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Query: UNIPROT:P56851 (epididymal)
 11,273 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seminiferous epithelium histology, Leydig cell density, and in vitro testosterone synthesis were quantitated in bilateral testicular biopsies from men with varying degrees of unilateral or bilateral varicoceles. Results were correlated with plasma levels of gonadotropins (follicle-stimulating hormone [FSH], luteinizing hormone [LH]) and testosterone (T), as well as with semen quality. In patients with bilateral varicoceles, spermatogenesis, Leydig cell density, plasma T levels, and in vitro T synthesis were significantly lower than in patients with unilateral varicoceles. Varicoceles appeared to affect maximally the latest stages of spermatogenesis. A negative correlation between FSH and LH levels and spermatogenesis was observed; however, a dissociation between the two gonadotropins occurred when spermatogenesis declined. Plasma T levels were within the normal range in all patients. The T:LH ratio was significantly correlated with spermatogenesis and sperm motility. Leydig cell density was abnormally low in oligospermic patients, and it was significantly correlated with in vitro T synthesis, spermatogenesis, sperm motility, and semen volume. Sperm count and motility were significantly correlated in this group of patients, suggesting a common pathophysiology for the effect of varicocele on spermatogenesis and sperm motility. This common pathophysiology appears to be disturbed Leydig cell function resulting in decreased testicular androgen production, in turn causing inadequate spermatogenesis and epididymal function.
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PMID:A possible mechanism for the detrimental effect of varicocele on testicular function in man. 72 Jun 47

The original study conducted 22 years earlier at the Chicago Lying-in Hospital attempted to determine the value of diethylstilbestrol (DES) in maintaining pregnancy. The number completing the course of therapy was 840 in the DES group; there were 860 in a control group. Increasing doses were given beginning during the 7th week of pregnancy. The present study was to determine the level of risk of cancer and other anomalies in the female and male offspring of mothers who participated in the study. So far, 84 DES-exposed females, 43 female controls, 43 DES-exposed males, and 37 male controls have been examined. No cases of cancer have been found. The average age was 22 years. For female patients the medical history, a general physical examination, a gynecological examination, a colposcopic study, and laboratory tests were made. Laboratory tests consisted of cervical, endocervical, and 4 vaginal wall Pap smears, urine cytology, and follicle stimulating hormone and luteinizing hormone determinations. Biopsies were performed when indicated. Progesterone and total estrogens were determined only in patients with irregular menstrual cycles. In male patients, a general physical examination, urologic studies, and laboratory work-up were done. Medical records of all the newborn infants were surveyed and pediatric records examined. No cases of congenital malformations were recorded. Minor differences in menstrual histories and in ability to conceive were noted. The differences appeared mainly at vaginal examinations. Circumferential ridges in the vagina and cervix were seen in 39% of the exposed females but in none of the controls. Erythroplakia of the cervix was seen in 67% of the exposed and in 53% of the controls. Colposcopic findings in the vagina revealed vaginal epithelial changes in 78% of the DES-exposed females and 2% of female controls. Iodine negative areas in the vagina were noted in 78% of the exposed females compared with 2% of the unexposed females. Iodine negative areas on the cervix were seen in 74% of the exposed and 58% of the unexposed. All dysplastic lesions were confirmed by histology. The cytology was negative in all. In the males abnormal findings were noted mainly in the DES-exposed group. An undersized penis was noted in 2, small testes in 2, varicocele in 1, and epididymal cysts in 4. Urine cy tology and prostatic fluid cytology did not reveal unusual findings. A more detailed analysis of findings will follow when material is larger and older.
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PMID:Follow-up study of male and female offspring of DES-treated mothers a preliminary report. 117 Dec 34

