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At least 19 recordsLinked to original sources

PubMed1984

A new type of alloplastic spermatocele: the bridge spermatocele.

A new type of artificial spermatocele is proposed. A Gore-tex cylinder is sutured to the tails of the epididymides making a bridge between the two testes. The advantages of this spermatocele are (1) use of a single puncture; (2) easy execution of the puncture because the bridge stabilizes and holds the testicles in place; (3) a greater quantity of aspirate and, therefore, easier conservation of sperm; (4) a better quality of aspirate; and (5) relative ease of the surgical procedure.

Animals↗

PubMed1984

Alloplastic spermatocele: diffusion across the allograft material and survival of spermatozoa in vitro and in vivo.

Alloplastic spermatoceles have not proved to be a very successful method for acquiring fertile spermatozoa from patients with obstructive azoospermia. Many basic aspects of spermatocele function have apparently not yet been considered; therefore, we performed experiments to determine the motility survival of rat spermatozoa in spermatoceles in vivo and in vitro, and of human spermatozoa in spermatoceles in vitro. Also, net diffusion of Na+, K+, 3H-H2O, 3H-inulin and 3H-polyethyleneglycol from alloplastic spermatoceles was determined in vitro. Spermatoceles were constructed from expanded polytetrafluoroethylene. In general, neither rat nor human spermatozoa motility survived 24 hr. incubation in alloplastic spermatoceles in vitro or in vivo. Na+ and K+ diffused from alloplastic spermatoceles, demonstrating that specific intraluminal electrolyte concentrations cannot be maintained in polytetrafluorethylene spermatoceles. 3H-H2O diffused freely across the spermatocele wall, demonstrating that fluids can enter or exit the spermatocele lumen and potentially effect sperm survival. 3H-inulin (m.w. 5000) and 3H-polyethyleneglycol (m.w. 4000) were largely retained in the spermatocele lumen over the 3-day experimental period. It is recommended that other basic aspects of spermatocele design be worked out experimentally before perhaps premature designs are installed in human patients.

Animals↗

PubMed2003

Retrieval and cryopreservation of sperm from spermatocele fluid.

OBJECTIVES: To evaluate the amount, motility, and viability of sperm in fluid aspirated from naturally occurring spermatoceles and to investigate the effect of cryopreservation of sperm retrieved from spermatoceles. Assisted reproductive technologies have led to successful pregnancies and deliveries using sperm harvested from the epididymis and/or testis of infertile men. METHODS: Aspiration of spermatocele fluid and analysis of the fluid obtained was performed on 20 patients before elective spermatocelectomy. Randomly selected samples (n = 5) were washed using a 70% Percoll gradient, and repeated semen analysis was performed. The washed specimens were cryopreserved in liquid nitrogen, and repeated semen analysis was performed on the thawed specimens. RESULTS: All spermatoceles (n = 20) had viable sperm present (count range 54 x 10(4) to 326 x 10(6)) and 16 (80%) of 20 contained motile sperm. The average percentage of motile sperm was 5%. The average sperm motility and average percent viability of sperm recovered after Percoll gradient improved compared with sperm in the initial spermatocele aspirates (motility 5%, range 0% to 25% and viability 36%, range 2% to 91% before Percoll vs. motility 13%, range 2% to 38% and viability 39%, range 10% to 92% after Percoll). Sperm retrieved after cryopreservation demonstrated reduced motility and viability; however, motile and viable sperm were recovered from all washed and cryopreserved samples. CONCLUSIONS: Our results suggest that spermatocele fluid may contain sufficient numbers of sperm for use with assisted reproductive technologies. Motile and viable sperm can be recovered after cryopreservation and storage of sperm obtained from a spermatocele. Spermatocele fluid may be an additional source of sperm for assisted reproductive technologies.

Cryopreservation↗

PubMed1995

Development of a new alloplastic spermatocele demonstrating successful sperm retrieval in an animal model.

