vasectomy

输精管切除术
  • 文章类型: Case Reports
    2022年7月4日,一名8岁的德国男性短毛指针因急性腹部和睾丸疼痛而出现。这只狗在他以前的主人的照顾下在一个未知的年龄被输精管切除。狗有一个扩大的,疼痛的左睾丸,阴囊水肿,和一个放大的,没有疼痛的前列腺.腹部超声显示轻度腹膜和腹膜后积液,睾丸炎,输精管和睾丸增大,怀疑良性前列腺增生和前列腺炎。腹腔积液细胞学检查显示精腹膜伴明显的中性粒细胞炎症。腹腔积液需氧培养和犬布鲁氏菌快速载玻片凝集试验均为阴性。狗在静脉内抗生素治疗和镇痛药中住院过夜。第二天,狗的腹痛,睾丸疼痛,阴囊水肿消退。在完成抗生素治疗和临床体征完全缓解后,将狗出院并阉割。睾丸组织病理学结果不可用。精膜腹膜在狗中并不常见,对于患有急性腹痛的狗来说是罕见的诊断。这是第二例已知的输精管切除的狗的半腹膜。
    An 8 yr old male German shorthaired pointer was presented on July 4, 2022, for acute abdominal and testicular pain. The dog was vasectomized at an unknown age under the care of his previous owners. The dog had an enlarged, painful left testis, scrotal edema, and an enlarged, nonpainful prostate. Abdominal ultrasound revealed mild peritoneal and retroperitoneal effusion, orchiepididymitis, enlarged ductus deferentes and testicles, and suspected benign prostatic hyperplasia versus prostatitis. Peritoneal effusion cytology revealed seminoperitoneum with marked neutrophilic inflammation. Peritoneal effusion aerobic culture and Brucella canis rapid slide agglutination test were negative. The dog was hospitalized overnight with IV antibiotic therapy and analgesics. The following day, the dog\'s abdominal pain, testicular pain, and scrotal edema were resolved. The dog was discharged and castrated after completion of antibiotic therapy and complete resolution of clinical signs. Testicular histopathology results were not available. Seminoperitoneum is uncommon in dogs and is a rare diagnosis for dogs with acute abdominal pain. This is the second known reported case of a seminoperitoneum in a vasectomized dog.
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  • 文章类型: Case Reports
    Arteriovenous haemangioma of the vas deferens is an extremely rare entity in clinical practice. To date, there have been no clinical or pathological cases reported in Medline, Embase or other published English literature. Herein, a 50-year-old male who presented with right scrotal pain for 4 years after vasectomy was admitted to our hospital. One painful nodule was palpable in the right scrotum on physical examination. Color Doppler ultrasound merely showed dilation of the epididymis and no additional information concerning the painful nodule in the right scrotum. Moreover, the laboratory test results were all within normal limits. Ibuprofen was administered to the patient for 2 months with a poor effect, and then spermatic cord block significantly relieved his symptoms. This patient underwent resection of the right painful nodule of the vas deferens under medical advice. Postoperative pathological examinations showed arteriovenous haemangioma of the vas deferens. There were no obvious complications after arteriovenous haemangioma excision, and the right scrotal pain was significantly relieved 1 month later. This article reminds urologists and oncologists that haemangioma can involve the vas deferens and, in addition to spermatic granuloma, might be a cause of post-vasectomy pain syndrome. Cauterization of the vas deferens might have a potential relationship with haemangioma.
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  • 文章类型: Case Reports
    输精管重复是一种非常罕见的异常,在精索中发现了两个输精管。可以在尸检或尸体解剖以及需要精索解剖的几种外科手术中识别,包括腹股沟疝修补术,诊所,输精管切除术,精索静脉曲张切除术,输精管切除术逆转和前列腺癌根治术。识别重复的输精管对于避免手术并发症例如不成功的输精管切除术或输精管横切是重要的。自1959年以来,仅在3具尸体和31名患者中报告。在这项研究中,我们描述了一例66岁患者在常规腹股沟疝修补术中偶然发现的重复输精管的新病例。我们还回顾了文献中所有以前报道的病例,以引起人们对这种罕见但重要的异常的关注。
    Duplication of vas deferens is a very rare anomaly which two vasa deferentia are found in the spermatic cord. It can be recognised during autopsy or cadaveric dissection and also several surgical procedures which require spermatic cord dissection including inguinal hernia repair, orchiopexy, vasectomy, varicocelectomy, vasectomy reversal and radical prostatectomy. Recognition of the duplicated vas deferens is important to avoid surgical complications such as an unsuccessful vasectomy or transection of the vas. It was reported in only three cadavers and 31 patients since 1959. In this study, we describe a new case of duplicated vas deferens found incidentally during routine inguinal hernia repair in a 66-year-old patient. We also review all previously reported cases in the literature to draw attention to this rare but important anomaly.