The purpose of the article is to review the current concepts regarding the etiology and treatment of male-factor infertility. The following general conclusions can be drawn: (a) conventional parameters for sperm quality and male fertility are inadequate and any assessment should involve several different tests of sperm cell function to increase the fertility prognosis; (b) the causes of disturbed sperm quality are still poorly understood; (c) the role of the varicocele is still controversial but some of the discrepancies reported in the literature may be explained by the negative influence of other factors such as smoking, epididymal pathology or glandular infections operating either in conjunction or independent of the varicocele; (d) the role of chronic inflammatory processes in the reproductive organs, in particular the involvement of chronic chlamydial infections, has been underestimated, largely because it is often asymptomatic and difficult to demonstrate objectively; (e) partial androgen insensitivity may account for a significant number of cases of severe oligozoospermia; (f) no major advances have been made in the medical treatment of poor sperm quality; (g) assisted fertilization techniques such as IVF and GIFT offer encouraging possibilities for the treatment of male-factor infertility; and (h) recent advances in microsurgical techniques are increasing the treatment possibilities for certain forms of obstructive azoospermia and severe oligozoospermia.
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PMID:Male infertility: current concepts. 138 88

Human chorionic gonadotropin, kallikrein, indomethacin, and hydralazine were administered to different groups of varicocelized rats, while surgical repair of the varicocele was performed in another group of rats. The effects of conservative and surgical treatment on epididymal sperm content and motility, the weights of the testes, epididymis, and male accessory genital glands, and fertility were compared between each group and a sham-treated group of rats. Surgical repair significantly improved all the evaluated parameters and all the conservative regimens, except hydralazine, resulted in a significant improvement in most parameters. Our results indicate that stimulation of the Leydig or/and Sertoli cells of a varicocelized testicle can counteract some of the detrimental consequences of the varicocele itself.
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PMID:Surgical repair versus medical treatment of varicocele in the rat: pharmacological manipulation of the varicocelized testicle. 142 45

To evaluate whether or not dilation of the right testicular vein is a constant finding in animals with left varicocele and to illustrate its contribution to the detrimental effect of a left varicocele on the right testis, an experimental varicocele model was produced in 40 rats. Ten other rats had a sham operation (group A). Seven weeks after the operation, all 50 rats underwent laparotomy and dilation of both testicular veins was seen in 23 rats, which were randomly assigned to group B (n = 11) and group C (n = 12). One week later, groups A and C underwent sham ligation of the right testicular vein, whereas group B rats underwent resection of this vein. At 84 days after the initial operation, group C rats showed a significant reduction in right epididymal sperm content, motility, and fertilizing capacity, right testicular weight, and right testicular vs. intraabdominal temperature difference when compared with groups A and B. Since surgical repair of the secondary right varicocele improved all the parameters indicating the harmful consequences of the primary left varicocele on the right testis, it appears that dilation of the right testicular vein contributes to the detrimental effect of a left varicocele on the right testis.
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PMID:Surgical repair of secondary right varicocele in rats with primary left varicocele: effects on fertility, testicular temperature, spermatogenesis, and sperm maturation. 155 Apr 27

The function of the epididymis and of the sex accessory glands have been investigated in a selected group of varicocele patients with normal sperm count. In the seminal plasma of these patients free-L-carnitine, fructose and zinc levels were determined as functional markers respectively of epididymis, seminal vesicles and prostate. Despite the unvaried free-L-carnitine and fructose levels, zinc levels were significantly lower (p less than 0.001) than in the control group. The Zn/F ratio, an index of the ratio between the prostatic and vesicular secretions, resulted also lower (p less than 0.01) with respect to the controls. The authors suggest that the impaired prostatic function could arise from the decreased venous drainage in the vesico-prostatic plexus. In the same patients sperm motility resulted significantly lower than in the controls, and was positively related to zinc levels (r = 0.44, p less than 0.01) and, to a higher degree, to the Zn/F ratio (r = 0.62, p less than 0.001). Our data show that in this selected group of varicocele patients with a not yet altered tubular epididymal unit, sex accessory gland secretions can influence, per se, the motility of the ejaculated spermatozoa.
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PMID:The evaluation of free-L-carnitine, zinc and fructose in the seminal plasma of patients with varicocele and normozoospermia. 271 70