OBJECTIVE: To create an alloplastic spermatocele capable of repeated sperm aspiration. The alloplastic spermatocele has long been a theoretical solution to infertility for those patients with congenital absence of the vas deferens or irreversible obstruction of the male reproductive ductal system. Recent studies have suggested that sperm from efferent ducts are capable of fertilization. Clinical use of alloplastic spermatoceles for collection of epididymal sperm has resulted in unacceptably low pregnancy rates. Improvement in spermatocele function may occur if a microsurgical anastomosis is performed to the epididymis. DESIGN: A newly designed alloplastic spermatocele was implanted in 17 mature male rabbits. The faceplate of the device had a 0.7-mm orifice, allowing direct precise microsurgical anastomosis to a specific loop of the epididymal tubule. RESULTS: Sperm retrieval was possible in 16/17 (94%) animals. Repeated successful aspirations (total of 73) were performed in all but one animal. The total number of sperm collected per spermatocele averaged 115 x 10(6) (range 0 to 734 x 10(6)). The sperm motility varied widely between animals and specimens, with a maximum average of 21.6% motile sperm/aspirate per animal. All spermatoceles eventually occluded (mean time of occlusion 14 days; range 3 to 30 days). The prostheses with the attached epididymides were examined histologically. CONCLUSIONS: This prototype alloplastic spermatocele allows repeated high density sperm retrieval over a short period of time. Low sperm motility may be less problematic clinically as new techniques of IVF become available.

Animals↗

PubMed2001

Percutaneous aspiration and sclerotherapy for treatment of spermatoceles.

PURPOSE: Spermatoceles are commonly treated with open surgical ablation. With the increasing shift towards minimally invasive surgery and heightened awareness, both patient and surgeon accept and prefer the less intrusive approach. Treatment of spermatoceles translates into the use of aspiration and sclerotherapy rather than open excision. We report on our prospective study of percutaneous aspiration and sclerotherapy with sodium tetradecyl sulfate for treatment of spermatoceles to determine safety, efficacy and cost-effectiveness. MATERIALS AND METHODS: Patients with symptomatic cystic scrotal lesions were prospectively enrolled in an aspiration and sclerotherapy protocol between October 1998 and June 2000. All patients underwent aspiration followed by sclerotherapy with a sodium tetradecyl sulfate solution. Followup included clinical assessment and scrotal ultrasonography at 12 weeks and on a needed basis thereafter. RESULTS: A total of 28 patients with 34 spermatoceles were enrolled in the protocol. Mean patient age was 61.0 years and mean spermatocele volume was 89.3 ml. Complete followup was available for 31 of 34 (91%) spermatoceles, and the mean duration of followup was 24.6 weeks. Results were cure in 29% success in 36%, partial success in 19% and failure in 16% of cases. Patient satisfaction was 85% and there were no complications. The total cost of each procedure was only $104 (Canadian), and none took more than 10 minutes. CONCLUSIONS: Percutaneous aspiration and sclerotherapy with sodium tetradecyl sulfate is a minimally invasive, simple, safe, inexpensive and reasonably efficacious treatment option for spermatoceles. Initial failures can be salvaged with second treatment.

Adult↗

PubMed1999

Degeneration of the seminiferous epithelium with ageing is a cause of spermatoceles?

A spermatocele refers to the cystic accumulation of semen in the male reproductive tract. Although it is thought to be caused by narrowing of the lumen of the excurrent duct with resultant cystic dilatation of the duct, the pathogenesis of the narrowing remains unknown. In the present study, we histologically examined spontaneous spermatoceles in C3H/He mice to elucidate the pathogenesis of the lesions. Testes, efferent ducts, epididymides and vas deferens obtained from young and aged C3H/He mice were embedded in plastic for histological observation at the light microscopic level. It was found that spontaneous spermatoceles were localized in the rete testis and efferent ducts of aged mice, as seen in man. The dilated rete testis and efferent ducts contained many degenerated and aggregated germ cells derived from the exfoliated seminiferous epithelium in the aged testis. In particular, it was noted that the agglutinated germ cells obstructed the narrow lumen of the efferent ducts, resulting in the failure of transport of germ cells to the caput epididymis, and spermatoceles were consistently found in the region between the rete testis and the obstructed site in the efferent ducts. However, no inflammatory cell infiltration, traumatic injury or spermatic granulomas were found in the occluded region. These results suggest that agglutinated germ cells may occupy the narrow lumen of the efferent ducts, resulting in the formation of a spermatocele. It may be that a senile change to the seminiferous epithelium, which releases immature germ cells into the lumen of the seminiferous tubules, is the cause of this type of spermatocele.