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  • 文章类型: Case Reports
    背景:输精管结扎术是一种永久性的避孕方法;然而,受孕的风险仍然存在。早期失败,定义为术后精液分析显示持续活动的精子,每250例患者中有1例发生。晚期失败,定义为输精管切断端的重新连接,每2000名患者中有1名发生。
    方法:一位37岁健康的英国男性出现在我们的诊所,因为他的妻子在接受输精管切除术后7年怀孕。输精管结扎后的精液分析结果为阴性,组织病理学报告证实该样本含有来自左右输精管的组织。他的妻子在手术后七年怀孕了,当时的精液分析证实,在6.3毫升的总精液样本中,每毫升精液总共有50万个精子。记录的活动精子总数为250万。
    结论:本病例显示,输精管结扎术后7年内可发生晚期再通。手术前应告知患者晚期再通,虽然罕见,仍然可能发生。输精管切除术后的亲子关系需要进一步的咨询,以确保患者和患者的伴侣充分了解他们的影响和选择。
    BACKGROUND: Vasectomy is one of the permanent methods of contraception; however, the risk of conception still exists. Early failure, defined as a postoperative semen analysis showing persistent motile sperm, occurs in 1 in every 250 patients. Late failure, defined as the rejoining of the severed ends of the vas deferens, occurs in 1 in every 2000 patients.
    METHODS: A healthy 37-year-old British male presented to our clinic because his wife had conceived seven years after he had undergone a vasectomy. The result of his semen analysis after the vasectomy was negative, and the histopathological report confirmed that the sample contained tissue from both the left and right vas deferens. His wife conceived seven years after the procedure, and semen analysis at that time confirmed a total of 0.5 million sperm per milliliter of semen in a total semen sample of 6.3 ml. The total number of motile sperm recorded was 2.5 million.
    CONCLUSIONS: This case shows that late recanalization can occur up to seven years after a vasectomy. Patients should be informed prior to the procedure that late recanalization, although rare, may still occur. Post-vasectomy paternity necessitates further counseling to ensure that the patient and the patient\'s partner fully understand the implications and options available to them.
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  • 文章类型: Case Reports
    BACKGROUND: Vasectomy is the most common and most effective method of achieving permanent male sterility. However, there is a low risk of vasectomy failure. To our knowledge, there is no symptom complex that has been identified and described that is predictive of early recanalization and vasectomy failure.
    METHODS: A 44-year-old man underwent a routine bilateral vasectomy without complication. Two months after the procedure, the patient experienced an acute onset of scrotal pain and hematospermia. Several semen analyses were performed during the following months, the results of which demonstrated progressively rising numbers of motile sperm and were indicative of vasal recanalization. The patient underwent repeated vasectomy, during which he was found to have right vasal recanalization leading to vasectomy failure.
    CONCLUSIONS: Delayed postvasectomy scrotal pain associated with hematospermia may be a sign of vasal recanalization. We propose that this symptom complex should prompt an investigation for vasal recanalization, during which the patient should be instructed to refrain from intercourse without the use of an additional method of contraception.
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  • 文章类型: Case Reports
    The couple from this clinical case consisted of a 55 years old male with an obstructive interval of 25 years post vasectomy, and a 38 years old female partner. Both partners had normal results in infertility workup. Five mature oocytes were injected with motile spermatozoa showing morphological alterations, obtained by percutaneous epididymal sperm aspiration. Four oocytes fertilized, and three embryos were transferred with assisted hatching on day three of development, of which one was a high-quality embryo. A clinical pregnancy was confirmed by the detection of two gestational sacs with foetal heartbeats. Pregnancy was ongoing during the submission of this manuscript. The use of ICSI with PESA/TESA should be considered as a feasible alternative when vasectomy reversal fails in vasectomized men wishing to father again. Case reports like this may inspire the counseling of couples that have suffered from a previous vasectomy reversal failure and support the recommendation of ICSI with PESA treatment, which could allow those couples to have their own children, even in the presence of advanced parental age.
