The use of a gracilis myocutaneous flap to overlay an extensively traumatized scrotoperineal soft tissue defect, through which both testes and the ruptured bulbous urethra were exposed, is discussed. The transplanted gracilis myocutaneous flap, which included vascularized and innervated tissue, was well taken and covered the perineal defect, exposed testes and urethral stricture both cosmetically and functionally.
Adult ; Case Report ; Human ; Male ; Muscles/surgery ; Perineum/*surgery ; Rupture ; Scrotum/*surgery ; Surgical Flaps/*methods ; Testis/*injuries/surgery ; Urethra/*injuries/surgery

OBJECTIVETo report 31 cases and 32 testicles of testicular injuries and summarize the experience of treatment.

METHODSThirty-one patients suffered from testicular injuries which included 26 cases of closed injuries and 5 cases of open injuries. Nine cases were treated with expectant treatment (surgical treatment were performed in 2 out of 9 cases later) and 22 cases were treated with surgical treatment directly.

RESULTSTwenty-five patients and 26 testicles were followed up from 7 months to 9 years,which included 9 cases of expectant treatment and 16 cases of surgical treatment. There were 2 patients with orchiatrophy in expectant treatment group and surgical treatment group respectively. No patient had testicular sclerosis and chronic pain.

CONCLUSIONPatients suffering from scrotal trauma or perineal trauma, might have testicular injuries simultaneously. The ultrasonic examination is preferred in these patients. Expectant treatment should be performed under the ultrasonic monitoring and some patients should be underwent operations research actively.

Adolescent ; Adult ; Child ; Child, Preschool ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Testis ; injuries ; Wounds and Injuries ; surgery

OBJECTIVETo explore the effect of burying testis in thigh pocket on spermatogenesis.

METHODSGuizhou miniature male pigs at child-bearing period were randomly divided to receive operation of scrotum incision and dissection with the testis burying in thigh pocket (experimental group) or without (control group). 3 months later, testis biopsy was performed on 2 pigs from each group for pathological examination. Then every male pig from both experimental (n = 6) and control group (n = 6) got a mating partner and lived together for 3 months. The fertility of the male pigs was observed. 6 months after operation, testis biopsy was performed again on all the animals from both the groups.

RESULTSBoth at 3 months and 6 months after operation, the pathological examination showed the spermatogenic cells of all stage in contorted seminiferous tubules markedly decreased with no mature sperm in experimental group, while normal spermatogenic cells with mature sperm in control group. After the male pigs lived with mating partners for 3 months, no female pigs staying with the experimental group became pregnant, but the male pigs in control group had a normal fertility.

CONCLUSIONSBurying testis in thigh pocket impedes spermatogenesis in the miniature male pig. So burying testis in thigh pocket is not recommended for patients with scrotum skin defect who wish to remain fertile.

Animals ; Female ; Fertility ; Male ; Pregnancy ; Pregnancy Rate ; Scrotum ; Skin ; injuries ; Spermatogenesis ; Swine ; Swine, Miniature ; Testis ; physiology ; Thigh ; surgery

AIMTo evaluate the outcome of repetitive micro-surgical testicular sperm extraction (mTESE) attempts in non-obstructive azoospermia (NOA) cases, in relation to patients' initial testicular histology results.

METHODSA total of 68 patients with NOA in whom mTESE had been performed in previous intracytoplasmic sperm injection (ICSI) attempts were reviewed.

RESULTSAmong the 68 patients with NOA, the first mTESE yielded mature sperm for ICSI in 44 (64%) (Sp(+)), and failed in the remaining 24 (36%) (Sp(-)). Following their first trial, 24 patients decided to undergo a second mTESE. Of these 24 patients, no spermatozoa were obtained in 5 patients, and Sp(+) but no fertilization/pregnancy were achieved in 19. In these 24 cases, mTESE was successively repeated for two (n = 24), three (n = 4) and four (n = 1) times. The second attempt yielded mature sperm in 3/5 patients from the Sp- group and 16/19 patients from the Sp(+) group. At the third and fourth trials, 4/4 and 1/1 of the original Sp(+) patients were Sp(+) again, respectively. Distribution of main testicular histology included Sertoli cell-only syndrome (16%), maturation arrest (22%), hypospermatogenesis (21%) and focal spermatogenesis (41%). Overall, in repetitive mTESE, 24/29 (82%) of the attempts were finally Sp(+).

CONCLUSIONRepeated mTESE in patients with NOA is a feasible option, yielding considerably high sperm recovery rate. In patients with NOA, mTESE may safely be repeated one or more times to increase sperm retrieval rate, as well as to increase the chance of retrieving fresh spermatozoa to enable ICSI.

Azoospermia ; surgery ; Female ; Fertilization ; Humans ; Male ; Microsurgery ; Pregnancy ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Testicular Diseases ; classification ; surgery ; Testis ; injuries ; surgery