Antegrade subinguinal sclerotization with temporary clamping of the spermatic cord: a new surgical technique for varicocele.

Objectives: The purpose of our study was to evaluate the duration, effectiveness, and complications associated with a new operating technique for varicocele, using a subinguinal surgical approach and antegrade sclerotization of the spermatic veins.

Methods: A total of 756 varicocele patients who came under our care for infertility underwent surgical treatment with our technique. The diagnosis was based on clinical examination and confirmed by color-Doppler ultrasound of the spermatic cord.

Evaluation of microalbuminuria in patients with erectile dysfunction.

Introduction: The recent sophisticated diagnostic procedures aimed at identifying the exact cause of erectile dysfunction (ED) are often complicated in clinical application, invasive, or highly expensive. Microalbuminuria, a test easy to perform and of low cost, is a marker of extensive endothelial dysfunction, and it has been suggested to be linked to ED.

Aim: The aim of this study was to investigate the eventual role of microalbuminuria in differentiating patients with arteriogenic and non arteriogenic ED.

Penile septoplasty for congenital ventral penile curvature: results in 51 patients.

Purpose: The technique most widely used to correct congenital ventral penile curvature is still corporoplasty as originally described by Nesbit. We present results in patients treated with a variation of Nesbit corporoplasty used specifically for congenital ventral penile curvature.

Materials And Methods: From June 2000 to June 2007 we treated 51 patients with congenital ventral penile curvature using modified corporoplasty (septoplasty), consisting of accessing the bed of the penile dorsal vein and excising 1 or more diamonds of tunica albuginea from it, extending in wedge-like formation 4 to 5 mm deep into the septum, until the penis is completely straightened.

Oxidative stress and antioxidant status in patients with erectile dysfunction.

Introduction: Erectile dysfunction (ED) is increasingly recognized as a public health problem. The interaction between nitric oxide and reactive oxygen species is one of the important mechanisms implicated in the pathophysiological process of ED. Plasma contains various antioxidant components to prevent free-radical injury.

Microsurgical TESE versus conventional TESE for ICSI in non-obstructive azoospermia: a randomized controlled study.

In a population of non-obstructive azoospermia patients, the efficacy of microsurgical testicular sperm extraction (microTESE) and conventional TESE was evaluated in a randomized controlled study on 138 testicles, classified and paired in a 48-square table according to the different classes of the following three variables: patient plasma FSH concentration, orchidometry and testicular histology. Sperm retrieval was positive in 21/22 testicles with hypospermatogenesis (11/11, 10/11; microTESE, TESE respectively), in 12/14 with maturation arrest (6/7, 6/7), in 16/22 with incomplete Sertoli cell-only syndrome (8/11, 8/11), and in 16/80 with complete Sertoli cell-only syndrome (11/40, 5/40). Sperm recovery was positive in 5/24 patients with FSH concentration > or = 3 x maximum value of normal range (N) (4/12, 1/12), in 17/40 patients with 2N < or = FSH < 3N (9/20, 8/20), in 30/48 patients with N < FSH < 2N (17/24, 13/24), and in 13/26 patients with FSH = N (6/13, 7/13).

Surgical treatment of varicocele by a subinguinal approach combined with antegrade intraoperative sclerotherapy of venous vessels.

Objective: To evaluate the efficacy, in terms of recurrences, complications and operative duration, of a new technique for treating varicocele.

Patients And Methods: Between September 1999 and December 2002 we evaluated 307 men aged 17-51 years with varicocele. In all of the men the clinical diagnosis was confirmed by ultrasonography.

Sperm retrieval for intra-cytoplasmic sperm injection in non-obstructive azoospermia.

Surgical testicular sperm retrieval for intra-cytoplasmic sperm injection (ICSI) purposes is the only possibility of biological fathering in case of non-obstructive azoospermia (NOA). Successful retrieval only correlates with histology, not with FSH values or testicular volume. Concurrent AZFa and AZFb microdeletion predict unsuccessful recovery.

Premature ejaculation. 1. Definition and etiology.

There is no general agreement on the definition of premature ejaculation, therefore scientific studies often reach discordant results depending on whether they assess the increase in ejaculatory latency or the couple's sexual satisfaction. Etiological theories can be divided into psycho-sexual (anxiety-related, behavioral) and biological (pelvic floor alteration, hypersensitivity of the glans penis, accelerated conduction and cortical amplification of the genital stimuli), both sharing the neurobiological assumption of serotonergic mediation. Premature ejaculation can be iatrogenic (amphetamine, cocaine, dopaminergic drugs) or secondary to urological diseases (prostatovesiculitis, frenulum breve) or to neurological diseases (multiple sclerosis, peripheral neuropathies, medullary expansion processes).

[Male contraception].

The only safe method of male contraception is vasectomy, with high reversibility secured by microsurgery. Italy, however, suffers from a lack of regulations on this subject. Hormonal treatment (testosterone plus progestational hormones) is far from providing reliability and safety, while some perspectives, theoretical only for the time being, are offered by studies on functional infertility induced by either speeding up (ganglioplegic, sympathomimetic, parasympatholytic, oxytocin, endothelin, angiotensin) or inhibiting (sympatholytic) the sperm transport through the epididymis, or altering the epididymal environment (alpha-chloridin, chlorodeoxyglucose).

Testicular function following chemo-radiotherapy.

Improvements in cancer survival raise infertility issues in young patients suffering from malignancies. The aim of the study is to review current knowledge on the effect of chemotherapy (CT) and radiotherapy (RT) for testis and hematological neoplasms on testicular function. Cisplatin-based regimens for testis neoplasm induce temporary azoospermia; permanent damage can occur with high doses (400-600 mg/m(2)).