Immunological and clinical study of patients after spermatic cord torsion

We studied 25 patients with spermatic cord torsion occurring after puberty. The elapsed time between the onset of symptoms and observation varied from 6 months to 7 years. We evaluated the semen of these patients and found that the number of spermatozoa was lower in patients with an atrophic testis (13 patients) than in those with a normal testis or, in those with torsion treated by orchidectomy. Moreover, the number of spermatozoa was lower in patients who had torsion for more than 2 years before being checked (12 patients) than in patients who had a more recent torsion (13 patients). Agglutinating antibodies were present in 20% of the patients but, they are not correlated fertility or sterility. Immunofluorescent antibodies also were not correlated with the changes found by semen analysis. They are not present in patients with a normal testis at the time of observation. On the other hand, immobilizing antibodies were significantly correlated with sterility and, particularly with changes of motility. These data suggest that sterility after spermatic cord torsion is correlated with an autoimmune mechanism. It may occur particularly in those patients with atrophic testes and has a slow onset taking more than 2 years to evolve completely.

[Scrotum transillumination: method and results (author's transl)]

The results obtained from a continuous series of 48 patients have been critically appraised. The report of the diaphanoscopy appeared pathognomonic only in the event of hyper-diaphanous cystic formation and of varicocele. In all other types of pathology the report was aspecific, requiring a knowledge of the clinical picture for its interpretation, and sometimes absent (neoplasia in the initial phase). For these reasons the diaphanoscopy of the scrotum may be considered as part of a clinical examination and not as a complete (self sufficient) experimental examination.

Ureteric substitution with a tapered ileal loop. An experimental study

The authors present their experience in replacement of the ureter by a tapered ileal loop over a 24-month period, in a group of 10 dogs. With regard to the morphological and functional behaviour of the neo-ureter, the results on the whole were considered satisfactory. However, some problems such as pyelonephritis, associated with obstruction due to mucosal hyperexcretion, remain unsolved at the present time.