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Biomedical subjects

D J Mehan

Publications and source records attributed to D J Mehan.

At least 19 recordsLinked to original sources
PubMed1992

Laparoscopic internal spermatic vein ligation: report of a new technique.

Over the past 22 months, 51 laparoscopic internal vein ligations have been performed to determine its application and practicality in treating the infertile male with varicoceles. Of the 33 cases available for a follow-up of greater than 6 months, 16 pregnancies are reported. Five patients reporting pregnancies refused to submit a postoperative semenogram. Of the reportable series, 17 of 33 had significant improvement in sperm density (51%), 15 of 33 (45%) in sperm viability, and 15 of 33 (45%) in sperm motility. No major complications were seen and minor complications were few and transient. Morbidity was extremely low. Laparoscopic internal spermatic vein ligations would appear to be a reasonable, practical, and effective method to correct varicoceles.

Adult↗
PubMed1992

Laparoscopic varicocelectomy: preliminary report of a new technique.

The use of varicocelectomy for the treatment of subfertility seems to be incontrovertible. However, there is a difference of opinion as to the proper surgical method of varicocele ablation. The inguinal and high retroperitoneal approaches are the most commonly accepted methods to date. However, significant postoperative morbidity is common and return to normal activity often is prolonged. Also, bilateral operations are being performed more commonly. These considerations have prompted many to search for alternative techniques. We developed a laparoscopic procedure that is as simple and effective as more traditional methods. In addition, it offers lower morbidity, allows for microscopic dissection with preservation of the spermatic artery and is amenable to bilateral ligation without a second incision. Ten patients 16 to 54 years old underwent laparoscopic ligation of the spermatic veins at the internal inguinal ring. The diagnosis was based on physical examination. Indications for the operation were infertility with a stress sperm pattern in 5 patients, testicular atrophy in 4 and scrotal pain in 1. Four patients underwent bilateral ligation. Preliminary followup showed resolution of the varicocele in all patients and disappearance of pain in the patient treated for this symptom. No morbidity related to this procedure has been encountered and all patients resumed normal activity within 2 days. We believe that this new method is a viable alternative for varicocelectomy.

Adolescent↗
PubMed1992

Simultaneous laparoscopic varicocelectomy and removal of an intrascrotal atrophic testicle.

We report on the concomitant removal of an atrophic intrascrotal left testicle secondary to mumps orchitis and a right varicocelectomy for athenospermia done laparoscopically. The procedure proved to be quite simple to complete, avoiding the need for secondary incisions, which would have been required otherwise if a standard open approach was chosen. The convalescence period was uneventful with the patient returning to regular activities within 72 h of the procedure. We feel that in selected cases a laparoscopic orchiectomy offers distinct advantages to conventional open surgical approaches.

Adult↗
PubMed1979

Chorionic gonadotropins in the treatment of the subfertile male.

Sixty-four men with idiopathic subfertility were given human chorionic gonadotropin, 50,000 units in 10 divided doses. Sixty-nine per cent of the men demonstrated significant improvement in semen quality in response to the medication, and thirty-six per cent achieved a pregnancy. Eight patients have achieved a second pregnancy without additional therapy.

Adult↗
PubMed1978

Testicular biopsies in 101 cases of varicocele.

Testicular biopsies were done on 101 patients who underwent ligation of the internal spermatic vein as primary treatment for infertility. Retrospective analysis included evaluation of tubular thickening, Leydig cell hyperplasia, premature sloughing, maturation arrest and decreased spermatogenesis. A comparison was made of biopsy profiles, sperm counts and pregnancies in an attempt to determine further the value of testicular biopsy in the subfertile man. The pregnancy rate was 40 per cent over-all, with 32 per cent of the patients with tubular thickening reporting pregnancies. There was only 1 pregnancy in patients with Leydig cell hyperplasia. The controversial finding of premature sloughing had no consistent relationship to results.

Female↗
PubMed1977

Adenocarcinoma of rete testis.

Adenocarcinoma of the rete testis is a very rare malignant neoplasm originating in the epithelium of the rete testis. Histologically, it appears as a papillary adenocarcinoma. The first case was reported in the literature in 1853 and since that time only 16 additional cases have been reported. This report represents the eighteenth case.

Adenocarcinoma↗
PubMed1977

A clinical evaluation of a new Silastic seminal fluid collection device.

A new Silastic seminal fluid collection device has been tested clinically and comparison studies have been made with both the polyethylene sheath and commercial latex condoms. In a series of 100 patients, the Silastic seminal fluid device has been found to be superior to the polyethylene sheath with regard to patient comfort and also has had greater reliability. In comparison with the latex device, the Silastic seminal fluid collection device is nearly as comfortable and has been found to be far more reliable.

Humans↗
PubMed1977

Meiotic indices in the oligospermic male.

Thirty-four oligospermic males were evaluated by determining the meiotic index in testicular biopsy specimens. Only 1 patient of 10 with a meiotic index of less than 15 achieved pregnancy, whereas 16 of 24 patients with a meiotic index of more than 15 had a successful outcome. Corresponding increases in the semenogram were also noted to be related to the meiotic index.

Biopsy↗
PubMed1977

Meiotic figures in the testicular biopsy of subfertile males.

The phases and sequence of meiotic division are herein reviewed and illustrated as they occur in the human testis. Normally all phases of meiosis can be identified, and arrest at a phase is indicative of faulty spermatogenesis. The correlation of these arrest patterns with the clinical course and response to clinical therapy is now in progress. These meiotic studies can be undertaken in any laboratory with cytogenetic capabilities, and this study is intended to serve as a base line illustration of the normal.

Biopsy↗
PubMed1976

Results of ligation of internal spermatic vein in the treatment of infertility in azoospermic patients.

Ten azoospermic men treated by ligation of the internal spermatic vein are reported. Treatment of two of the ten resulted in pregnancies. The advisability of thorough evaluation of the azoospermic patient is well demonstrated by the finding of one patient with Klinefelter's syndrome. In our judgement, based on this small series, azoospermia should not be considered a contraindication to surgery. Complete evaluation of the azoospermia is essential. Indeed, the varicoceles seen in patients 9 and 10 were an incidental finding and in all likelihood played no role in the azoospermia.

Humans↗
PubMed1976

Polyorchidism.

Explore the source record for details and available documents.

Adult↗
PubMed1976

A study of meiotic preparation of human spermatocytes and their relationship to infertility.

Although our experience is based on a small series of 50 cases we believe that several points can be made. Meiotic preparations can be performed in any competent cytogenetic laboratory. These preparations appear to yield more specific information as to the site of arrest and may be more reliable than the static testicular biopsy to appraise the true status of spermatogenesis. With these facts in mind a more accurate prognosis and therapeutic regimen can be realized.

Cytodiagnosis↗
PubMed1975

Urethral duplication, with associated agenesis of left kidney and right ureteral ectopia.

We report an unusual case of an accessory or duplicated urethra. This case is unique because of its association with multiple urologic anomalies which made management and diagnosis of this condition unusual. The unusual combination of right ectopic ureter and left renal and ureteral agenesis in association with the accessory urethra is presented, along with the diagnostic and surgical management particular to this case.

Abnormalities, Multiple↗