The aim of this study was to determine the eventual fertility of those patients following vasectomy reversal who have no pressure-induced secondary epididymal blockage. These patients underwent simple vasovasostomy because at the time of the reversal surgery there were sperm present in large numbers in the vas fluid. It was possible to obtain long-term follow-up on 326 early patients who underwent vasectomy reversal 8-10 years ago. Two hundred and eighty-two of those patients had sperm in the vas fluid. These patients were studied for pregnancy rate and post-operative semen parameters in relation to presence or absence of sperm in the vas fluid at the time of vasectomy reversal, duration of time since vasectomy, pre-operative serum antisperm antibody titers, the influence of varicocoele and quantitative evaluation of testicular biopsy. All of the 44 patients with no sperm in the vas fluid remained azoospermic following vasovasostomy. Of the 282 patients with sperm in the vas fluid, 228 (81%) eventually impregnated their wives. Twenty-four patients with sperm in the vas fluid (9%) were azoospermic and did not impregnate their wives. Of the 258 patients who had sperm patency, the pregnancy rate was 88%. The number of mature spermatids per tubule in the testis correlated closely with the post-operative sperm count in patent cases. Quantitative evaluation of the testicular biopsy revealed normal spermatogenesis, even in patients with azoospermia or severe oligospermia post-operatively. Technical failures were due to blockage either at the vasovasostomy site, or epididymal blockage unrecognized at the time of vasovasostomy.2+perm count had a minimal impact on the
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PMID:Pregnancy after vasovasostomy for vasectomy reversal: a study of factors affecting long-term return of fertility in 282 patients followed for 10 years. 271 9

The most important disturbances of male infertility are described in detail. The varicocele is in 30 to 40% the main cause of subfertility. 106 out of 125 patients are operated because of unability to conceive a child. Postoperatively, the results show a significant improvement of the sperm density, total sperm count, sperm morphology and the initial and late forward progression. 26% of the couples were achieve pregnancies. In obstructive azoospermia microsurgical repair is the preferable method. The obstruction, whether developmental or acquired, is most frequently at the epididymal junction. Vasography is performed intraoperative immediately before the planned reconstruction to demonstrate the block. In only 5 of 12 patients microsurgical repair was possible. The other patients had developmental abnormalities or scarring and long-distant obstruction. The diagnostic and therapeutic procedures in erectile impotence are described, 5 patients are operated by implantation of a penile prosthesis. The most important step in prophylaxis of infertility is the treatment of cryptorchidism. The therapy should be closed at the end of the second year of life. The role of testicular autotransplantation in selected cases is discussed. Because of more recent data suggest that a male factor is present in or contribute to as many as 50 per cent of the infertility problems and the urologist has the best training and expertise to examine and to diagnose disorders of the male reproductive tract, he should be at the forefront of treatment of these problems.
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PMID:[Contribution of urology in the interdisciplinary treatment concept of fertility disordered males]. 285 19

Surgical corrections of male fertility disturbances are discussed. Following a short historical review, operative treatment of the undescended testicle, the indication and date of surgery and postoperative andrological results are dealt with. Modern principles of varicocoele surgery are discussed with special attention to fertility correction. Surgical treatment of vas deferens obstruction, results and microsurgical interventions concerning vaso-epididymal anastomoses and vasovasostomies are also described together with the ultimate possibilities for surgical therapy of sexual disturbances.
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PMID:Operative andrology. 289 78

Ninety-six couples, consulting for primary (n = 73) or secondary (n = 23) infertility, and thought to be infertile due to a varicocele in the husband associated with sperm abnormalities, were subjected to a follow-up study. Of these, 57 were surgically corrected and 39 were not, depending only on the patient's choice. All women were intensively treated where necessary. All patients who were corrected were subjected to scrotal exploration in a search for epididymal anomalies. From our data we conclude that (1) on a statistical basis, comparing observed with expected pregnancy rates, varicocelectomy is useful in primary infertility and unnecessary in secondary infertility and (2) on an individual basis, patients with primary infertility and 'pure' varicoceles have a better prognosis than patients with concomitant epididymal dysfunction.
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PMID:Clinical aspects in the surgical treatment of varicocele in subfertile men. II. The role of the epididymal factor. 333 8


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