined for the weights of the testis, epididymis plus vas deferens and seminal vesicle, serum testosterone levels, sperm concentration, histological structures and diameter of testis, and testicular tyrosine phosphorylation levels by immunoblotting. Results： The CT flower extracts had capabilities for DPPH scavenging and high reducing power. At 100 mg/kg BW, the extract had no toxic effects on the male reproductive system. Significantly, in CT＋KET groups, CT flower extracts （50 and 100 mg/kg BW） alleviated the reduction of reproductive organ weight parameters, testosterone levels, and sperm concentration. In addition, CT flower extracts gave protection from testicular damage in KET-induced rats. Moreover, in the CT100＋KET group, CT flower extracts significantly enhanced the expression of a testicular 50-kDa tyrosine phosphorylated protein compared with that of other groups. Conclusions： C. ternatea flower extracts possessing antioxidant activity are not harmful to the male reproductive system and can protect against testicular damage in KET-induced rats.展开更多
基金supported by the National Natural Science Foundation of China(82371709).
文摘Testicular torsion is a urological emergency that requires prompt diagnosis and treatment,accounting for 10%-15%of cases of acute scrotum.[1]It occurs most frequently during the perinatal period and adolescence and can occur at any age.[2]The incidence of testicular torsion is 1/4,000 in males under 25 years of age and 1/160 in males over 25 years of age.[3]Unilateral torsion is relatively common,with a higher incidence on the left side.Testicular torsion is typically managed through surgical exploration.Necrotic testes,identified by a black appearance,require orchiectomy.[4]
文摘Testicular tumor is the most common solid malignancy in males under 40 years of age.This malignancy is known to have a negative impact on male fertility.Therefore,several techniques for sperm retrieval have been proposed,including microdissection testicular sperm extraction(mTESE).The objective of this study was to review the literature on the outcomes of oncological(Onco)-mTESE at the time of radical orchiectomy.We conducted a comprehensive literature search through PubMed,Scopus,and Cochrane Central Controlled Register of Trials.Only studies reporting ex vivo mTESE in patients with testicular tumor were considered.Twelve papers met the inclusion criteria and were included in this review.Tumor size was identified as the sole preoperative factor influencing spermatogenesis.The considered studies demonstrated a satisfactory success rate for Onco-mTESE,associated with a similarly valid percentage of live healthy births through assisted reproductive technology.Currently,no comparison has been made between Onco-mTESE and conventional Onco-TESE,hence further assessment is required.In cases where the tumor completely replaces the cancer-bearing testicle,a contralateral micro-TESE may be a viable alternative.However,the surgeon should evaluate associated risks and benefits preoperatively.In conclusion,Onco-mTESE at the time of radical orchiectomy appears to be a promising therapeutic option for young patients with testicular tumors.Nevertheless,additional studies are necessary to achieve a definitive conclusion.
基金supported by the National Natural Science Foundation of China(No.82371633)Peking University Clinical Scientist Training Program and the Fundamental Research Funds for the Central University(BMU2023PYJ H012).
文摘Oncological microdissection testicular sperm extraction(onco-micro-TESE)represents a significant breakthrough for patients with nonobstructive azoospermia(NOA)and a concomitant in situ testicular tumor,to be managed at the time of sperm retrieval.Onco-micro-TESE addresses the dual objectives of treating both infertility and the testicular tumor simultaneously.The technique is intricate,necessitating a comprehensive understanding of testicular anatomy,physiology,tumor biology,and advanced microsurgical methods.It aims to carefully extract viable spermatozoa while minimizing the risk of tumor dissemination.This review encapsulates the procedural intricacies,evaluates success determinants,including tumor pathology and spermatogenic tissue health,and discusses the implementation of imaging techniques for enhanced surgical precision.Ethical considerations are paramount,as the procedure implicates complex decision-making that weighs the potential oncological risks against the profound desire for fatherhood using the male gametes.The review aims to provide a holistic overview of onco-micro-TESE,detailing methodological advances,clinical outcomes,and the ethical landscape,thus offering an indispensable resource for clinicians navigating this multifaceted clinical scenario.
