Metodologia da análise seminal para pacientes azoospérmicos no laboratório fleury / Methodology of seminal analysis for azoospermicos patients in the laboratório fleury

A azoospermia é definida como a ausência de espermatozoide no líquido seminal ejaculado pelo homem depois de aplicada a técnica de centrifugação em pelo menos duas amostras. Dada a importância de um diagnóstico correto da análise seminal para os casais, toda amostra que não apresentar espermatozoides no exame a fresco deve seguir em avaliação laboratorial. Com isso, o presente estudo tem como objetivo analisar os resultados de centrifugação de uma alíquota do sêmen ejaculado ou de todo o volume ejaculado de pacientes com diagnóstico de azoospermia para determinar qual o melhor método a ser empregado na análise seminal para esse grupo de pacientes.

The azoospermia is defined as the absence of sperm in the ejaculate by the seminal fluid man after centrifugation technique conducted in at least two samples. Given the importance of a correct diagnosis of the seminal analysis for couples, all sample no sperm present in fresh examination should follow in laboratory tests. Thus the present study aims to analyze the results of a spin rate of ejaculate or all of the ejaculate volume of patients with azoospermia to determine the best method to be used in semen analysis for this group of patients.

Residual urinary volume and urinary tract infection--when are they linked?

PURPOSE: Large post-void residual urinary volume may be related to the development of urinary tract infection. However, the maximum post-void residual volume that predisposes patients to a higher risk of urinary tract infection is not known. In this prospective study we determined the cutoff value for post-void residual volume that places adult men at risk for bacteriuria. MATERIALS AND METHODS: Data were obtained from 196 consecutive healthy adult men (median age 62 years) who came for prostate evaluation without symptoms of acute urinary tract infection. Right after spontaneous voiding, bladder catheterization was performed under normal aseptic conditions, and the post-void residual volume measured. Urine samples were collected for culture from each patient and the results were compared to the various post-void residual volume. RESULTS: Overall 27% of the patients presented with a positive urine culture. The mean post-void residual volume in this group was 257 ml (range 150 to 560) compared to 133 ml (range 10 to 340) for the group with negative culture (p <0.001). The post-void residual volume value of 180 ml was determined to have the best specificity and sensitivity. The positive predictive value for bacterial growth at a post-void residual volume of 180 ml or greater was 87.0% and the negative predictive value was 94.7%. CONCLUSIONS: Clinically asymptomatic adult men with a post-void residual volume of 180 ml are at a high risk for bacteriuria. Such cases require close medical attention since it may be necessary to introduce early drug therapy or surgical intervention to improve the bladder emptying.