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Marta De Almeida - One of the best experts on this subject based on the ideXlab platform.

  • effect of testis nondescent or Orchidopexy on antisperm antibodies and testis histology in rats
    Fertility and Sterility, 2010
    Co-Authors: Petros Mirilas, Ioannis Panayiotides, Anastasia Mentessidou, Georgios Mavrogenis, Elissaios Kontis, Panagiotis Lainas, Marta De Almeida
    Abstract:

    Objective To examine effects of nondescent of normal testis and of various Orchidopexy techniques on antisperm antibody (ASA) production and histologic testicular lesions. Design Experimental cohort study. Setting Laboratories of surgical research and biology of reproduction, academic medical centers. Patient(s) Lewis rats, immature and adult. Intervention(s) Eighteen-day-old rats (6 groups): intra-abdominal stay of testis after closure of inguinal canal, classic dartos pouch Orchidopexy, Orchidopexy by testis fixation through tunica albuginea, Orchidopexy by transparenchymal testicular fixation, sham operation, and bilateral vasectomy. Adult rats (1 group): transparenchymal testicular fixation. Main Outcome Measure(s) The ASA—antiacrosome and antitail—were measured by indirect immunofluorescence in sera collected preoperatively, on 50th and 120th day in immature rats, and 90 days after surgery in adult rats. Testicular histology was also examined at the end of sera collection. Result(s) Neither intra-abdominal testicular localization nor orchidopexies induced significant ASA. Testicular nondescent and fixation (transparenchymal or transtunical) caused hypospermatogenesis; dartos pouch was harmless. Bilateral vasectomy produced significantly increased ASA, but no significant testicular lesions. Contralateral testes were unaffected. Conclusion(s) Intra-abdominal testicular stay and Orchidopexy do not elicit autoimmune response to sperm; histologic testicular lesions might not be associated with ASA. In operated cryptorchids, ASA are probably due to other reason than testicular heat or Orchidopexy trauma.

  • Effect of testis nondescent or Orchidopexy on antisperm antibodies and testis histology in rats.
    Fertility and sterility, 2009
    Co-Authors: Petros Mirilas, Ioannis Panayiotides, Anastasia Mentessidou, Georgios Mavrogenis, Elissaios Kontis, Panagiotis Lainas, Marta De Almeida
    Abstract:

    To examine effects of nondescent of normal testis and of various Orchidopexy techniques on antisperm antibody (ASA) production and histologic testicular lesions. Experimental cohort study. Laboratories of surgical research and biology of reproduction, academic medical centers. Lewis rats, immature and adult. Eighteen-day-old rats (6 groups): intra-abdominal stay of testis after closure of inguinal canal, classic dartos pouch Orchidopexy, Orchidopexy by testis fixation through tunica albuginea, Orchidopexy by transparenchymal testicular fixation, sham operation, and bilateral vasectomy. Adult rats (1 group): transparenchymal testicular fixation. The ASA--antiacrosome and antitail--were measured by indirect immunofluorescence in sera collected preoperatively, on 50th and 120th day in immature rats, and 90 days after surgery in adult rats. Testicular histology was also examined at the end of sera collection. Neither intra-abdominal testicular localization nor orchidopexies induced significant ASA. Testicular nondescent and fixation (transparenchymal or transtunical) caused hypospermatogenesis; dartos pouch was harmless. Bilateral vasectomy produced significantly increased ASA, but no significant testicular lesions. Contralateral testes were unaffected. Intra-abdominal testicular stay and Orchidopexy do not elicit autoimmune response to sperm; histologic testicular lesions might not be associated with ASA. In operated cryptorchids, ASA are probably due to other reason than testicular heat or Orchidopexy trauma. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Petros Mirilas - One of the best experts on this subject based on the ideXlab platform.

  • effect of testis nondescent or Orchidopexy on antisperm antibodies and testis histology in rats
    Fertility and Sterility, 2010
    Co-Authors: Petros Mirilas, Ioannis Panayiotides, Anastasia Mentessidou, Georgios Mavrogenis, Elissaios Kontis, Panagiotis Lainas, Marta De Almeida
    Abstract:

    Objective To examine effects of nondescent of normal testis and of various Orchidopexy techniques on antisperm antibody (ASA) production and histologic testicular lesions. Design Experimental cohort study. Setting Laboratories of surgical research and biology of reproduction, academic medical centers. Patient(s) Lewis rats, immature and adult. Intervention(s) Eighteen-day-old rats (6 groups): intra-abdominal stay of testis after closure of inguinal canal, classic dartos pouch Orchidopexy, Orchidopexy by testis fixation through tunica albuginea, Orchidopexy by transparenchymal testicular fixation, sham operation, and bilateral vasectomy. Adult rats (1 group): transparenchymal testicular fixation. Main Outcome Measure(s) The ASA—antiacrosome and antitail—were measured by indirect immunofluorescence in sera collected preoperatively, on 50th and 120th day in immature rats, and 90 days after surgery in adult rats. Testicular histology was also examined at the end of sera collection. Result(s) Neither intra-abdominal testicular localization nor orchidopexies induced significant ASA. Testicular nondescent and fixation (transparenchymal or transtunical) caused hypospermatogenesis; dartos pouch was harmless. Bilateral vasectomy produced significantly increased ASA, but no significant testicular lesions. Contralateral testes were unaffected. Conclusion(s) Intra-abdominal testicular stay and Orchidopexy do not elicit autoimmune response to sperm; histologic testicular lesions might not be associated with ASA. In operated cryptorchids, ASA are probably due to other reason than testicular heat or Orchidopexy trauma.

  • Effect of testis nondescent or Orchidopexy on antisperm antibodies and testis histology in rats.
    Fertility and sterility, 2009
    Co-Authors: Petros Mirilas, Ioannis Panayiotides, Anastasia Mentessidou, Georgios Mavrogenis, Elissaios Kontis, Panagiotis Lainas, Marta De Almeida
    Abstract:

    To examine effects of nondescent of normal testis and of various Orchidopexy techniques on antisperm antibody (ASA) production and histologic testicular lesions. Experimental cohort study. Laboratories of surgical research and biology of reproduction, academic medical centers. Lewis rats, immature and adult. Eighteen-day-old rats (6 groups): intra-abdominal stay of testis after closure of inguinal canal, classic dartos pouch Orchidopexy, Orchidopexy by testis fixation through tunica albuginea, Orchidopexy by transparenchymal testicular fixation, sham operation, and bilateral vasectomy. Adult rats (1 group): transparenchymal testicular fixation. The ASA--antiacrosome and antitail--were measured by indirect immunofluorescence in sera collected preoperatively, on 50th and 120th day in immature rats, and 90 days after surgery in adult rats. Testicular histology was also examined at the end of sera collection. Neither intra-abdominal testicular localization nor orchidopexies induced significant ASA. Testicular nondescent and fixation (transparenchymal or transtunical) caused hypospermatogenesis; dartos pouch was harmless. Bilateral vasectomy produced significantly increased ASA, but no significant testicular lesions. Contralateral testes were unaffected. Intra-abdominal testicular stay and Orchidopexy do not elicit autoimmune response to sperm; histologic testicular lesions might not be associated with ASA. In operated cryptorchids, ASA are probably due to other reason than testicular heat or Orchidopexy trauma. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Caleb P. Nelson - One of the best experts on this subject based on the ideXlab platform.

  • variations in timing of surgery among boys who underwent Orchidopexy for cryptorchidism
    Pediatrics, 2010
    Co-Authors: Paul Kokorowski, Jonathan C. Routh, Dionne A. Graham, Caleb P. Nelson
    Abstract:

    OBJECTIVE: Current clinical guidelines recommend that Orchidopexy be performed by the age of 1 in patients with congenital undescended testis. We sought to examine trends in surgical timing and to determine what factors are associated with age at surgery. METHODS: The Pediatric Health Information System (PHIS) is a national database of >40 freestanding children9s hospitals. We searched the PHIS to identify boys with cryptorchidism who underwent Orchidopexy between 1999 and 2008. Patient age at Orchidopexy was evaluated, and we used multivariate models to determine factors associated with timing of surgery. RESULTS: We identified 28 204 children who underwent Orchidopexy at PHIS hospitals. Of these, 14 916 (53%) were white, and 17 070 (61%) had public insurance. Only 5031 patients (18%) underwent Orchidopexy by the age of 1 year; only 12 165 (43%) underwent Orchidopexy by the age of 2 years. These figures remained stable over time (P = .32). After adjusting for patient clustering, race (P CONCLUSIONS: Only 43% had surgery by 2 years of age, which suggests that either significant numbers of boys with congenital cryptorchidism do not undergo surgery in a timely fashion or late-onset testicular ectopy is more common than generally recognized. Factors associated with the timing of Orchidopexy include patient race, insurance status, and the hospital in which surgery is performed.

  • Variations in Timing of Surgery Among Boys Who Underwent Orchidopexy for Cryptorchidism
    Pediatrics, 2010
    Co-Authors: Paul Kokorowski, Jonathan C. Routh, Dionne A. Graham, Caleb P. Nelson
    Abstract:

    Current clinical guidelines recommend that Orchidopexy be performed by the age of 1 in patients with congenital undescended testis. We sought to examine trends in surgical timing and to determine what factors are associated with age at surgery. The Pediatric Health Information System (PHIS) is a national database of >40 freestanding children's hospitals. We searched the PHIS to identify boys with cryptorchidism who underwent Orchidopexy between 1999 and 2008. Patient age at Orchidopexy was evaluated, and we used multivariate models to determine factors associated with timing of surgery. We identified 28 204 children who underwent Orchidopexy at PHIS hospitals. Of these, 14,916 (53%) were white, and 17,070 (61%) had public insurance. Only 5031 patients (18%) underwent Orchidopexy by the age of 1 year; only 12,165 (43%) underwent Orchidopexy by the age of 2 years. These figures remained stable over time (P=.32). After adjusting for patient clustering, race (P<.001) and insurance status (P<.001) remained associated with patient age at Orchidopexy; however, the treating hospital (P<.001) was the most important factor in predicting the timing of the procedure. Only 43% had surgery by 2 years of age, which suggests that either significant numbers of boys with congenital cryptorchidism do not undergo surgery in a timely fashion or late-onset testicular ectopy is more common than generally recognized. Factors associated with the timing of Orchidopexy include patient race, insurance status, and the hospital in which surgery is performed.

Jack S. Elder - One of the best experts on this subject based on the ideXlab platform.

  • 1529 OPENING THE INGUINAL CANAL IS UNNECESSARY IN INGUINAL ORCHIOPEXY
    The Journal of Urology, 2012
    Co-Authors: Frank J. Penna, Jack S. Elder, Mireya Diaz
    Abstract:

    INTRODUCTION AND OBJECTIVES: In boys with an inguinal testis, the traditional approach is to perform an inguinal incision, open the inguinal canal, mobilize the testis and spermatic cord, repair the inguinal hernia if present, and place the testis in a dartos pouch in the scrotum. In boys, the inguinal canal is short and during inguinal hernia repair, it is often unnecessary to extend the dissection to the internal inguinal ring in order to mobilize enough length. The purpose of this study is to determine if performing a modified inguinal orchiopexy (without opening the inguinal canal) results in a successful orchiopexy. METHODS: Boys with an inguinal testis who underwent orchiopexy were reviewed retrospectively. Patient age and surgical approach (inguinal, with or without inguinal dissection, or prescrotal) were recorded. Only if the testis did not reach the dartos pouch was the inguinal canal opened and a standard orchiopexy performed with inguinal dissection. Presence of an inguinal hernia was also noted. All patients underwent clinical follow-up at 4-6 weeks. Boys with an ectopic, abdominal or absent testis and those undergoing previous inguinal surgery were excluded. RESULTS: A total of 254 boys with 323 undescended inguinal testes were reviewed. The results are shown in Table 1. Overall, 171 underwent a modified inguinal orchiopexy without opening the inguinal canal, 36 underwent inguinal orchiopexy with standard inguinal dissection, and 116 underwent prescrotal orchiopexy. A total of 123 (38.1%) testes were associated with an inguinal hernia that was repaired during orchiopexy. Of those with a hernia, 92 underwent a modified inguinal orchiopexy, 23 underwent a standard inguinal orchiopexy, and 9 were corrected via a prescrotal approach. There was one complication of testicular re-ascent in the modified inguinal orchiopexy group. CONCLUSIONS: In boys with an inguinal undescended testis, orchiopexy can be performed without opening the inguinal canal, even if there is an associated inguinal hernia, with the decision being dependent upon the ability to mobilize the testis and spermatic cord into the dartos pouch. Inguinal (M) Inguinal (S) Prescrotal Total No. testis 171 36 116 323 Mean age (yrs.) 5.1 5.9 4.9 5.1 Hernia 92 (54%) 23 (64%) 9 (8%) 123 (38%) No. side Lt 79 20 56 155 Rt 92 16 60 168 No. complications 1 (0.5%) 0 (0%) 0 (0%) 1 (0.3%) (M) modified, (S) standard

  • Results of orchiopexy for the undescended testis
    World Journal of Urology, 2006
    Co-Authors: Irina Taran, Jack S. Elder
    Abstract:

    The undescended testis is one of the most common congenital abnormalities of the genitourinary system. Outcomes of orchiopexy include (1) having a viable, palpable testis in the scrotum, (2) fertility, as measured by paternity rates or semen analysis in adulthood and (3) risk of testicular cancer. Multiple operative techniques have been described and are associated with various success rates. In the past decade, success of orchiopexy for inguinal testes has been >95%. For abdominal testes, success for orchiopexy has been >85–90% in most series with single stage orchiopexy or two stage Fowler–Stephens orchiopexy, both with open surgical or laparoscopic technique. However, having a palpable testis in the scrotum does not assure fertility, as there are iatrogenic factors that may adversely affect the outcome. In adult men with a history of unilateral orchiopexy, fertility is nearly normal, but is significantly reduced following bilateral orchiopexy. The risk of testicular carcinoma is increased by a factor of 3.7 to 7.5 times. Tumor type is most commonly seminoma if the testis is undescended, whereas tumors that occur following orchiopexy are much more likely to be nonseminomatous.

Pawel Nachulewicz - One of the best experts on this subject based on the ideXlab platform.