基金VMR is funded by the AUA and Urology Care Foundation(Research Scholars Award)as well as an NIH NRSA training grant(5T32DK060442-20)HT is funded by the AUA and Urology Care Foundation(Research Scholars Award),SUFU(Chemodenervation Grant),and the Office of Faculty Development at Harvard Medical School.
文摘A 14-year-old presented with an asymptomatic left testicular mass after a brief episode of pain.Examination showed a non-tender left testis that was significantly larger than the right.Ultrasound revealed a 4.5-cm avascular mass and an absence of normal testicular parenchyma.Tumor markers were unremarkable.A CT scan demonstrated no lymphadenopathy but identified a prominent left spermatic cord.Due to a suspicion of chronic torsion vs.malignancy,a left radical orchiectomy was performed.Pathology identified a hemorrhagic paratesticular venous malformation without signs of germ cell neoplasia,a rare entity.
基金This study was funded by the Guangdong High-level Hospital Construction Fund and Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties(SZXK035).
文摘The aim of this study was to investigate the trend in testicular volume changes after orchiopexy in children with cryptorchidism.The clinical data of 854 children with cryptorchidism who underwent orchiopexy between January 2013 and December 2016 in Shenzhen Children’s Hospital(Shenzhen,China)were retrospectively analyzed.The mean(standard deviation)age of the patients was 2.8(2.5)years,and the duration of follow-up ranged from 1 year to 5 years.Ultrasonography was conducted preoperatively and postoperatively.The variables analyzed included age at the time of surgery,type of surgical procedure,laterality,preoperative testicular position,preoperative and postoperative testicular volumes,and the testicular volume ratio of them.The average testicular volumes preoperatively and at 1 year,2 years,3 years,and 5 years postoperatively were 0.27 ml,0.38 ml,0.53 ml,0.87 ml,and 1.00 ml,respectively(P<0.001).The corresponding testicular volume ratios were 0.67,0.76,0.80,0.83,and 0.84(P<0.001).The mean volume of the undescended testes was significantly smaller than the mean normative value(P<0.001,lower than the 10th percentile).The postoperative testicular volumes in children with cryptorchidism were generally lower than those in healthy boys but were still greater than the 10th percentile and exhibited an increasing trend.The older the child is at the time of surgery,the larger the gap in volume between the affected and normal testes.Although testicular volume tends to gradually increase after orchiopexy for cryptorchidism,it could not normalizes.Earlier surgery results in affected testicular volumes closer to those of healthy boys.
基金The research was conducted without any financial support from external funding agency.
文摘Objective:To assess the effects of azoxystrobin on sperm quality,hormone levels and testicular structure in Swiss albino mice.Methods:48 Swiss albino male mice were divided into 7 groups containing 6 mice in each group except Group桏in which 12 mice were taken.Group栺served as the control group and treated with vehicle(distil water for 30 and 60 days).Azoxystrobin at three different doses(125,250,500 mg/kg body weight)was orally administered to Group栻,栿and桇for 30 days and Group桋,桍and桏for 60 days.After dose completion,sperm parameters,hormonal profile and testis histology were analysed.Half animals of group桏(500 mg/kg body weight)were left untreated for next 30 days to assess the recovery from reproductive toxicity.Results:At azoxystrobin 125 and 250 mg/kg,sperm viability,count,and motility remained largely unaffected,but a significant decline was observed at azoxystrobin 500 mg/kg after 30 days.After 60 days,all dose levels led to a significant decrease in sperm parameters.Morphological abnormalities in sperm,such as globular heads,bent or coiled tails,and headless or tailless sperm,were noted to be increased in a dose dependent manner.Antioxidant parameters,serum level of reproductive hormones and steroidogenic enzymes followed a similar trend with non-significant changes at low and medium doses but a marked decline at the high dose after both 30 and 60 days of exposure.Histopathology of testis also revealed degenerative changes in seminiferous tubules and Leydig cell.Conclusions:Azoxystrobin exposure at high dose(500 mg/kg)affects sperm quality and disrupts testicular function via potentially impairing antioxidant defences,deregulating steroidogenesis in Swiss albino male mice.