Aging↗

PubMed2002

Pro-inflammatory cytokine response of the fluid contents of spermatoceles and epididymal cysts.

The aim of the study was to determine the cellular contents and concentrations of interleukin 6 (IL-6), interleukin 8 (IL-8) and tumour necrosis factor alpha (TNF-alpha) in fluids of patients with spermatocele or epididymal cyst. Twenty-five symptomatic patients, 14 with epididymal cysts and 11 with spermatoceles, were included in the study. Fluids were obtained during surgical excision of the cysts and cytological smears were stained with May-Gruenwald-Giemsa to establish cell components. The concentrations of IL-6, IL-8 and TNF-alpha were measured by chemiluminescent immunometric assay. Cytological analysis of the fluids demonstrated various sperm forms ranging from immature germ cells to degenerated spermatozoa without inflammatory cells such as neutrophils and macrophages. The concentrations (mean+/- SEM, pg/mg protein) of IL-6, IL-8 and TNF-alpha were 13.52 +/- 1.40, 22.20 +/- 2.43, 3.51 +/- 1.43 in spermatocele fluids and 5.76 +/- 0.48, 11.57 +/- 1.89, 2.53 +/- 0.41 in epididymal cyst fluids. Both IL-6 and IL-8 concentrations in the spermatocele group were higher than in the epididymal cyst group (P < 0.0001). There were no differences in TNF-alpha concentrations between the groups (P > 0.05). These findings indicate that local production of pro-inflammatory cytokines is involved in cyst formation. The presence of immunologic activation in these fluids advocates a policy of selective surgical intervention in patients with spermatocele or epididymal cyst.

Adult↗

PubMed1993

Ultrasound follow-up of ethanolamine oleate sclerotherapy for spermatoceles.

Although sclerotherapy as a treatment for hydroceles has gained in popularity during the last few years, there is no consensus on whether it can also be adopted for the treatment of spermatoceles. We examine here the efficacy and safety of ethanolamine oleate sclerotherapy in cases of spermatocele using ultrasound (US) before treatment and during follow-up. Thirty-seven consecutive outpatients aged 36-84 years (mean 61) with symptoms of 40 spermatoceles (1-3 chambers) treated by sclerotherapy were included in the series. It is concluded that US allows multilocular spermatoceles to be differentiated from hydroceles. Post-treatment US findings are typical, including heteroechoic masses with cystic areas extratesticularly, hyperechoic lines peritesticularly (thickened tunicas) and a thickened scrotal wall. All lesions are reversible, however. US is helpful when assessing the need for resclerotherapy. Ethanolamine oleate proved to be effective as a sclerosant, as 83% of the cases were cured or became significantly better. Complications were few and there were no changes in the epididymis. Ethanolamine oleate sclerotherapy can be recommended as an alternative treatment to surgery, especially in older patients with spermatoceles consisting of 1-3 chambers.

Adult↗

PubMed1980

[Dissection of spermatoceles and fertility (author's transl)].

The majority of spermatoceles originate in retention cysts of the vasa efferentia. Cystic embryonic remnants of the testis and epididymis are not so frequent. Only 10 of 20 patients undergoing surgical treatment of unilateral, singular spermatoceles preoperatively showed normozoospermia. Excision of the spermatocele in more than 50% of our patients caused permanent deterioration of their spermiogramm. The number of sperms was reduced to less than the half of the preoperative counts. Obstruction of the epididymal duct caused by postoperative cicatrices is thought to be the reason. In consequence of these results operative treatment of spermatoceles should be though over. Our series clearly shows that the dissection of a spermatocele by no means should be practiced by way of treating infertility.

