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

The results in 21 patients with Peyronie's disease who were managed with a course of dermo-jet percutaneous injections of dexamethasone into the plaques are described herein. These patients had 6 to 10 injections at intervals of 1 month for 6 months. In a high percentage of the cases there occurred a disappearance or decrease in the size of the plaques, pain on erection and discomfort during sexual relations. Also, there was a high rate of improvement in the chordee. Because of the natural history of resolution of the plaques and the small number of patients, statistical significance is not believed applicable, although 71 per cent of the patients had experienced prior failure with other modes of therapy. Eight patients experienced urinary or prostato-epididymal infections at some time in their medical history, correlating well with the inflammatory theory as the cause of the disorder.
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PMID:Peyronie's disease: results with dermo-jet injection of dexamethasone. 119 71

Between 250,000 and 300,000 US men undergo vasectomy each year. The Association for Voluntary Surgical Contraception has performed almost 400,000 vasectomies worldwide since 1982. 2 hospital-based case control studies indicate a 1.7-5 fold increased risk of prostate cancer in vasectomized patients, but other studies do not find this association. Besides, there is no biologic basis for such an association. A theoretical relationship does exist between testicular cancer and vasectomy, however, since testicular biopsy studies reveal abnormalities, perhaps secondary to back pressure. No epidemiologic studies have yet found such a link, though. In China, some 8 million men have undergone the no-scalpel vasectomy developed in the 1970s. This technique has fewer complications than the traditional technique (e.g., a hematoma rate of only .08%). Indeed, hematomas are the most common complication. Other complications include epididymitis, congested epididymis, and sperm granuloma. The open-ended vasectomy (proximal testicular end of vas left open and closure of the distal end) reduces postoperative testicular and epididymal discomfort and increases the likelihood of vas reversal (1 surgeon reports a success rate of 100%). Regardless of the vasectomy technique, vas reanastomosis is more likely to be successful if performed within 5 years after the vasectomy (e.g., 1 study reported a pregnancy rate of 52% for reanastomosis within 5 years vs. 30% for 5 years; p .02). Physicians recommend a postvasectomy semen analysis after 20 ejaculations to determine if azoospermia has been achieved. If not, another analysis is needed after 10 more postvasectomy ejaculations. If motile sperm still exist, the vasectomy has failed. Yet, many men (36-45% in the US) do not return for analysis. Return visits are often difficult, impractical, and embarrassing for men, so physicians should suggest patients use condoms until after they have achieved a predetermined number of ejaculations to ensure protection against pregnancy.
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PMID:Male sterilization. 132 23

The incidence of chronic testicular pain following vasectomy has not been previously assessed. We have carried out a survey by postal questionnaire and telephone interview of 172 patients 4 years after vasectomy to assess the incidence of chronic testicular pain. Significant early post-operative complications occurred in 6 patients (3.5%): 2 infection, 3 haematoma and 1 orchitis. Chronic testicular discomfort was present in 56 patients (33%), considered by 26 (15%) to be troublesome but not by the other 30 (17%). Testicular discomfort related to sexual intercourse occurred in 9 cases (5%). Of the 9 patients who had sought further medical help only 2 had had further surgery (1 an epididymectomy and 1 excision of a hydrocele). Only 3 patients regretted having had the vasectomy because of chronic pain. On ultrasound examination, epididymal cysts were a common finding on both asymptomatic and symptomatic patients following vasectomy. Prior to vasectomy, all patients should be counselled with regard to the risk of chronic testicular pain.
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PMID:Chronic testicular pain following vasectomy. 142 2

A 36-year-old man noticed a discomfort in the right scrotum since January, 1981, and came to our hospital in October of the same year. Palpation detected a hard and painless tumor in the right epididymal tail and exploratory excision revealed an induration measuring 3 X 2 X 1 cm. The rapid diagnosis of tumors by frozen section was made and we diagnosed it as right epididymal seminoma. Right high inguinal orchiectomy was performed and histopathologically, tumor cells which mainly occupied the testis were observed. This case was diagnosed as seminoma which showed epididymal swelling as the clinical symptom.
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PMID:[A case of seminoma with epididymal swelling]. 409 Nov 33

Presentation of the case of one patient with epididymal adenomatoid tumour presenting as episodes of inguino-scrotal discomfort. With no evidence of relapse, the case is monitored three years after surgery. On the lines of the literature review presented, a series of considerations on what has been a controversial histogenesis are made. The reason for this report is the differential diagnosis which conditions all inguino-scrotal processes with torpid evolution.
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PMID:[Epididymal neoplasms. New case report. Report of an adenomatoid tumor]. 794 21