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  • 文章类型: Case Reports
    睾丸支持细胞肿瘤极为罕见。一般来说,它们是良性肿瘤,属于性索间质肿瘤。在这篇文章中,我们提供了一个支持细胞肿瘤的病例报告,这是在一名42岁男性的泌尿科咨询中意外发现的。超声显示2.1x2.2厘米的低回声,左睾丸中部三分之一的高血管肿瘤。血清肿瘤标志物(甲胎蛋白,碱性磷酸酶,β-人绒毛膜促性腺激素,和乳酸脱氢酶)均在正常范围内。手术期间新鲜冷冻切片的快速显微镜评估尚无定论,这导致决定不立即进行根治性睾丸切除术。在福尔马林固定石蜡包埋(FFPE)切片上,肿瘤组织学表现出不典型的模式,进行免疫组织化学分析以确定肿瘤的类型并将其与其他类型的睾丸肿瘤区分开来,以便指定进一步的治疗方案。行根治性腹股沟睾丸切除术。最终病理报告显示肿瘤没有攻击性行为的预测迹象,最类似于支持细胞肿瘤。
    Testicular Sertoli cell tumors are extremely rare. Generally, they are benign neoplasms, which belong to a group called sex cord-stromal tumors. In this article, we present a case report of a Sertoli cell tumor, which was accidentally discovered during a urological consultation of a 42-year-old male. An ultrasound showed a 2.1 x 2.2 cm hypoechogenic, hypervascular tumor in the middle third of the left testicle. Serum tumor markers (α-fetoprotein, alkaline phosphatase, β-human chorionic gonadotropin, and lactic dehydrogenase) were all within the normal range. Rapid microscopic evaluation of fresh frozen sections during the operation was inconclusive, which led to a decision not to perform a radical orchiectomy immediately. On formalin-fixed paraffin-embedded (FFPE) sections, the tumor histology showed atypical patterns, and immunohistochemical analysis was performed in order to determine the type of neoplasm and differentiate it from other types of testicular tumors, so as to assign the further course of treatment. Radical inguinal orchiectomy was performed. The final pathology report showed a tumor with no predictive signs of aggressive behavior, which most closely resembled a Sertoli cell tumor.
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  • 文章类型: Journal Article
    陷阱-中子-返回(TNR)程序,在其中捕获流浪猫,绝育和重返环境被提倡为人道,安乐死的伦理选择。我们根据目前关于澳大利亚是否应该进一步进行TNR试验的辩论,回顾了TNR文献。我们重新审视了与人类居住相关的流浪猫所产生的问题,并通过科学指导的TNR计划来估计有多少只流浪猫必须进行处理,以避免安乐死率高。我们还确定了必须解决的10个道德和福利挑战:我们考虑流浪猫的生活质量,他们会住在哪里,TNR过程本身是否有压力,TNR猫是否容易受伤,寄生虫和疾病,可以进行医学治疗,流浪猫的身体状况和饮食,以及它们对人们的影响,宠物猫,城市野生动物,尤其是地方性动物.我们得出的结论是,在几乎所有情况下,TNR都不适合澳大利亚,因为它不太可能解决流浪猫造成的问题或遇到道德和福利挑战。有针对性的采用,早期脱敏,社区教育倡议和负责任的宠物饲养有更大的希望,以尽量减少安乐死,迅速减少数量,并解决已确定的问题。
    Trap-Neuter-Return (TNR) programs, in which stray cats are captured, neutered and returned to the environment are advocated as a humane, ethical alternative to euthanasia. We review the TNR literature in light of current debate over whether or not there should be further TNR trials in Australia. We revisit the problems arising from stray cats living in association with human habitation and estimate how many stray cats would have to be processed through a scientifically-guided TNR program to avoid high euthanasia rates. We also identify 10 ethical and welfare challenges that have to be addressed: we consider the quality of life for stray cats, where they would live, whether the TNR process itself is stressful, whether TNR cats are vulnerable to injury, parasites and disease, can be medically treated, stray cats\' body condition and diet, and their impacts on people, pet cats, and urban wildlife, especially endemic fauna. We conclude that TNR is unsuitable for Australia in almost all situations because it is unlikely to resolve problems caused by stray cats or meet ethical and welfare challenges. Targeted adoption, early-age desexing, community education initiatives and responsible pet ownership have greater promise to minimize euthanasia, reduce numbers rapidly, and address the identified issues.
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  • 文章类型: Case Reports
    Acute vasitis is a rare infection of the vas deferens. Clinical presentation and disease rarity can cause difficulty in correctly diagnosing this condition. Adjuncts to aid diagnosis can be used that include ultrasound scan (USS) or computed tomography. We report a unique case of acute vasitis following vasectomy, reversal and subsequent re-do vasectomy diagnosed using USS.
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  • 文章类型: Journal Article
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