Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P56851 (epididymal)
11,273 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This article discusses the role of ultrasound in the workup of patients with suspected or palpable scrotal masses. By characterizing masses as intra- or extratesticular, the differential diagnosis can be narrowed considerably. Neoplasm is the primary concern with intratesticular masses, although non-neoplastic conditions, such as hematoma and focal orchitis, may have a similar appearance. Correlation with the patient's history is essential. The sonographic presentation of extratesticular pathology, including varicocele and masses of epididymal origin, is also described.
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PMID:Ultrasound assessment of testicular and paratesticular masses. 888 20

The researchers studied a group of azoospermic patients with obstructions of the seminal canals and a group of oligoasthenospermic patients suffering from varicocele in order to analyze the factors that influence the success of surgery aimed at recovering fertility. In the 46 patients suffering from obstructions of the deferent duct and the extremity of the epididymis, the time factor proved decisive if the obstruction lasted longer than 6 years: in this case, damage to the seminiferous tubules is not reversible. With obstructions dating back less than 4 years, the causes and the location of the obstruction are more incisive. Success was achieved in 100% of vasectomy cases and in 37.5% of epididymal-deferential anastomoses. In research literature, the superiority of microsurgery for treating these types of pathologies is taken for granted. In patients affected by oligoasthenospermia the effectiveness of laparoscopic ligation of the spermatic veins was compared to that of the Belgrano I technique. Of the 30 patients with bilateral varicocele and oligoasthenospermia dating back less than 4 years, 73.3% of the 15 patients operated on using the Belgrano 1 technique experienced sperm normalization; in the 15 cases operated on using laparoscopic ligation of the spermatic canals, normalization was much less frequent. Seventy-five percent of another group of 40 patients whose infertility did not have a duration of longer than 4 years and were operated on using microsurgery techniques were normalized. The percentage of the 60 oligoasthenospermic patients for longer than 6 years normalized was 16.6%.
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PMID:Microsurgery and changes in the testicular and epididymal production of spermatozoa. 900 77

We report a case of testicular microlithiasis in a 24-year-old man who was referred to us for evaluation of unclear ultrasonographic appearance of his testes while being examined for bilateral varicocele and epididymal cysts. Since testicular microlithiasis has been found to be associated with testicular germ cell tumours we suggest a diagnostic work-up with testis biopsy to rule out testicular intraepithelial neoplasia (so-called carcinoma in situ) in otherwise normal appearing testis.
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PMID:Testicular microlithiasis: case report and discussion of management under special consideration of testicular germ cell tumours. 911 40

In order to assess the relative incidence of varicocele (V) alone and V+ coincidental didymo-epididymal morphological abnormalities (DEMA) and the role of these pathologies on the pre- and post-surgical sperm outcome, 151 selected (previous exclusion of cases with bilateral V, seminal infections, antisperm autoAb) patients (aged 20-41 yrs) affected by left V at Doppler ultrasonography, underwent both ultrasound scrotal content examinations and semen analyses (sperm density, total sperm count, forward motility and normal morphology employing as frequency distribution) before and after varicocelectomy (on months 4-8-12, taking for statistical comparison the maximal post-surgical sperm value registered vs. mean correspective pre-treatment value). One-hundred two (67.5%) patients exhibited V alone (group A), whilst 49 (32.5%) patients showed V+DEMA (group B). As regards V, DEMA lesions (testis size < 12 ml; epididymides abnormalities: increased head (> 11 mm) and/or tail (> 6 mm) diameter, multiple microcysts; large idrocele) were omolaterally in 21/49 (42.8%) eterolaterally in 11/49 (22.5%) or bilaterally in 17/49 (34.7%). An additional group of 25 patients, exhibiting the above ultrasonic DEMA lesions alone without V, served as controls (group C) for semen statistical analysis in the pre-surgical period only. In this phase among groups A vs B, A vs C, B vs C, frequency distributions of all sperm parameters studied (excepted for density not significative only between B and C group patients) were significantly different. The following data were registered from A, B and C patient groups respectively: a) azoospermia was present in 12.7%, 34.8% and 24%; b) oligozoospermia (< 20 mil/ml) in 39.2%, 49% and 48%; c) normozoospermia in 48.1%, 16.3% and 8%; d) total sperm count was < 40 millions/ejaculate in 44.1%, 91.9% and 76%; e) asthenozoospermia (forward motility < 25%) was present in 32.3%, 71.4% e 72%; f) teratozoospermia (oval form <30%) was present in 34.3%, 62.3% and 48%. In the post-surgical follow-up examinations, significative changes with ameliorated frequency distributions of all semen parameters were observed within group A only, while these same parameters remained unmodified within group B patients, thus being together a significative difference between groups A vs B higher than that observed in the pretreatment. The coexistence of DEMA+V seems to determine two important effects on sperm output: a) in the pre-treatment, this selection judgement allowed to distinguish a different frequency distribution of semen parameters between patients affected by V alone and V+DEMA; b) since patients with V alone in comparison with V+DEMA patients groups had a favourable sperm outcome, the assessment of DEMA in patients with V seems to be mandatory for a better sperm prognostic judice.
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PMID:[The negative effect in patients with varicocele of coincidental didymo-epididymal morpho-pathology on sperm response before and after surgical correction]. 927 91

