Numerous reports have recently focused on various aspects of adverse trends in male reproductive health, such as the rising incidence of testicular cancer; low and probably declining semen quality; high and possibly increasing frequencies of undescended testis and hypospadias; and an apparently growing demand for assisted reproduction. Due to specialization in medicine and different ages at presentation of symptoms, reproductive problems used to be analysed separately by various professional groups, e.g. paediatric endocrinologists, urologists, andrologists and oncologists. This article summarizes existing evidence supporting a new concept that poor semen quality, testis cancer, undescended testis and hypospadias are symptoms of one underlying entity, the testicular dysgenesis syndrome (TDS), which may be increasingly common due to adverse environmental influences. Experimental and epidemiological studies suggest that TDS is a result of disruption of embryonal programming and gonadal development during fetal life. Therefore, we recommend that future epidemiological studies on trends in male reproductive health should not focus on one symptom only, but be more comprehensive and take all aspects of TDS into account. Otherwise, important biological information may be lost.

Testicular dysgenesis syndrome ; an increasingly common developmental disorder with environmental aspects

Sickle-cell disease is one of the most common severe monogenic disorders in the world. Haemoglobin polymerisation, leading to erythrocyte rigidity and vaso-occlusion, is central to the pathophysiology of this disease, although the importance of chronic anaemia, haemolysis, and vasculopathy has been established. Clinical management is basic and few treatments have a robust evidence base. One of the main problems of sickle-cell disease in children is the development of cerebrovascular disease and cognitive impairment, and the role of blood transfusion and hydroxycarbamide for prevention of these complications is starting to be understood. Recurrent episodes of vaso-occlusion and inflammation result in progressive damage to most organs, including the brain, kidneys, lungs, bones, and cardiovascular system, which becomes apparent with increasing age. Most people with sickle-cell disease live in Africa, where little is known about this disease; however, we do know that the disorder follows a more severe clinical course in Africa than for the rest of the world and that infectious diseases have a role in causing this increased severity of sickle-cell disease. More work is needed to develop effective treatments that specifically target pathophysiological changes and clinical complications of sickle-cell disease.

https://www.nejm.org/doi/pdf/10.1056/NEJMra1510865

Sickle Cell Disease

Urotrauma: aua guideline

https://peds.arizona.edu/sites/default/files/curriculum-files/cryptorchidismauaguideline2014_000.pdf

Evaluation and Treatment of Cryptorchidism: AUA Guideline

https://uroweb.org/wp-content/uploads/Salonia-A.-et-al-Eur-Urol-2014-652480-9.-European-Association-of-Urology-Guidelines-on-Priapism.pdf

European Association of Urology Guidelines on Priapism

OBJECTIVES: To assess epidemiologic characteristics of penile cancer in Brazil. MATERIALS AND METHODS: From May 2006 to June 2007, a questionnaire was distributed to all Brazilian urologists. Their patients' clinical and epidemiological data was analyzed (age, race, place of residence, history of sexually transmitted diseases, tobacco smoking, performance of circumcision, type of hospital service), as well as the time between the appearance of the symptoms and the diagnosis, the pathological characteristics of the tumor (histological type, degree, localization and size of lesion, stage of disease), the type of treatment performed and the present state of the patient. RESULTS: 283 new cases of penile cancer in Brazil were recorded. The majority of these cases occurred in the north and northeast (53.02%) and southeast (45.54%) regions. The majority of patients (224, or 78.96%) were more than 46 years of age while only 21 patients (7.41%) were less than 35 years of age. Of the 283 patients presenting penile cancer, 171 (60.42%) had phimosis with the consequent impossibility to expose the glans. A prior medical history positive for HPV infection was reported in 18 of the 283 cases (6.36%). In 101 patients (35.68%) tobacco smoking was reported. The vast majority of the cases (n = 207; 73.14%) presented with tumors localized in the glans and prepuce. In 48 cases (16.96%) the tumor affected the glans, the prepuce and the corpus penis; in 28 cases (9.89%) the tumor affected the entire penis. The majority of the patients (n = 123; 75.26%) presented with T1 or T2; only 9 patients (3.18%) presented with T4 disease. CONCLUSION: Penile cancer is a very frequent pathology in Brazil, predominantly affecting low income, white, uncircumcised patients, living in the north and northeast regions of the country.

/pdf/epidemiologic-study-on-penile-cancer-in-brazil-3tt9s2t2ou.pdf

Epidemiologic study on penile cancer in Brazil

Ureteropelvic junction stenosis: vascular anatomical background for endopyelotomy

http://www.urogenitalresearch.org/prod/intra_arteries_JUrol172_2077_81_2004.pdf

Pig kidney: anatomical relationships between the intrarenal arteries and the kidney collecting system. applied study for urological research and surgical training

Intrarenal Access: 3-Dimensional Anatomical Study

We present detailed anatomic findings on collecting system anatomy and renal morphometry in the pig and compare these findings with previous findings in humans. We studied three-dimensional polyester resin corrosion endocasts of the pelviocaliceal system obtained from 100 kidneys (50 pigs). Eighty kidneys were evaluated morphometrically, considering length, cranial pole width, caudal pole width, thickness, and weight. The pig collecting system was classified into two major groups (A and B). Group A (40%) was composed of kidneys in which the mid-zone is drained by calices dependent on the cranial or the caudal caliceal group or both. Group B (60%) kidneys have the mid-zone drained by calices independent of the polar groups. Group B includes two subtypes (B-I and B-II). The pig collecting system showed only angles smaller than 90 degrees between the caudal (lower) infundibulum and the renal pelvis. Renal morphometric measurements revealed the following means: length 11.8 cm, cranial pole width 5.64 cm, caudal pole width 5.35 cm, thickness 2.76 cm, and weight 98 g. As in human kidneys, one may group the pig collecting system into two groups. Nevertheless, in pigs, we did not find a subdivision of Group A. The incidence of collecting systems in Groups A and B and the subtypes of Group B in pigs are different from those in humans. Also different from humans, in pigs, we found only angles smaller than 90 degrees between the caudal (lower) infundibulum and the renal pelvis. Except for the length, the means of the other morphometric measurements of the pig kidney are smaller than those of humans. From an anatomic standpoint, despite the differences pointed out, we conclude that the pig kidney is a good animal model for endourologic research and training.

Luciano A. Favorito

Papers

Epidemiologic study on penile cancer in Brazil

Ureteropelvic junction stenosis: vascular anatomical background for endopyelotomy

Pig kidney: anatomical relationships between the intrarenal arteries and the kidney collecting system. applied study for urological research and surgical training

Intrarenal Access: 3-Dimensional Anatomical Study

The pig kidney as an endourologic model: anatomic contribution.