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InTRODUcTIOnWith the development of imaging diagnosis techniques, and the higher number of requested exams, there has been a growth of the incidence of small renal tumors, and an increase of the indication of nephron-sparing surgery, with excellent oncological and functional outcomes (1). In the last years, the incidental lesions are responsible for more than 60% of kidney tumors and 80% of these are in stages I and II (2).Nephron-sparing renal surgery has been increasingly used for small renal mass (<4 cm) and, in selected cases, up to 7 cm renal tumors with similar oncological outcomes compared to radical nephrectomy, (3-5) with small complication ratio (6). The 5-year recurrence-free survival is approximately 96% for lesions smaller than 4 cm, and of 83% for lesions from 4 to 7 cm (7).However, renal occult tumors diagnosed by imaging techniques represent greater technical diffi culties for localization and resection, and may Objective: Partial nephrectomy for small kidney tumors has increased in the last decades, and the approach to non-palpable endophytic tumors became a challenge, with larger chances of positive margins or complications. The aim of this study is to describe an alternative nephron-sparing approach for small endophytic kidney tumors through anatrophic nephrotomy. Patients and Methods: A retrospective analysis of patients undergoing partial nephrectomy at our institution was performed and the subjects with endophytic tumors treated with anatrophic nephrotomy were identifi ed. Patient demographics, perioperative outcomes and oncological results were evaluated. Results: Among the partial nephrectomies performed for intraparenchymal tumors between 06/2006 and 06/2010, ten patients were submitted to anatrophic nephrotomy. The mean patient age was 42 yrs, and the mean tumor size was 2.3 cm. Mean warm ischemia time was 22.4 min and the histopathological analysis showed 80% of clear cell carcinomas. At a mean follow-up of 36 months, no signifi cant creatinine changes or local or systemic recurrences were observed. Conclusion: The operative technique described is a safe and effective nephronsparing option for complete removal of endophytic renal tumors. Anatrophic Nephrotomy as ABSTRAcTARTIcLe InfO _______________________________________________________________ _____________________

Varicocele has been extensively described and studied as the most important reversible cause of male infertility. Its impact on semen parameters, pregnancy rates, and assisted reproductive outcomes have been associated with multifactorial aspects, most of them converging to increase of reactive oxygen species (ROS). More recently, sperm DNA fragmentation has gained significant attention and potential clinical use, although the body of evidence still needs further evolution. The associations between sperm DNA damage and a variety of disorders, including varicocele itself, share common pathways to ROS increase. This mini-review discusses different aspects related to the etiology of ROS and its relation to varicocele and potential mechanisms of DNA damage.

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