PurposeSince the 1990s, it has been well known that orchiopexies should be performed by no later than 2 years of age. Nevertheless, studies from other countries report a substantial number of delayed orchiopexies. On the basis of an analysis of a tertiary care hospital database, we aimed to investigate the incidence of delayed orchiopexies performed in patients after 5 years of age and to understand the causes of such delays and the possible consequences.Materials and MethodsWe retrospectively analyzed the surgical database of Seoul National University Hospital between 2004 and 2012 and detected patients who underwent orchiopexy later than 5 years of age. Reasons for delayed orchiopexies were studied and the possible consequences of delayed orchiopexies were assessed with respect to surgical difficulty and testicular volume.ResultsWe found 160 cases of delayed orchiopexies, which accounted for about 15% of all orchiopexies performed. Two major reasons for delay were related to the parents of the child: parental delay and parental request for the treatment of persistent retractile testis. Acquired cryptorchidism was found in 21 cases (13.1%), mainly associated with hypospadias. Surgical difficulty, especially owing to a short testicular cord, was encountered in 48 cases (30.2%), and a comparison with age-matched normative values showed substantially smaller testicular volume.ConclusionsDespite well-established guidelines for the optimal age of surgery, 15% of orchiopexies were not performed at a proper time. Improved propagation of an optimal age limit is necessary to reduce the rate of delayed orchiopexies considering increases in surgical difficulty and potential testicular growth retardation.
PurposeIn the present study, we aimed to identify the incidence of fever in patients after subinguinal microsurgical varicocelectomy and to evaluate the clinical factors associated with the occurrence of the fever.Materials and MethodsWe retrospectively reviewed the cases of patients who underwent subinguinal microsurgical varicocelectomy (group A) under spinal anesthesia. In addition, we reviewed the cases of patients who underwent microsurgical vasovasostomy under spinal anesthesia as a control group (group B). The incidence of fever in each group was compared. We investigated the clinical factors influencing the occurrence of fever in the patients of group A.ResultsThe incidence of fever in group A was significantly higher than that in group B (32.5% [53/163] vs. 0.4% [1/284]; p<0.001). Clinical factors such as age, varicocele grade, weight, height, operation time, number of ligated veins, usage of immediate postoperative analgesics, presence of postoperative hematoma, and duration of hospital stay were not significantly associated with the occurrence of fever.ConclusionsWe found that one-third of the patients developed transient fever after subinguinal microsurgical varicocelectomy, and therefore, this information should be provided during preoperative counseling.
A few previous reports have described cases wherein electrical wire cables were inserted into the male urethra and bladder. Electrical wire cables are available at home and are easy to insert. However, after they coil in the patient's bladder, they are difficult to remove. In February 2013, a 30-year-old man presented to the emergency room of SMG-SNU Boramae Medical Center with a urethral foreign body. He had inserted an electrical wire cable into his urethra for the purpose of masturbation, despite having a regular sex partner and no underlying disease. A kidney-ureter-bladder radiography showed a tangled wire in his bladder and urethra. On the next day, we tried to remove the wire cystoscopically, but this proved to be impossible because of complex coiling and the slippery surface of the wire. A Pfannenstiel incision was made to remove the foreign body. No postoperative complications were noted.
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