基金supported by the Key Research and Development Program of Guangzhou Science and Technology Projects(No.2023B03J1260).
文摘Testicular histology based on testicular biopsy is an important factor for determining appropriate testicular sperm extraction surgery and predicting sperm retrieval outcomes in patients with azoospermia.Therefore,we developed a deep learning(DL)model to establish the associations between testicular grayscale ultrasound images and testicular histology.We retrospectively included two-dimensional testicular grayscale ultrasound from patients with azoospermia(353 men with 4357 images between July 2017 and December 2021 in The First Affiliated Hospital of Sun Yat-sen University,Guangzhou,China)to develop a DL model.We obtained testicular histology during conventional testicular sperm extraction.Our DL model was trained based on ultrasound images or fusion data(ultrasound images fused with the corresponding testicular volume)to distinguish spermatozoa presence in pathology(SPP)and spermatozoa absence in pathology(SAP)and to classify maturation arrest(MA)and Sertoli cell-only syndrome(SCOS)in patients with SAP.Areas under the receiver operating characteristic curve(AUCs),accuracy,sensitivity,and specificity were used to analyze model performance.DL based on images achieved an AUC of 0.922(95%confidence interval[CI]:0.908-0.935),a sensitivity of 80.9%,a specificity of 84.6%,and an accuracy of 83.5%in predicting SPP(including normal spermatogenesis and hypospermatogenesis)and SAP(including MA and SCOS).In the identification of SCOS and MA,DL on fusion data yielded better diagnostic performance with an AUC of 0.979(95%CI:0.969-0.989),a sensitivity of 89.7%,a specificity of 97.1%,and an accuracy of 92.1%.Our study provides a noninvasive method to predict testicular histology for patients with azoospermia,which would avoid unnecessary testicular biopsy.
文摘Polyorchidism is a rare anomaly of the male urogenital tract characterized by the presence of one or more extra testes.Supernumerary testes can often present with coexistent conditions,including cryptorchidism,inguinal hernia,and torsion.We report a case of a pediatric patient with initial concern for intra-scrotal left testicular torsion on ultrasonography who was ultimately found to have torsion of an intra-abdominal supernumerary testis.He underwent scrotal exploration with bilateral orchiopexy and laparoscopic excision of the torsed gonad.This case highlights a unique presentation of polyorchidism with incongruent descent of an ipsilateral supernumerary testis.
文摘Infertility,defined as the inability to conceive after 1 year of regular unprotected intercourse,impacts 10%–20%of couples globally.Both male and female factors contribute equally to this condition.Azoospermia,particularly nonobstructive azoospermia(NOA),which affects 10%–15%of infertile men,represents a significant challenge in male infertility.The advent of assisted reproductive technology(ART),specifically microdissection testicular sperm extraction(micro-TESE)followed by intracytoplasmic sperm injection(ICSI),offers a possibility for men with NOA to father biological children.Recent studies have focused on the predictors of sperm retrieval in NOA patients,such as age,testicular volume,and follicle-stimulating hormone(FSH)level.This review aims to explore the limited data on the anatomical characteristics of NOA patients and provide surgical considerations for micro-TESE,thereby enhancing understanding and improving outcomes for this challenging condition.
