Late hormonal levels, semen parameters, and presence of antisperm antibodies in patients treated for testicular torsion.
Marco A. Arap,Fabio C. Vicentini,Marcello Cocuzza,Jorge Hallak,Kelly S. Athayde,Antonio Marmo Lucon,Sami Arap,Miguel Srougi +7 more
TLDR
Although sperm quality was preserved in most of the patients with the exception of sperm morphology, patients treated with orchiectomy presented better motility and morphology compared with the detorsion group, and it was found that after torsion patients maintain late hormonal levels within the normal range.Abstract:
In spite of prompt diagnosis and either orchiectomy or preservation of the affected testis, infertility remains a significant sequel to testicular torsion. The objective of this study was to evaluate the late endocrine profile, seminal parameters, and antisperm antibody levels after testicular torsion. We also analyzed the impact of orchiectomy or detorsion on the organ fate. Of 24 patients evaluated after testicular torsion, 15 were treated with orchiectomy (group 1) and 9 were treated with orchiopexy (group 2). All subjects were assessed by semen analysis, endocrine profile (levels of follicle-stimulating hormone, luteinizing hormone, and testosterone), and seminal antisperm antibody levels. A group of 20 proven fertile men was used as the control. Median ischemia time in group 1 (48 hours) was significantly higher than in group 2 (7 hours). Both groups demonstrated decreases in sperm count and morphology compared with controls. Group 1 showed a significantly higher motility than group 2 (P = .02). Group 1 also showed a significantly better morphology by World Health Organization and Kruger criteria than group 2 (P = .01). All patients presented endocrine profiles within the normal range, and no significant differences in antisperm antibody levels were detected between the groups. However, a trend for higher levels was found in patients treated for testicular torsion, regardless of the fate of the testis. Moreover, no significant correlation was found between antisperm antibody levels and age at torsion, ischemia time, seminal parameters, or treatment applied. In conclusion, we found that after torsion patients maintain late hormonal levels within the normal range. Testicular fate did not have any correlation with the formation of antisperm antibodies. Although sperm quality was preserved in most of the patients with the exception of sperm morphology, patients treated with orchiectomy presented better motility and morphology compared with the detorsion group. Further studies may clarify whether maintenance of a severely ischemic testicle may impair testicular function.read more
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Guidelines on paediatric urology
Journal ArticleDOI
Pediatric Testicular Torsion Epidemiology Using a National Database: Incidence, Risk of Orchiectomy and Possible Measures Toward Improving the Quality of Care
TL;DR: The modern incidence of testicular torsion as well as the current rates of orchiectomy and attempted testicular salvage are determined, and the risk factors for testicular loss are identified.
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The epidemiology and etiology of azoospermia
TL;DR: The epidemiology and etiology of azoospermia is discussed in detail and a thorough literature survey was performed using the Medline, EMBASE, BIOSIS, and Cochrane databases, limiting the survey to clinical publications that were relevant to male infertility and azoOSpermia.
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Organ-sparing surgery for adult testicular tumours: a systematic review of the literature.
TL;DR: Prospective multicentre studies are warranted to further qualify TSS as a treatment option to be recommended as an alternative to radical orchidectomy and to explore the perceived functional advantages of testis preservation.
References
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Journal ArticleDOI
Predictive value of abnormal sperm morphology in in vitro fertilization
Thinus F. Kruger,Anibal A. Acosta,Anibal A. Acosta,K.F. Simmons,K.F. Simmons,R.J. Swanson,R.J. Swanson,J.F. Matta,J.F. Matta,Sergio Oehninger,Sergio Oehninger +10 more
TL;DR: By evaluating sperm morphology with the proposed strict criteria, its predictive value in in vitro fertilization is enhanced.
Journal ArticleDOI
Torsion of the testis and allied conditions
TL;DR: Both conditions occurred primarily in adolescents, but among prepubertal boys torsion of an appendage was as common as torsions of a normally descended testis, and there was a slight left‐sided preponderance in testicular torsION, more marked in torsional of the appendages.
Journal ArticleDOI
Testicular Torsion: Late Results with Special Regard to Fertility and Endocrine Function
TL;DR: Late results were determined for 42 patients who had undergone detorsion and fixation for unilateral testicular torsion in the prepubertal and pubertal age and exocrine and endocrine function for the testes was determined in 30 Patients who had reached postpuberal age.
Journal ArticleDOI
Semen parameters, including WHO and strict criteria morphology, in a fertile and subfertile population: an effort towards standardization of in-vivo thresholds
Roelof Menkveld,Wai Yee Wong,Carl Lombard,Alex M.M. Wetzels,Chris M.G. Thomas,Hans M.W.M. Merkus,Régine P.M. Steegers-Theunissen +6 more
TL;DR: The semen analysis results of a fertile population were compared with those from a subfertile population, in order to establish normal cut-off values for the standard semen parameters with the aid of receiver operating characteristic (ROC) curve analysis.
Journal ArticleDOI
The Testes After Torsion
TL;DR: In torsion of the testis a large proportion of testes saved by surgery develop secondary atrophy, resulting in decreased spermatogenesis and the fertility of the torsions patients is reduced.