Introduction. Until recently, simple cysts of the testicular parenchyma were considered extremely rare pathology. Recently, this condition has been diagnosed more often, which is largely due to the widespread use of ultrasound examination of the scrotum. To date, a unified approach to the management of patients with this nosology has not been developed, which served as the basis for a review of the literature on simple cysts of the testicular parenchyma.Results. Simple cysts of the testicular parenchyma are observed in 8–10 % of patients. The etiology of simple intratesticular cysts remains unknown. Small cysts of the testicular parenchyma are most often asymptomatic, pain symptoms of a nature for large cysts larger than 2 cm. Asymptomatic single cysts of the testicular parenchyma do not require surgical treatment and probably need dynamic monitoring. In patients with symptomatic and multiple cysts, surgical treatment should be recommended. Preference should be given to organpreserving techniques in the form of cyst resection/enucleation. Orchiectomy for the treatment of simple intratesticular cysts should be considered in exceptional cases.

Introduction. Short frenulum of the penis (frenulum breve) is a condition associated with a decrease in the length of the frenulum of the penis and/or a decrease in its elasticity. A number of different techniques have been proposed for the surgical treatment of a short frenulum of the penis, from a simple incision (frenulotomy) to complex frenuloplasty and frenulum grafting techniques. Purpose of the study. To assess the results of various surgical techniques in the treatment of frenulum brevis by examining the current evidence base in the world literature. Materials and methods. A search was made for publications in the international database MEDLINE on the platform PubMed, in the scientific electronic library eLibrary.ru and in the Google Scholar search engine. Results. A total of 12 publications were selected. Selected publications were represented by retrospective cohort studies and case series. 3 studies evaluated the results of frenulotomy (frenulectomy), 8 – different methods of frenuloplasty and one – circumcision in the treatment of a short frenulum of the penis. Conclusion. The results of the literature review showed that all techniques of surgical correction of the short frenulum of the penis demonstrate excellent early functional and aesthetic results, with a minimum number of postoperative complications. The best results in the treatment of a short frenulum of the penis can be achieved by choosing the optimal surgical technique in each case.

Introduction. TStandard sperm examination, performed according to WHO guidelines, remains the main method of assessment of male fertility. At the same time, this research method has a number of significant limitations, including a low predictive value regarding the outcomes of assisted reproductive technologies (ART) programs and the outcome of naturally occurring pregnancies. The limitations of standard sperm examination dictate the need for additional methods for assessing male fertility. The most promising and widely used test is the assessment of the level of sperm DNA fragmentation. Aim. To evaluate the associations between the levels of sperm DNA fragmentation and the age of the patients along with the following parameters used as a part of standard sperm analysis: semen volume, total number of spermatozoa, percentages of progressively-mobile, non-progressively-mobile and immobile forms, percentages of morphologically normal forms and the forms bearing head defects within the structure of total number of morphological anomalies, as well as semen leukocyte count. Materials and methods. Study materials were the examination results from 121 males aged from 21 to 53 years old (mean age 32.7±4.5 years old), undergoing an examination within the Clinical Institution «Mother and Child – Yaroslavl» during a time period from January 2019 until April 2020. Standard sperm analysis procedures were carried out according to latest edition of WHO Guidelines (2010). The determinations of germ cell DNA fragmentation levels were performed using the TUNEL method. Results. The test results have revealed a weak negative relation between the sperm DNA fragmentation (%) and the percentage of progressively-mobile forms (%) – r = -0.26 (p <0.01). The correlation of sperm DNA fragmentation with age and other parameters was considered statistically insignificant. The second stage of the analysis have demonstrated that the increased degree sperm DNA fragmentation is 1.8-fold more often found in the patients having signs of astenozoospermia (23.6%) comparing to the patients showing normal degree of spermatozoa mobility (13.1%), (p <0.05). Conclusions. The level of sperm DNA fragmentation correlates with the percentage of progressively-mobile forms of spermatozoa (negative relation) and no correlations were found with other semen parameters and with the age. The rates of increased levels of sperm DNA fragmentation are 1.8-fold more often found in astenozoospermia patients comparing to the patients showing normal degrees of spermatozoa mobility.

Introduction. A cyst of the tunica albuginea of the testis is a rare benign formation, the prevalence in the male population varies from 0.3 to 0.76%. Cysts of the tunica albuginea are usually small in size from 2 to 5 mm. Clinical case. A case of a large cyst of the tunica albuginea (3.5×2.5×2.9 cm) of the left testicle in a 44-year-old man is presented. In the case presented, the cyst was probably of post-traumatic origin, since the patient had suffered a blunt trauma to the scrotum about 10 years ago. The patient complained of pain in the left half of the scrotum. An operation was performed – microsurgical excision of the cyst of the albuginea of the left testicle. Postoperative period without complications. The pain syndrome was relieved 14 days after the operation. Histological examination – a cystic formation with a connective tissue wall lined with cubic, in places ciliated epithelium. Ultrasound control after 3 months – the size of the left testicle is 4.2 * 2.7 * 1.9 (volume 11.2 cm3), the parenchyma is homogeneous. Conclusion. The presented observation demonstrates that cysts of the albuginea of the testis can reach a significant size, spreading into the testicular parenchyma. Organ-sparing treatment in symptomatic patients with large cysts of the albuginea with intraparenchymal growth allows to eliminate pain symptoms and preserve the residual testicular parenchyma. The use of microsurgical techniques may be useful in minimizing circulatory disturbance and reducing the risk of atrophic changes in the testicular parenchyma.