文摘BACKGROUND Primary testicular lymphoma(PTL)is a rare,aggressive malignancy,representing a small fraction of testicular tumors and non-Hodgkin lymphomas,yet it is the most common testicular malignancy in older men.Diffuse large B-cell lymphoma(DLBCL),which is typically the aggressive subtype,dominates PTL and shows diffuse B-cell infiltration.Venous tumor thrombus,uncommon in lymphomas,is uniquely reported in this case of testicular DLBCL with gonadal vein involvement.CASE SUMMARY A 62-year-old man presented with a two-month history of painless left testicular swelling and stiffness.Diagnostic imaging[ultrasonography,computed tomography(CT),and 18F-fluorodeoxyglucose positron emission tomography/CT(18FFDG-PET/CT)]revealed bilateral testicular masses and a gonadal vein tumor thrombus(SUVmax 16.5).Left orchiectomy confirmed DLBCL with CD20,Bcl-2,and MUM1 positivity(Ki-67:approximately 80%).The disease was staged as Ann Arbor stage IVA(International Prognostic Index score 3,high-intermediate risk).The patient received Rituximab,Polatuzumab Vedotin,Cyclophosphamide,Epirubicin,and Prednisolone chemotherapy,completing the first cycle with good tolerability.No adverse events were reported,and follow-up is ongoing to assess long-term outcomes.This case highlights the diagnostic utility of 18F-FDGPET/CT and the importance of multidisciplinary management in rare PTL presentations with tumor thrombus.CONCLUSION This case demonstrates the diagnostic complexities of PTL with gonadal vein tumor thrombus,underscoring the importance of considering lymphoma in elderly patients with testicular masses and venous involvement.A multi-disciplinary team including urologists,hematologists,and radiation oncologists is needed to ensure appropriate therapy.
文摘Testicular biopsy was considered the cornerstone of male infertility diagnosis for many years in men with unexplained infertility and azoospermia. Recent guidelines for male infertility have limited the indications for a diagnostic testicular biopsy to the confirmation of obstructive azoospermia in men with normal size testes and normal reproductive hormones. Nowadays, testicular biopsies are mainly performed for sperm harvesting in men with non-obstructive azoospermia, to be used for intracytoplasmic sperm injection. Testicular biopsy is also performed in men with risk factors for testicular malignancy. In a subgroup of infertile men, there is an increased risk for carcinoma in situ of the testis, especially in men with a history of cryptorchidism and testicular malignancy and in men with testicular atrophy. Ultrasonographic abnormalities, such as testicular microlithiasis, inhomogeneous parenchyma and lesions of the testes, further increase the risk of carcinoma in situ （CIS） in these men. For an accurate histological classification, proper tissue handling, fixation, preparation of the specimen and evaluation are needed. A standardized approach to testicular biopsy is recommended. In addition, approaches to the detection of CIS of the testis testicular immunohistochemistry are mandatory. In this mini-review, we describe the current indications for testicular biopsies in the diagnosis and management of male infertility.
文摘Objective To observe the clinical efficacy of thunder-fire moxibustion on pediatric testicular hydrocele. Methods Thunder-fire moxa was used for suspending moxibus on on Shu？dào（水道 ST 28） and Guānyuán（关元 CV 4） on both sides for 10 children with tes cular hydrocele,the moxa s ck was kept 2–3 cm above from the skin and the moxibustion was carried out until the skin become red and hot for about 15–20 min. The treatments were carried out once a day and ten mes were considered as a treatment course,and the therapeutic efficacy was subjected to statistics after two treatment courses. Results Eight cases were cured,and eff ec ve in 2 cases; the cured rate was 80% and the effective rate was 100%. Conclusion Thunder-fire moxibustion has rela vely good clinical effi cacy in trea ng tes cular hydrocele in children.
文摘Introduction: Testicular cancer accounts for 5% of urological tumors, predominantly affecting young men. The aim of our study was to report the diagnostic and evolutionary aspects of testicular cancer cases treated in our center. Patients and Methods: A retrospective study conducted over a 15-year period involving 12 patients treated for testicular cancer at the University Hospital of Brazzaville. Results: The median age was 31 years (range 11 to 49 years), with a median consultation delay of 10.6 months (range 3 to 27 months). Scrotal mass was the most common reason for consultation. Cancer was bilateral in two patients. Two patients were admitted with metastatic disease. Histopathological examination favored germ cell tumors in 7 cases, two cases of non-Hodgkin’s malignant lymphoma, and one case of epididymo-testicular adenocarcinoma. Adjuvant chemotherapy resulted in complete remission in patients with germ cell tumors. However, neoadjuvant chemotherapy was not effective in patients admitted with advanced-stage disease. Conclusion: Testicular cancer is a rare condition that is curable in the majority of cases, but its management is often complicated in our setting due to delayed diagnosis caused by taboos surrounding genital organ pathologies.