One-hundred thirty-three patients (aged 22 to 48, median 27 years) found affected by repetitive severe astheno-necrozoospermia (ASNE) (forward sperm motility < 10%; viable forms < 25%) in their ejaculates detected by both conventional viability tests (eosin Y exclusion and HOS tests) associated with oligo (51.1%), poly (3.7%), terato- (82.7%), -zoospermia, hyperdesfoliation of seminal spermatids (36.8%), hypospermia (11.3%), a comprehensive (history analysis; physical examination; lab: hormonal, microbiological, hemato-chemical blood screening, ultrasound scans at didymo-epididymal and prostato-vesicular glands, genital venous doppler) work-up allowed to recognize the following possible causes of ASNE: infectious (24.1%), spermiotoxyc (16.5%), hormonal (15.0%), iatrogenic (12.8%), chronic extratesticular diseases (CETD) (10.9%), varicocele (6.8%), idiopathic (14.3%). Overall population, except CETD patients gave their written informed consent about trial options for a three month period: a. rational, evidence-based treatment, group-standardised for doses and lenght (treated patients = subgroups T: total number = 71); b. short-term treatment/no treatment, (matched-control = subgroups Co: total number = 47). Follow-up semen data performed after completion of the assigned trial, together detected a conventionally normal percentage (> 25%) of viable sperm (necrozoospermic-responders (NR) in 37 (52.1%) out of subgroup-T patients. All subgroups-T patient, excepted subgroup-T patient affected by idiophathic ASNE (NR = 0%), exhibited NR rate (range 50-69.2%) values always significantly higher than subgroups-Co (NR = 0%, in all subgroups). Moreover, in each subgroup-T patients the percentages of viable and forward motile sperms values were significantly higher than matched-controls. The results of this study indicate that in patients affected by ASNE an andrological comprehensive work-up is mandatory because ASNE has a heterogeneous pathogenesis and a favourable prognosis, in terms of viable forms sperm improvement is possible after evidence-based therapeutic strategy.
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PMID:[Diagnostic approach and therapeutic strategy in 133 infertile patients with astheno-necrozoospermia]. 1019 19

In order to evaluate the sperm output and the adverse-side-effects after subinguinal varicoceloctomy, a follow-up study of 16 months was performed on 196 selected patients (aged from 22 to 43 years) affected by left varicocele (VR). In the pre-treatment, both Doppler ultrasonography and didymo-epididymal ultrasonography allowed to distinguish two homogeneous patient groups: group A (no. = 136), including patients affected by VR alone and, group B (n. = 60), including patients with VR combined to coincidental didymo-epididymal morphological abnormalities, DEMA). These DEMA lesions (testis size < 12 ml, epididymides abnormalities: increased head- > or = 12 mm- and/or tail- > or = 6 mm-diameter, multiple microcysts, large idrocele) were omolaterally to VR in 30/60 (50%), eterolaterally in 19/60 (31.7%) or bilaterally in 11/60 (18.3%). During sperm follow-up, group A patients showed both a significant temporal change (p < 0.01 ANOVA) of all sperm parameters studied (sperm density, total sperm count, motility and morphology) from month 8 onward and sperm values significantly higher than found in group B patients. On the contrary, the sperm parameters of group B patients did not change significantly during the follow-up observations. As far as the varicocelectomy-mediated clinical symptoms, some patients complained early and transiently (on 1-2-4 weeks following varicocelectomy) the following symptoms: didymal pain (1.5%), didymo-epididymal pain (4.1%) and parasthesiaes on the anterior-medial side of the left thigh (4.1%) or scrotal (3.1%); only four patients (2%) complained permanent paresthesiaes on the anterior-medial side of the left thigh. Furthermore, the clinical follow-up also revealed a low rate of complications: persistent VR (3.6%), hydrocele (1.5%), intrascrotal venous ecstasies (6.1%), epididymitis (0.5%). Some morpho-structural abnormalities at US scans were transient (1-2 weeks): scrotal oedema (6.1%), orchitis (2%), orchi-epididymitis (1%). Subinguinal varicocelectomy performed on large population demonstrated a significant improvement of the sperm output from month 8th onward in patients with VR alone, while sperm parameters did not show any significant change in patients with VR plus coincidental DEMA. This surgical technique also demonstrated safety since both low rates of symptoms and (transient) complications were registered.
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PMID:[Clinical and sperm follow-up after subinguinal varicocelectomy]. 1095 92