Adult↗

PubMedDate not supplied

Artificial spermatocele inserted onto the vas deferens: a clinical report.

This procedure was devised in an attempt to treat azoospermia caused by severe vas obstruction. An artificial spermatocele is prepared by resection of the vas slightly distal to the epididymal-deferential ansa and anastomosing onto its proximal stump a piece of Dardik's prosthesis sealed at the far end. During the partner's ovulatory period the spermatocele fluid is aspirated, mixed with fertile donor seminal plasma and used for artificial insemination. To date 8 subjects have had the operation: spermatocele fluids of 4 contained some highly motile spermatozoa with normal ability to penetrate cervical mucus for some months. Spermatocele implantation onto the vas apparently has the following advantages: the anatomic and functional integrity of the epididymis is maintained, the storage function of the epididymal-deferential ansa is preserved, and the risk of spermatocele collapse seems to be reduced by the high "vis a tergo" developed during ejaculation.

Bioprosthesis↗

PubMed1992

Ethanolamine oleate sclerotherapy for hydroceles and spermatoceles: a survey of 158 patients with ultrasound followup.

Sclerotherapy with 5% ethanolamine oleate was used to treat 102 hydroceles in 100 patients and 63 spermatoceles in 58 patients. Scrotal ultrasound examination was performed before the sclerotherapy and at each followup visit. Of the hydroceles 98% were cured completely and 68% were cured after only 1 sclerosant instillation, while 60% of the spermatoceles resolved completely and 33% partially, with 7% failures. No hydroceles recurred during an average followup of 43 months, whereas spermatocele recurred in 4 patients more than 1 year after successful treatment, with a mean followup of 46 months. Approximately half of the patients experienced pain after treatment, 3 had infection and 2 had hematoma. No changes in the structure or size of the testicles were found by ultrasound during followup. Ethanolamine oleate sclerotherapy is a safe, effective and economical form of outpatient therapy that can be recommended as primary treatment for hydroceles in adults and as an alternative to surgery for spermatoceles with 1 to 3 cysts in elderly men in whom fertility is not important.

Adolescent↗

PubMed2002

Torsion of spermatocele: a rare manifestation.

Torsion of a spermatocele on its pedicle is an extremely rare clinical condition that mimics acute testicular torsion. This rare condition has not been well characterized. Here, we report a case of torsion of a spermatocele. The present case is the 5th case of torsion of a spermatocele and the first report in a patient with a history of scrotal trauma. A tender cystic mass adjacent to the normally appearing testicle in the scrotum is highly significant for the differentiation from other types of acute scrotum. Torsion of a spermatocele should be considered a differential diagnosis of acute scrotum in adolescents and adults.

Adult↗

PubMed1988

[A case of bilateral spermatocele].

A case of bilateral spermatocele is reported. A 46-year-old man was admitted to our hospital complaining of bilateral scrotal swelling. We obtained a colorless, opalescent fluid which contained numerous spermatozoa. The fluid volume, pH and gravity obtained from right spermatocele were 85 ml, 6.8 and 1.005, respectively, and those obtained from left side were 40 ml, 6.8 and 1.006, respectively. Spermatocelectomy was done under lumbal anesthesia. Both spematocele were found near the body of the epididymis. The wall of spermatocele had on epithelial lining of cuboidal cells. Twenty two cases of spermatocele reported in Japan since 1951 are reviewed.

Humans↗

PubMedDate not supplied

Effect of spermatocele fluid on growth of human prostatic cells in culture.