文摘Aim： To evaluate the relationship between testicular function and testicular volume measured by using Prader orchidometry and ultrasonography （US） to determine the critical testicular volume indicating normal testicular function by each method. Methods： Total testicular volume （right plus left testicular volume） was measured in 794 testes in 397 men with infertility （mean age, 35.6 years） using a Prader orchidometer and also by ultrasonography. Ultrasonographic testicular volumes were calculated as length x width x height x 0.71. To evaluate volume-function relationships, patients were divided into 10 groups representing 5-mL increments of total testicular volume by each method from below 10 mL to 50 mL or more. Results： Mean total testicular volume based on Prader orchidometry and US were 36.8 mL and 26.3 mL, respectively. Semen volume, sperm density, total sperm count, total motile sperm count, and serum FSH, LH, and testosterone all correlated significantly with total testicular volume measured by either method. Mean sperm density was in the oligozoospermic range in patients with total testicular volume below 35 mL by orchidometry or below 20 mL by ultrasonography. Mean total sperm count was subnormal in patients with total testicular volume below 30 mL by orchidometry or under 20 mL by ultrasonography. Conclusion： Testicular volume measured by either ultrasonography or Prader orchidometry correlated significantly with testicular function. However, critical total testicular volume indicating normal or nearly normal testicular function was 30 mL to 35 mL using Prader orchidometer and 20 mL using ultrasonography. Prader orchidometry morphometrically and functionally overestimated the testicular volume in comparison to US. （Asian JAndro12008 Mar; 10： 319-324）
文摘Testicular microlithiasis （TM） is one of the symptoms of testicular dysgenesis syndrome （TDS）. TM is particularly interesting as an informative marker of testicular germ cell tumors （TGCTs）. KIT ligand gene （KITLG）, BCL2 antagonist/killer 1 （BAK1）, and sprouty RTK signaling antagonist 4 （SPRY4） genes are associated with a high risk of TGCTs, whereas bone morphogenetic protein 7 gene （BMP7）, transforming growth factor beta receptor 3 gene （TGFBR3）, and homeobox D cluster genes （HOXD） are related to TDS. Using polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP） analysis, we investigated allele and genotype frequencies for KITLG （rs995030, rs1508595）, SPRY4 （rs4624820, rs6897876）, BAK1 （rs210138）, BMP7 （rs388286）, TGFBR3 （rs12082710）, and HOXD （rs17198432） in 142 TGCT patients, 137 TM patients, and 153 fertile men （control group）. We found significant differences in the KITLG GG_rs995030 genotype in TM （P= 0.01） and TGCT patients （P = 0.0005） compared with the control. We also revealed strong associations between KITLGrs1508595 and TM （G allele, P = 0.003; GG genotype, P= 0.01） and between KITLG_rs1508595 and TGCTs （G allele, P-- 0.0001; GG genotype, P = 0.0007）. Moreover, there was a significant difference in BMP7_rs388286 between the TGCT group and the control （T allele, P = 0.00004; TT genotype, P = 0.00006） and between the TM group and the control （T allele, P= 0.04）. HOXDalso demonstrated a strong association with TGCTs （rs17198432 A allele, P = 0.0001; AA genotype, P = 0.001）. Furthermore, significant differences were found between the TGCT group and the control in the BAK1_rs210138 G allele （P= 0.03） and the GG genotype （P= 0.01）. KITLG and BMP7genes, associated with the development of TGCTs, may also be related to TM. In summary, the KITLG GG_rs995030, GG_rs1508595, BMP7 TT_rs388286, HOXD AA_rs17198432, and BAK1 GG_rs210138 genotypes were associated with a high risk of TGCT development.
