The association between testicular microlithiasis and semen parameters in Chinese adult men with fertility intention: experience of 226 cases.

OBJECTIVE: To investigate the association between testicular microlithiasis (TM) and semen parameters in Chinese adult men with fertility intention. MATERIALS AND METHODS: We retrospectively reviewed the ultrasonography results of the reproductive system of 16,204 consecutive adult male patients in our hospital with fertility intention from November 2012 to October 2013. TM was diagnosed by scrotal ultrasonography. Patients with TM were divided into classic testicular microlithiasis (CTM) or limited testicular microlithiasis (LTM). The clinical data of CTM, LTM, and non-TM groups, especially of patients in whom sperms were found in semen analysis, were collected and analyzed. RESULTS: There were 226 men (1.39%) diagnosed with TM. The mean age was 28.96 ± 5.12 years (range, 21-46 years), whereas mean testicular volume was 15.38 ± 4.90 mL (range, 1.62-31.23 mL). CTM and LTM were detected in 141 (62.39%) and 85 patients (37.61%), respectively. Among 200 patients who underwent semen analysis, sperms were found in 159 men (79.5%; 97 men with CTM and 62 men with LTM). One hundred and twenty cases without TM (ie, non-TM group) were collected in the control group. Sperm concentration, total motility, and percentage of progressively motile of CTM, LTM, and non-TM groups was (38.01 ± 31.58 million/mL vs 52.31 ± 33.26 million/mL vs 67.16 ± 36.94 million/mL; P <.001), (46.03 ± 23.69% vs 55.37 ± 24.16% vs 62.08 ± 20.45%; P <.001), and (35.88 ± 20.17% vs 43.15 ± 21.08% vs 47.10 ± 17.84%; P <.001), respectively. CONCLUSION: TM is associated with worse semen parameters in adult men with fertility intention. The extent of microlithiasis correlates inversely with semen parameters.

Sonographic detection of unilateral hip dislocation in a spica cast after closed reduction for developmental dysplasia of the hip.

OBJECTIVES: To determine the value of sonography for evaluating unilateral hip dislocation in a spica cast after closed reduction for developmental dysplasia of the hip. METHODS: Seventy-three cases of unilateral hip dislocation were detected by sonography after closed reduction and monitored through the perineal opening of the cast during follow-up. The transinguinal approach was used first to determine the position of the femoral head. Then a sonogram of the bilateral hips was obtained by transverse scanning on the lower margin of the pubic symphysis. To determine the status of the affected femoral head, a bilateral comparison of the femoral head positions was made by measuring the horizontal distance from the medial rim of each femoral head to a center line through the pubic symphysis. RESULTS: In all 73 cases, the femoral head position after reduction could be identified by sonography. With the transinguinal approach, the reduction was successful in 69 cases and unsuccessful in 4. On the sonograms of the bilateral hips, the dislocated femoral heads were repositioned in the acetabular fossa in the successful cases and redislocated posterolaterally in the unsuccessful cases. Among the successful cases, the position differences were less than 2 mm in 61, 3 to 4 mm in 7, and 5 mm in 1. In the unsuccessful cases, the positions of the bilateral hips were asymmetric; the differences were indecipherable after an unsuccessful first reduction but were 3 to 5 mm after a successful second reduction. During follow-up, the differences were never greater than 2 mm in the cases with initial differences of less than 2 mm and gradually decreased to less than 2 mm in those with initial differences of greater than 2 mm. CONCLUSIONS: Sonography can be considered as the first imaging tool for evaluating the effect of closed reduction for developmental dysplasia of the hip.

[Value of degree diagnosis with color Doppler flow imaging in the treatment of male erectile dysfunction].

OBJECTIVE: To study the value of degree diagnosis with color Doppler flow imaging (CDFI) in the treatment of male erectile dysfunction (ED). METHODS: After CDFI and intracavernosal vasoactive agent injection (ICI) with papaverine 60 mg and prostaglandin E(1) 10 microg, 198 male ED patients were divided into 4 groups by their penile stiffness based on the Schramek criterion. The therapeutic methods such as antibiotics for prostatitis, sexual behavior therapy, sildenafil, vacuum constriction device (VCD), vena fistula repairing operation, prosthetic implantation and enhanced external counterpulsation (EECP) were recommended to the patients according to their different penile stiffness degree and their different preferences. RESULTS: Prior to ICI, there was no significant difference in the cavernosa artery peak systolic velocities (PSV), end diastolic velocities (EDV), resistant indexes (RI), dorsal artery PSV, EDV, RI and deep dorsal vein velocity (V) (P > 0.05). After ICI, the cavernosa artery PSV, EDV and RI were significantly different (P < 0.05) while other indices were not (P > 0.05). The patients were treated differently according to their preferences. The selective goal-oriented therapy increased the satisfactory rate to 91.91% (182/198). CONCLUSION: Based on the penile stiffness degree with CDFI plus ICI, different therapeutic methods yield a better clinical outcome.