The present study was carried out to investigate whether testicular fluid derived from a spermatocele contains substance(s) that promote the growth of human prostatic cells in culture. Human spermatocele fluid was centrifuged to sediment spermatozoa. The supernatant was then added to cultures of human prostatic stromal or epithelial cells that were isolated from surgical specimens of benign prostatic hyperplasia. Addition of spermatocele fluid in quantities of 1 microgram/ml of protein resulted in a significant increase in the number of both prostatic stromal and epithelial cells at the end of a 6-day culture period. Human serum at equivalent protein concentrations in the culture medium had no stimulatory effect. At least two separate growth-promoting factors were found in spermatocele fluid, one for stromal cells and one for epithelial cells. The mitogen for stromal cells was heat labile and persisted after treatment with activated charcoal. The factor for epithelial cells was heat stable but was removed by charcoal treatment. These observations are consistent with the concept that the human testis secretes nonandrogenic substances that can promote prostatic growth.

Cell Division↗

PubMed1986

Alloplastic spermatocele: poor sperm motility in intraoperative epididymal fluid contraindicates prosthesis implantation.

After vasectomy reversal by vasovasostomy or vasoepididymostomy motile sperm appear commonly in the semen even when only nonmotile sperm are present in the intraoperative vasal or epididymal fluid. We studied patients with bilateral congenitally absent vasa deferentia to see if relief of obstruction by implantation of an alloplastic spermatocele also benefits sperm motility in such patients. A total of 130 alloplastic spermatoceles was implanted in 91 patients. Of 21 patients with only nonmotile sperm in the epididymal fluid intraoperatively only 1 had motile sperm in the postoperative aspirates from the alloplastic spermatocele. The quality of sperm motility in the intraoperative epididymal fluid was predictive of the quality of sperm motility in the postoperative aspirates. Conception postoperatively did not occur whenever less than 20 per cent of the intraoperative epididymal sperm was motile. Thus, poor or absent sperm motility in the epididymal fluid during planned alloplastic spermatocele implantation predicts a poor postoperative result and, therefore, contraindicates implantation of the prosthesis. Pregnancy, which occurred postoperatively in 7 of 91 wives, ended in spontaneous abortion in 3 and progressed to full-term delivery in 4.

Body Fluids↗

PubMed1991

Clinical experience and successful impregnation using an artificial spermatocele.

We have to date installed artificial spermatoceles made of silicone in a total of 33 patients. Artificial insemination of husband (AIH) was performed in 1-9 times using semen collected from 11 of the 33 patients in whom spermatocele was installed, and pregnancy was achieved in 2 cases. Reported cases of pregnancy achieved using semen collected from artificial spermatoceles are few in number; indeed, our successful cases were the fifth and sixth reported so far. The key point for success in achieving pregnancy by means of the artificial spermatocele is considered to be attempting AIH as soon as possible after collecting the sperm, because collection of sperm soon becomes impossible, due to early obstruction of the incised region at the epididymis by degeneration of fibrous tissue. 3% HSA-TMPA medium was found to be useful for sperm collection.

Adult↗

PubMed1987

[Silastic spermatocele].

The study was carried out in two stages. An initial experimental study in the rat showed that it was possible to attach a spermatocele to the rat epididymus and to collect spermatozoa during the months that followed. The clinical trial involved the implantation of 8 spermatoceles in 5 male patients. The technic is simple, as predicted by the animal study but, as previously described by numerous other authors, the communication between epididymus and spermatocele is obliterated within several months. These findings confirm the possibility of use of a spermatocele that is well tolerated and of simple functioning, but which does not allow fertile spermatozoa capable of producing pregnancy to be obtained.

Adult↗

PubMed2001

Multilocular spermatocele: a case report.

We describe a case of a multilocular spermatocele. Ultrasound examination revealed several cystic spaces at the head of the left epididymis. Epididymal tumor could not be excluded, and therefore surgical exploration was performed. Histopathological examination of the specimen revealed a multilocular spermatocele arising from the rete testis. Most spermatoceles remain small and rarely present marked clinical problems. but they are occasionally large, and may simulate a solid tumor.

Humans↗