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Evaluation and Management of Male Infertility
Published in Steven R. Bayer, Michael M. Alper, Alan S. Penzias, The Boston IVF Handbook of Infertility, 2017
Most scrotal abnormalities are visible and palpable on physical examination. This includes varicoceles (dilated veins in the scrotum), spermatoceles (epididymal cysts), absence of the vas deferens, epididymal induration, and testicular masses. Scrotal ultrasonography may identify non-palpable varicoceles. Scrotal ultrasonography may be useful to clarify ambiguous findings on examination, such as may occur in patients with testes that are in the upper scrotum, small scrotal sacs, or other anatomy that makes physical examination difficult.
A cross-sectional study of the genital duct and renal anomalies in Egyptian cases of congenital absence of the vas deferens
Published in Human Fertility, 2022
Taha AbdElnaser, Yasser Ibrahem Elkhiat, Hatem Mohamed El-Azizi, El Fatah, Mohamed Abd, Ahmed Mahmoud Elshibany, Sameh Fayek GamalEl Din
A cross sectional study was carried out between July 2017 and May 2019 after institutional ethics review board approval (reference: I-061016) and informed consent obtained from all cases. This study included a total of 200 patients with absent unilateral or bilateral vas deferens. This condition was diagnosed by physical examination as absence of the round, firm, sliding linguini-like vas deferens that is in continuation with the epididymis or by the use of trans-rectal ultrasonography (TRUS) to detect the missing vas. The demographic characteristics, physical examination findings including palpation of the vasa and epididymes were all included. Scrotal ultrasonography (7.5 MHz linear scan) and trans-rectal ultrasonography (TRUS, 7.5 MHz transrectal sound) were used as the diagnostic methods for evaluating unilateral or bilateral CAVD with associated visible abnormalities or agenesis of the testes, epididymes, seminal vesicles and prostate while abdominal sonar (3.5 MHz sector scan) was done to detect any associated renal anomalies.
Unsatisfactory testicular position after inguinal orchidopexy: Is there a role for upfront laparoscopy?
Published in Arab Journal of Urology, 2020
Ahmed Abdelhaseeb Youssef, Mahmoud Marei Marei, Mohamed Hamed Abouelfadl, Wesam Mohamed Mahmoud, Atef Salaheldin Abdulaziz Elbarawy, Tamer Yassin Mohamed Yassin
The patients were followed-up regularly, at 1 week postoperatively then every 3–6 months until 12 months postoperatively. At their 6-month visit, a scrotal ultrasonography was performed, which confirmed a good position and size of the testis, in comparison to the contralateral one, as a reference for normality. In all 12 cases, the testes retained their scrotal position after 12 months of follow-up, and had a good size when compared to the contralateral normally descended one, by clinical examination. We considered a postoperative testicular volume of >50% on the operated side to be the least acceptable as a good outcome, which is in keeping with the published literature [18–20]. Ultrasonographically, we found the relative/differential testicular volume (operated UDT volume divided by the contralateral normal testis volume) to have a mean ratio (±SD) of 0.78 (±0.12) and a median ratio (range) of 0.8 (0.6–0.9) [18]. There was no decline in testicular size over the first postoperative year.
Improved Arterial Preservation Achieved by Combined Use of Indocyanine Green Angiography and Doppler Detector During Microsurgical Subinguinal Varicocelectomy
Published in Journal of Investigative Surgery, 2020
Sota Kurihara, Yasuhiro Shibata, Seiji Arai, Yoshitaka Sekine, Yoshiyuki Miyazawa, Hidekazu Koike, Hiroshi Matsui, Kazuto Ito, Kazuhiro Suzuki, Tetsuya Nakamura
A total of 140 men who underwent microsurgical subinguinal varicocelectomy at Gunma University Hospital were included in the study. The patients underwent a varicocele examination before or after undergoing a Valsalva maneuver. The identified varicoceles were categorized as follows: grade 1, difficult to diagnose without a Valsalva maneuver; grade 2, easily palpable; and grade 3, visible through the skin at a distance. Scrotal ultrasonography with color Doppler imaging was also performed in most patients. The criteria for diagnosing a varicocele with ultrasound required at least the presence of dilated veins with a diameter of >3.0 mm with reversal flow after a Valsalva maneuver.