Subinguinal versus peritesticular diameters of varicocele veins in the supine and standing posture.

OBJECTIVE: To determine the region which should be taken as a standard of measurement for varicocele veins. METHODS: The cross-sectional study was conducted at the Fatima Memorial Hospital, Lahore, Pakistan, from October 2018 to October 2019, and comprised patients aged 20-45 years diagnosed with left-sided varicocele and infertility having varicocele vein diameter >2.5mm on scrotal colour Doppler ultrasound. The parameters were determined at subinguinal and peritesticular region in the patients. Data was anaylsed using SPSS 23. RESULTS: There were 35 male patients with a mean age of 32.83±5.91 years. In both supine and standing positions, the mean diameters of varicocele vein at the peritesticular region were significantly greater than the mean values at the subinguinal region (p<0.01). All the 35(100%) patients had semen abnormalities, but the diameter of varicocele veins had no significant correlation with such abnormalities (p>0.05). CONCLUSIONS: Varicocele vein diameter at the peritesticular region was found to be significantly greater than the subinguinal diameter in both lying and standing position.

Communicating seminal vesicles leading to indirect vasal communication: A case report.

We are presenting a case of 42 year old male, suffering from secondary infertility. Nine years ago he developed bilateral scrotal pain followed by azoospermia and infertility. At our center during vasography we found that the dye was not seen in bladder or prostatic urethra. But interestingly a direct communication was observed between both seminal vesicles, and through that channel an indirect communication was observed between both vas deferens. It is suggested that the patient developed obstructive azoospermia as a sequel of epididymo-orchitis. It is also concluded that seminal vesicle communication was initially not a primary problem for patient's fertility.

The outcome of living related kidney transplantation with multiple renal arteries.

The aim of our study was to compare the surgical complications and short-term outcome of renal transplants with single and multiple renal artery grafts. We reviewed the records of 105 kidney transplantations performed consecutively at our institution from July 2006 to May 2010. The data of 33 (31.4%) renal transplants with multiple arteries were compared with the 72 transplants with single artery (68.6%), and the incidence of surgical complications, post-transplant hypertension, acute tubular necrosis, acute graft rejection, mean creatinine level, and patient and graft survival was analyzed. We further subdivided the study recipients into three groups: group A (n = 72) with one-renal-artery allografts and one-artery anastomosis, group B (n = 6) with multiple-artery allografts with single-artery anastomosis, and group C (n = 27) with multiple-artery allografts with multiple arterial anasatomosis, and compared their outcome. No significant differences were observed among the recipients of all the three groups regarding early vascular and urological complications, post-transplant hypertension, acute tubular necrosis, acute rejection, creatinine level, and graft and patient survival. The mean cold ischemia time in groups B and C was significantly higher (P <0.05). One patient in group A developed renal vein thrombosis resulting in graft nephrectomy. None of the patients with multiple renal arteries developed either vascular or urological complications. In conclusion, kidney transplantation using grafts with multiple renal arteries is equally safe as using grafts with single renal artery, regarding vascular, urological complications, as well as patient and graft survival.