It is generally assumed that men with congenital bilateral absence of the vas deferens (CBAVD) have azoospermia because of obstruction and that sperm production is normal. This study examines spermatogenesis in men with CBAVD to assess the validity of this assumption. We identified all men with CBAVD who had undergone either a diagnostic or therapeutic fertility procedure. Procedures included diagnostic biopsy, testis fine needle aspiration (FNA) mapping, microscopic epididymal sperm aspiration (MESA), and testis sperm extraction (TESE). Among 33 CBAVD men, 18 underwent testis biopsy, 27 had MESA/TESE, and 10 had FNA mapping. On evaluation of these procedures, normal spermatogenesis was present in 29 men. Four men (12%) demonstrated impaired spermatogenesis. One patient had FNA testis cytology consistent with late maturation arrest, another demonstrated hypospermatogenesis on biopsy and low sperm yield by MESA, and two patients had pure Sertoli cell only histology on biopsy. Aetiologies for impaired spermatogenesis included varicocele and underlying genetic abnormalities. Although patients with CBAVD are assumed to have normal spermatogenesis and infertility due simply to obstruction, the potential for concomitant defects in sperm production exists. A clinical suspicion of testis failure should prompt further diagnostic evaluation of spermatogenesis prior to sperm retrieval. In addition, genetic counselling should be offered and testing for genetic lesions, including cystic fibrosis gene mutations and/or variants, Y chromosome microdeletions, and karyotype abnormalities, should be considered.
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PMID:Impaired spermatogenesis in men with congenital absence of the vas deferens. 1122 24

The authors carried out a retrospective study of 162 cases of male infertility explored in a hospital unit in Lyon, France. Assays of 1 -alpha-1,4-glucosidase (epididymal function marker) backed up by clinical findings were used to select 3 types of epididymal malfunction. 1) There was complete obliteration of the epididymal duct, resulting in azoospermia. This diagnosis was based on both testicular biopsy findings, demonstrating unimpaired spermatogenesis and on the dramatically reduced level of assayed activity ( 40 mIU/ejaculation), as well as on clinical findings. 2) There was anamalous epididymal function combined with moderate oligoasthenozoospermia or normospermia. In these cases, low levels of assayed activity do not parallel fairly high sperm counts (between 20-30 million spermatozoal/ml). 3) There were those cases which were difficult to interpret and which involved severe oligoasthenozoospermia ( 5 million/ml) and reduced level of epididymal marker, suggesting partial blockage of the epididymis due to a focus of infection. Varicoceles were found more frequently among the European population, whereas a history of genital infection was more frequent among the North African population. However, when the various types of abnormality in the spermatogram were related to patient history and epididymal abnormality, no differences were found between the 2 populations. (author's modified)
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PMID:[Comparative study of epididymal disorders in two populations of male patients consulting for infertility: one from the Maghreb region of North Africa and the other of European origin]. 1231 60

Bilateral obstruction of the male reproductive tract is suspected in men with azoospermia, normal testicular volume and normal FSH. A testicular biopsy is required to differentiate between an obstruction and a testicular insufficiency. Unilateral or subtotal bilateral obstructions and epididymal dysfunction may cause severe oligozoospermia in men with a normal spermatogenesis. However, information on spermatogenesis in oligozoospermic men is lacking, since testicular biopsy is not routinely performed. Men with a sperm concentration of <1 x 10(6) spermatozoa/ml were investigated for possible partial obstruction by performing a testicular biopsy under local anaesthesia. Spermatogenesis was determined by the Johnsen scoring method. A testicular biopsy was performed in 78 men with severe oligozoospermia. The medical history showed male accessory gland infection in 12.8%, previous hernia repair in 14.1% and a history of cryptorchidism in 12.8%. A normal or slightly disturbed spermatogenesis (Johnsen score >8) was present in 39/78 (50%) of the men. Hernia repair occurred more often in men with normal spermatogenesis. A varicocele was predominantly seen in men with a disturbed spermatogenesis. FSH was significantly lower ( P<0.0001) in men with normal spermatogenesis. Subtotal obstruction of the male reproductive tract is a frequent cause of severe oligozoospermia in men with a normal testicular volume and a normal FSH. In other cases, an epididymal dysfunction might explain the oligozoospermia in men with a normal testicular biopsy score.
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PMID:Subtotal obstruction of the male reproductive tract. 1262 59

Infertility affects 13-18% of couples and growing evidence from clinical and epidemiological studies suggests an increasing incidence of male reproductive problems. The pathogenesis of male infertility can be reflected by defective spermatogenesis due to pituitary disorders, testicular cancer, germ cell aplasia, varicocele and environmental factors or to defective sperm transport due to congenital abnormalities or immunological and neurogenic factors. Recent studies suggest an increased incidence of genetic disorders related to male infertility which may affect different levels, interfering with germ cell generation and maturation or leading to the production of non-functional spermatozoa. The identification of genetic causes of male infertility raises the issue of the transmission of defects to the offspring, a situation that is becoming more important given the increasing use of intracytoplasmic sperm injection (ICSI), a procedure in which the natural selection of the spermatozoa is by-passed. Fertilization can occur in vitro using ejaculated, epididymal or testicular spermatozoa, either fresh or frozen-thawed, providing opportunities hitherto not possible for men to be genetic fathers.
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PMID:Male infertility. 1275 96


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