文摘Aim： To evaluate the outcome of repetitive micro-surgical testicular sperm extraction （mTESE） attempts in non-obstructive azoospermia （NOA） cases, in relation to patients＇ initial testicular histology results. Methods： A total of 68 patients with NOA in whom mTESE had been performed in previous intracytoplasmic sperm injection （ICSI） attempts were reviewed. Results： Among the 68 patients with NOA, the first mTESE yielded mature sperm for ICSI in 44 （64%） （Sp^＋）, and failed in the remaining 24 （36%） （Sp^-）. Following their first trial, 24 patients decided to undergo a second mTESE. Of these 24 patients, no spermatozoa were obtained in 5 patients, and Sp^＋ but no fertilization/pregnancy were achieved in 19. In these 24 cases, mTESE was successively repeated for two （n = 24）, three （n = 4） and four （n = 1） times. The second attempt yielded mature sperm in 3/5 patients from the Sp group and 16/19 patients from the Sp^＋ group. At the third and fourth trials, 4/4 and 1/1 of the original Sp^＋ patients were Sp^＋ again, respectively. Distribution of main testicular histology included Sertoli cell-only syndrome （16%）, maturation arrest （22%）, hypospermatogenesis （21%） and focal spermatogenesis （41%）. Overall, in repetitive mTESE, 24/29 （82%） of the attempts were finally Sp^＋. Conclusion： Repeated mTESE in patients with NOA is a feasible option, yielding considerably high sperm recovery rate. In patients with NOA, mTESE may safely be repeated one or more times to increase sperm retrieval rate, as well as to increase the chance of retrieving fresh spermatozoa to enable ICSI.
基金funded by the Medical Science and Technology Research Project of Henan Province provided by the Health Commission of Henan Province(No.LHGJ20190383).
文摘Cryptorchidism affects the growth of testicular volume.Testicular volume is associated with reproductive function.The testicular atrophy index evaluates the degree of damage caused by cryptorchidism,but it remains unclear whether changes in testicular atrophy index are related to age.We selected patients who underwent surgery for unilateral palpable cryptorchidism.Testicular volume was measured using ultrasonography.The testicular atrophy indices of the undescended testes were then reviewed,and their correlation with age was analyzed.We studied 228 cases(age range:6–53 months).Scatter plots were constructed,and Loess curves were fitted,revealing a turning point at 24 months of age.The patients were divided into age groups of 6–24 months and 25–53 months.The testicular volume of the cryptorchid side was smaller than that of the normal side in both groups(both P<0.001).In the 6–24-month group,the testicular atrophy index was positively correlated with age,testicular volume on the cryptorchid side was not correlated with age,and testicular volume was positively correlated with age on the normal side.In the 25–53-month group,testicular atrophy index and testicular volumes on either side were not correlated with age.A palpable unilateral cryptorchid testis is smaller than the contralateral testis.The testicular atrophy index increases with age between 6 months and 24 months,but not between 25 months and 53 months.Testicular volume increased with age on the normal side between 6 months and 24 months,but not on the cryptorchid side.Trends in testicular atrophy index with age contribute to the decision of operation time.
文摘Advances in the oncology field have led to improved survival rates.Consequently,quality of life after remission is anticipated,which includes the possibility to conceive children.Since cancer treatments are potentially gonadotoxic,fertility preservation must be proposed.Male fertility preservation is mainly based on ejaculated sperm cryopreservation.When this is not possible,testicular sperm extraction(TESE)may be planned.To identify situations in which TESE has been beneficial,a systematic review was conducted.The search was carried out on the PubMed,Scopus,Google Scholar,and CISMeF databases from 1 January 2000 to 19 March 2020.Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)recommendations were followed in selecting items of interest.Thirty-four articles were included in the systematic review,including 15 articles on oncological testicular sperm extraction(oncoTESE),18 articles on postgonadotoxic treatment TESE and 1 article on both oncoTESE and postgonadotoxic treatment TESE.Testicular sperm freezing was possible for 42.9%to 57.7%of patients before gonadotoxic treatment and for 32.4%to 75.5%of patients after gonadotoxic treatment,depending on the type of malignant disease.Although no formal conclusion could be drawn about the chances to obtain sperm in specific situations,our results suggest that TESE can be proposed before and after gonadotoxic treatment.Before treatment,TESE is more often proposed for men with testicular cancer presenting with azoospermia since TESE can be performed simultaneously with tumor removal or orchiectomy.After chemotherapy,TESE may be planned if the patient presents with persistent azoospermia.
