Sclerotherapy of hydroceles and spermatoceles with alcohol: results and effects on the semen analysis.

PURPOSE: To evaluate the success rates of sclerotherapy of the tunica vaginalis with alcohol for the treatment of hydroceles and/or spermatoceles, as well as, evaluation of pain, formation of hematomas, infection and its effects in spermatogenesis. MATERIALS AND METHODS: A total of 69 patients, with offsprings and diagnosis of hydrocele and/or spermatocele, were treated during the period from April 2003 to June 2007. Semen analysis was obtained from patients who were able to provide us with samples. The sclerotherapy with alcohol at 99.5% was undertaken as outpatient procedure. RESULTS: The average volume drained pre-sclerotherapy was 279.82 mL (27 to 1145). The median follow-up was 43 months (9 to 80). A total of 114 procedures were performed on 84 units, with an average of 1.35 procedures/unit and an overall success rate of 97.62%. Of the 69 patients, 7 (10.14%) reported minor pain immediately after the procedure, 3 (4.35%) moderate pain and 2 (2.89%) intense pain. Post-Sclerotherapy spermograms revealed reduction of the parameters regarding: concentration, motility and morphology up to 6 months post procedure, with return to normal parameters 12th months after procedure. CONCLUSIONS: Sclerotherapy of hydroceles and spermatoceles with 99.5% alcohol is an efficient procedure that can be performed without difficulties, cost-effectiveness, with few side effects and which may be performed in patients who wish fertility.

Sclerotherapy of hydroceles and spermatoceles with alcohol: results and effects on the semen analysis

PURPOSE: To evaluate the success rates of sclerotherapy of the tunica vaginalis with alcohol for the treatment of hydroceles and/or spermatoceles, as well as, evaluation of pain, formation of hematomas, infection and its effects in spermatogenesis . MATERIALS AND METHODS: A total of 69 patients, with offsprings and diagnosis of hydrocele and/or spermatocele, were treated during the period from April 2003 to June 2007. Semen analysis was obtained from patients who were able to provide us with samples. The sclerotherapy with alcohol at 99.5 percent was undertaken as outpatient procedure. RESULTS: The average volume drained pre-sclerotherapy was 279.82 mL (27 to 1145). The median follow-up was 43 months (9 to 80). A total of 114 procedures were performed on 84 units, with an average of 1.35 procedures / unit and an overall success rate of 97.62 percent. Of the 69 patients, 7 (10.14 percent) reported minor pain immediately after the procedure, 3 (4.35 percent) moderate pain and 2 (2.89 percent) intense pain. Post-Sclerotherapy spermograms revealed reduction of the parameters regarding: concentration, motility and morphology up to 6 months post procedure , with return to normal parameters 12th months after procedure. CONCLUSIONS: Sclerotherapy of hydroceles and spermatoceles with 99.5 percent alcohol is an efficient procedure that can be perormed without difficulties, cost-effectiveness, with few side effects and which may be performed in patients who wish fertility.

Sclerotherapy of idiopathic hydroceles and epididymal cysts: a historical comparison trial of 5% phenol versus tetracycline

Operating time for idiopathic hydroceles and epididymal cysts is scarce as these conditions compete with an increasing caseload of more consequential surgical disease. Therapy is often relegated to repeated aspiration. Sclerotherapy appears to be effective in a majority of published trials, but comparative effectiveness, efficacy and safety of most agents, including phenol versus tetracycline, has not been established A deliberate strategy of re-treatment until cure is not universally practised, with surgery still being offered after single-treatment failures. Two trials, the first consisting of 53 scrotal cysts treated with 5% phenol-in-water and the second, 42 cysts treated with tetracycline, are compared for effectiveness, efficacy and safety of sclerotherapy per se and of re-treatment. Intention-to-treat analysis yields similar cure rates (no re-accumulation three months after last injection) for phenol and tetracycline (83% and 81% respectively, p = 0.8). Per-protocol analysis also yields similar cure rates (100% and 97% respectively, p = 0.26) and mean number of injections to cure (1.34 and 1.12 respectively, p = 0.069), with range 1-4 and 1-3 respectively. Severe pain following tetracycline injection required administration of pre-injection cord block. Other complications occurred equally (25% and 25.7% respectively, p = 0.94) and were trivial except for one case of chronic haematocele treated by orchiectomy in the tetracycline group. Phenol (5%) and tetracycline are equally efficacious sclerosants for idiopathic scrotal cysts, achieving almost 100% cure with re-treatment and matching the efficacy of surgery. Concern about post-treatment fertility applies equally to surgery and demands informed consent for both modalities.