A total of 606 modified subinguinal microscopic varicocelectomies was performed on 466 outpatients using local anesthesia and sedation. The patients selected for these procedures were infertile for at least 12 months and had at least 1 semen parameter below threshold level: less than 20 million per ml., less than 50% motility or less than 40% normal morphological forms. The lymphatics, spermatic artery and vas were preserved, whereas all refluxive veins were transected or obliterated. Postoperative complications were limited to transient epididymal discomfort in 5.5% of the patients, ecchymosis at the wound site in 3.4% and wound inflammation in 2.4%. There was only 1 permanent hydrocele. The palpable recurrence rate was 0.82% per procedure. The median values for each semen parameter were compared preoperatively and postoperatively by the Wilcoxon signed rank test. The differences in the median values were significant for all parameters. As an alternative statistical model, the average preoperative semen value was subtracted from the average postoperative semen value for each parameter. The median differences were 10.8 million sperm per ml. for sperm density, 13.9% for motility and 3.8% for normal morphological forms. These differences were significantly greater than zero by the Wilcoxon signed rank test. The intra-quartile ranges for these differences suggested that postoperatively more than 75% of the patients had a difference of greater than zero for sperm density and per cent motility, and 63% had a difference of greater than zero for normal morphology. The 1-year pregnancy rate was 35.6% for 186 varicocelectomy patients compared to 15.8% for 19 medically treated men with varicocele. The difference between the true 1-year pregnancy rates was 19.8% and the 95% confidence intervals estimated bounds of 1.91 to 37.5%. These data suggest that outpatient subinguinal microscopic varicocelectomy has minimal morbidity and recurrence, and may be beneficial for select patients.
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PMID:Subinguinal microsurgical varicocelectomy: a technical critique and statistical analysis of semen and pregnancy data. 807 81

Following vasectomy, spermatogenesis continues, the human epididymis and ductus deferens may distend and leak, and the extravasated spermatozoa stimulate formation of a sperm granuloma. Granulomas may occur at 60% of vasectomy sites and are usually asymptomatic and relieve intraluminal pressure. About 3-5% of patients experience pain. Intraluminal phagocytosis may explain why some reproductive tracts become depleted of spermatozoa. Distension of the epididymis is common after vasectomy and may lead to granuloma formation there. Up to 6% of patients have symptoms, but many with epididymal changes have no discomfort. Most episodes of painful epididymitis and granulomas resolve with conservative treatment, but < 1% require vasectomy reversal or, if this is ineffective, excision of the epididymis and obstructed ductus deferens.
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PMID:Vasectomy review: sequelae in the human epididymis and ductus deferens. 884 41

Since the late 1960s, vasectomy has been a popular contraceptive option in Great Britain for couples who have achieved their desired family size. In recent years, however, considerable concern has been expressed about possible associations with cardiovascular disease and testicular and prostate cancer as well as long-term localized effects. This article reviewed the literature published during 1986-96 on these health concerns. Although vasectomized monkeys fed atherogenic diets appear to have a higher risk of peripheral artery disease, long-term studies of vasectomized men have failed to detect increased cardiovascular disease. No evidence has been found that vasectomy predisposes to testicular cancer or accelerates the growth of early testicular cancer. Studies demonstrating a 2-fold increase in the risk of prostate cancer after vasectomy were conducted in the US, where prostate cancer is common, and contained possible biases. European studies have not detected such an increased risk. Even if a relationship between vasectomy and prostate cancer is proven, further investigations would be required to determine if vasectomy causes prostate cancer through mechanisms such as hormonal changes, immunologic responses, or failure of growth inhibitors to reach the prostate due to obstruction of the reproductive tract, or whether vasectomized men are more exposed to the real causal agent. Moreover, even if the risk for vasectomized men in the UK is doubled, only 6/1000 men 65-74 years old would be expected to develop prostate cancer each year. The local effects of vasectomy on the reproductive tract are not fully determined. Distention of the epididymal duct occurs in most patients and granuloma formation is common. Vasectomy may also induce autoimmune orchitis. While many men develop structural changes in the reproductive tract after vasectomy, only a minority report discomfort. Although men considering vasectomy should be told that some studies have suggested a small increased risk of prostate cancer, they can be reassured that other health concerns are without foundation.
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PMID:Is vasectomy harmful to health? 923 76

Case report of a 42-year old patient with an epididymal adenomatoid tumour found after a three-month history of increased left hemiscrotum and scrotal discomfort. Definite diagnosis was arrived at following surgical exeresis and pathoanatomical study. The etiopatogenesis, clinical presentation and management are all analyzed. Since urological incidence is very low within intrascrotal processes, we believe it is important to understand the condition so that a differential diagnosis from other inflammatory processes can be established; also the convenience of a much more aggressive attitude in scrotal diseases is restated due to the low morbidity of this type of surgery.
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PMID:[New report of epididymal adenomatoid tumor. Infrequent pathology]. 941 79

A total of 37 percutaneous epididymal sperm aspiration (PESA) and/or testicular sperm aspiration (TESA) procedures were performed under local anaesthesia (LA) on 34 men between June and November 1996. Local anaesthesia was achieved by injecting 10 ml of 1% lignocaine solution along the sides of the vas deferens near the external inguinal ring (spermatic cord block). Sperm retrieval was successful in 92% of the procedures. Of the 37 procedures, in 29 the patients felt either no pain or mild discomfort while in six they experienced moderate but tolerable pain. Analgesia was incomplete in two procedures and was supplemented with i.v. sedation. Vasovagal reflex in two procedures was reversed by i.v. atropine. In 24 procedures patients felt relaxed, whilst in 13 they felt anxious. In 32 procedures the patients expressed overall satisfaction. If the procedure was to be repeated, after 29 procedures the patients requested LA again, while after four procedures they preferred i.v. sedation and after four were undecided. LA is adequate for PESA and TESA in a large proportion of patients. Prior discussion of LA technique with the patient is necessary. Back-up facilities for i.v. sedation and atropine should be available.
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PMID:The efficacy of local anaesthesia for percutaneous epididymal sperm aspiration and testicular sperm aspiration. 957 27


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