基金This work was funded by National Key R&D Program of China(2018YFC1004300 and 2018YFC1004304)National Natural Foundation of China(No.81871148 and No.818701539).
文摘Male reproductive infections are known to shape the immunological homeostasis of the testes,leading to male infertility.However,the specific pathogenesis of these changes remains poorly understood.Exosomes released in the inflammatory microenvironment are important in communication between the local microenvironment and recipient cells.Here,we aim to identify the immunomodulatory properties of inflammatory testes-derived exosomes(IT-exos)and explore their underlying mechanisms in orchitis.IT-exos were isolated using a uropathogenic Escherichia coli(UPEC)-induced orchitis model and confirmed that IT-exos promoted proinflammatory M1 activation with increasing expression of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and interleukin-6(IL-6)in vitro.We further used small RNA sequencing to identify the differential miRNA profiles in exosomes and primary testicular macrophages(TMs)from normal and UPEC-infected testes,respectively,and identified that miR-155-5p was highly enriched in IT-exos and TMs from inflammatory testes.Further study of bone marrow derived macrophages(BMDMs)transfected with miR-155-5p mimic showed that macrophages polarized to proinflammatory phenotype.In addition,the mice that were administrated IT-exos showed remarkable activation of TM1-like macrophages;however,IT-exos with silencing miR-155-5p showed a decrease in proinflammatory responses.Overall,we demonstrate that miR-155-5p delivered by IT-exos plays an important role in the activation of TM1 in UPEC-induced orchitis.Our study provides a new perspective on the immunological mechanisms underlying inflammation-related male infertility.
基金Project supported by the Faculty of Medicine,Khon Kaen University(No.I 55222),Thailand
文摘Background： Ketoconazole （KET）, an antifungal drug, has adverse effects on the male reproductive system. Pre-treatments with antioxidant plant against testicular damage induced by KET are required. The flowers of Clitoria tematea （CT） are proven to have hepatoprotective potential. However, the protective effect on KET-induced testicular damage has not been reported. Objective： To investigate the protective effect of CT flower extracts with antioxidant activity on male reproductive parameters including sperm concentration, serum testosterone level, histopathology of the testis, and testicular tyrosine phosphorylation levels in rats induced with KET. Methods： The antioxidant activity of CT flower extracts was determined using 2,2-diphenyl-1-picrylhydrazyl （DPPH） and ferric reducing antioxidant power （FRAP） assays. Male rats were treated with CT flower extracts （10, 50, or 100 mg/kg BW） or distilled water via a gastric tube for 28 d （preventive period： Days 1-21） and induced by KET （100 mg/kg BW） via intraperitoneal injection for 7 d （induction period： Days 22-28）. After the experiment, all animals were examined for the weights of the testis, epididymis plus vas deferens and seminal vesicle, serum testosterone levels, sperm concentration, histological structures and diameter of testis, and testicular tyrosine phosphorylation levels by immunoblotting. Results： The CT flower extracts had capabilities for DPPH scavenging and high reducing power. At 100 mg/kg BW, the extract had no toxic effects on the male reproductive system. Significantly, in CT＋KET groups, CT flower extracts （50 and 100 mg/kg BW） alleviated the reduction of reproductive organ weight parameters, testosterone levels, and sperm concentration. In addition, CT flower extracts gave protection from testicular damage in KET-induced rats. Moreover, in the CT100＋KET group, CT flower extracts significantly enhanced the expression of a testicular 50-kDa tyrosine phosphorylated protein compared with that of other groups. Conclusions： C. ternatea flower extracts possessing antioxidant activity are not harmful to the male reproductive system and can protect against testicular damage in KET-induced rats.