El tiempo de operación para los hidroceles y los quistes epididimales es escaso, ya que estas condiciones triviales compiten con una creciente carga de casos de enfermedades quirúrgicas de mayores consecuencias. La terapia es a menudo relegada a una aspiración repetida. La escleroterapiaparece ser efectiva en la mayoría de los ensayos publicados, pero no se han establecido la seguridad, eficacia y efectividad comparativa de la mayor parte de los agentes, incluyendo el fenol, frente a la tetraciclina. No se practica universalmente una estrategia deliberada de re-tratamiento hasta la cura, ofreciéndose todavía la cirugía, luego de fracasos con tratamientos individuales. Dos ensayos, el primero consistente en 53 quistes escrotales tratados con fenol acuoso al 5%, y el segundo, en 42 quistes tratados con tetraciclina, se comparan en cuanto a efectividad, eficacia y seguridad para laescleroterapia per se y para el re-tratamiento. El análisis de intención de tratamiento produce tasas de curación similares (no hay re-acumulación 3 meses después de la última inyección) para el fenol y la tetraciclina (83% y 81% respectivamente, p = 0.8). El análisis por protocolo también produce tasas de curación similares (100% y 97% respectivamente, p = 0.26) y el número medio de inyecciones paracurar (1.34 y 1.12 respectivamente, p = 0.069), con rangos de 1–4 y 1–3 respectivamente. El dolor severo tras la inyección de tetraciclina requirió hacer un bloqueo espinal de pre-inyec-ción. Asimismo ocurrieron otras complicaciones (25% y 25.7% respectivamente, p = 0.94) y fueron triviales, con excepción de un caso de hematoceles crónicos tratado mediante orquiectomía en el grupo de tetraciclina. El fenol (5%) y la tetraciclina poseen igual eficacia como esclerosantes de los quistes escrotales idiopáticos, ya que logran una curación de casi 100% con el re-tratamiento, e igualan la eficacia de la cirugía...

Sclerotherapy of idiopathic hydroceles and epididymal cysts: a historical comparison trial of 5% phenol versus tetracycline.

Operating time for idiopathic hydroceles and epididymal cysts is scarce as these conditions compete with an increasing caseload of more consequential surgical disease. Therapy is often relegated to repeated aspiration. Sclerotherapy appears to be effective in a majority of published trials, but comparative effectiveness, efficacy and safety of most agents, including phenol versus tetracycline, has not been established A deliberate strategy of re-treatment until cure is not universally practised, with surgery still being offered after single-treatment failures. Two trials, the first consisting of 53 scrotal cysts treated with 5% phenol-in-water and the second, 42 cysts treated with tetracycline, are compared for effectiveness, efficacy and safety of sclerotherapy per se and of re-treatment. Intention-to-treat analysis yields similar cure rates (no re-accumulation three months after last injection) for phenol and tetracycline (83% and 81% respectively, p = 0.8). Per-protocol analysis also yields similar cure rates (100% and 97% respectively, p = 0.26) and mean number of injections to cure (1.34 and 1.12 respectively, p = 0.069), with range 1-4 and 1-3 respectively. Severe pain following tetracycline injection required administration of pre-injection cord block. Other complications occurred equally (25% and 25.7% respectively, p = 0.94) and were trivial except for one case of chronic haematocele treated by orchiectomy in the tetracycline group. Phenol (5%) and tetracycline are equally efficacious sclerosants for idiopathic scrotal cysts, achieving almost 100% cure with re-treatment and matching the efficacy of surgery. Concern about post-treatment fertility applies equally to surgery and demands informed consent for both modalities.

Afecções do aparelho reprodutor do cão e do gato: parte I: alterações da bolsa escrotal, testículos, epidídimos, pênis e prepúcio no cão e no gato / Disorders of reproductive system of the dog and cat: part I:

As afecções nos órgãos da reprodução dos machos caninos e felinos são comuns e, geralmente, o único sinal clínico é a subfertilidade ou a infertilidade. As afecções podem comprometer o desempenho reprodutivo, seja por alterar os hormônios da reprodução, bem como a produção espermática ou simplesmente por impedir o acasalamento devido a alterações anatômicas ou infecções. Na primeira parte desta revisão serão incluídas as principais alterações da bolsa escrotal, dos testículos, de epidídimos, do pênis e do prepúcio de cães e gatos(AU)

Disorders of the reproductive organs were common in mole dogs and cats. Generally, the unique clinical signal is subfertility or infertility. These disorders can compromise reproductive performance, either for modifying reproductivehormones, as well as the espermatic production or simply for hindering the breeding due the anatomical defects or infections. In the first port of this review the main diseases of the scrotum, testes, epididymes, penis and prepuce inthe dog and cat of dogs will be approached(AU)

Afecções do aparelho reprodutor do cão e do gato: parte I: alterações da bolsa escrotal, testículos, epidídimos, pênis e prepúcio no cão e no gato / Disorders of reproductive system of the dog and cat: part I:

As afecções nos órgãos da reprodução dos machos caninos e felinos são comuns e, geralmente, o único sinal clínico é a subfertilidade ou a infertilidade. As afecções podem comprometer o desempenho reprodutivo, seja por alterar os hormônios da reprodução, bem como a produção espermática ou simplesmente por impedir o acasalamento devido a alterações anatômicas ou infecções. Na primeira parte desta revisão serão incluídas as principais alterações da bolsa escrotal, dos testículos, de epidídimos, do pênis e do prepúcio de cães e gatos

Disorders of the reproductive organs were common in mole dogs and cats. Generally, the unique clinical signal is subfertility or infertility. These disorders can compromise reproductive performance, either for modifying reproductivehormones, as well as the espermatic production or simply for hindering the breeding due the anatomical defects or infections. In the first port of this review the main diseases of the scrotum, testes, epididymes, penis and prepuce inthe dog and cat of dogs will be approached

Adult paratesticular tumors: report of two cases.

Paratesticular tumors are uncommon tumors, most being found incidentally at autopsy. The most common benign paratesticular tumor is the adenomatoid tumor. A somewhat less frequent benign paratesticular tumor, papillary cystadenoma, accounts for approximately 33 percent of all the primary epididymal tumors and is frequently seen in patients with Von Hippel-Lindau disease. Malignant tumors are rare. Of these, rhabdomyosarcoma is the most frequent. Seen almost exclusively in the pediatric population, paratesticular rhabdomyosarcomas account for 7 percent of childhood rhabdomyosarcomas. We describe two cases of paratesticular tumors in adults: a papillary cystadenoma of the epididymis in a 72-year old male, and an incidental rhabdomyosarcoma in a 49-year old male.

Adult paratesticular tumors: report of two cases

Paratesticular tumors are uncommon tumors, most being found incidentally at autopsy. The most common benign paratesticular tumor is the adenomatoid tumor. A somewhat less frequent benign paratesticular tumor, papillary cystadenoma, accounts for approximately 33 percent of all the primary epididymal tumors and is frequently seen in patients with Von Hippel-Lindau disease. Malignant tumors are rare. Of these, rhabdomyosarcoma is the most frequent. Seen almost exclusively in the pediatric population, paratesticular rhabdomyosarcomas account for 7 percent of childhood rhabdomyosarcomas. We describe two cases of paratesticular tumors in adults: a papillary cystadenoma of the epididymis in a 72-year old male, and an incidental rhabdomyosarcoma in a 49-year old male

Espermatocele artificial em agenesia dos canais deferentes / Alloplastic spermatocele in agenesis of the vas deferens

Os autores descrevem nova técnica de criaçäo de espermatocele artificial utilizando enxerto vascular tubular de politetrafluoroetileno (Goretex). O procedimento, empregado em quatro pacientes com agenesia-atresia dos canais deferentes, permitiu a obtençäo no pós-operatório de espermatozóides viáveis em três dos quatro pacientes. Embora nenhum caso de gestaçäo da parceira tenha sido observado com a inseminaçäo artificial de material obtido por punçäo das espermatoceles, esta técnica pode representar uma alternativa válida para tratar pacientes com esterilidade decorrente de processos obstrutivos graves das vias seminais