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Neurovascular bundle dissection for Nesbit procedure in congenital penile curvature patients： medial or lateral？

Asian Journal of Andrology 2014年第3期16卷 442-445页

作者： Fatih Akbulut Tolga Akman emre salabas Murat Dinqer Mazhar Ortac Ates Kadioglu Department of Urology Haseki Training and Research Hospital Istanbul Turkey Department of Urology Istanbul Faculty of Medicine Istanbul Turkey.

The objective of this study was to compare the outcomes of the modified Nesbit procedure using different techniques for dissecting the neurovascular bundle （NVB） to correct ventral congenital penile curvatures （CPCs）. The bundle was mobilized using the medial and lateral dissection technique in 21 （Group 1） and 13 （Group 2） patients, respectively. In the medial technique, Buck＇s fascia is opened at the dorsal side of the penis, the deep dorsal vein is removed at the most prominent site of the curvature and a diamond-shaped tunica albuginea （TA） is excised from the midline of the penis. In the lateral technique, the bundle is mobilized using a longitudinal lateral incision of the Buck＇s fascia above the urethra at the 5 and 7 o＇clock positions via a bilateral approach. The localization and degree of curvature was evaluated using the combined intracavernous injection stimulation test or from the patients＇ photographs. The mean patient age and degree of curvature were similar between groups. The mean operation time was longer for Group 2 （P= 0.01）. In Group 1, nine patients （42.8%） required one diamond excision, 10 （47.6%） required two diamond excisions and two （9.5%） required more than two excisions; in Group 2, six patients （46.2%） required two diamond excisions and seven patients （53.8%） required more than two diamond excisions （P = 0.019）. The differences in penile shortening, penile straightening and numbness of the glans penis were not statistically significant. Medial dissection of the bundle for the modified Nesbit procedure reduces the number of diamond-shaped removals of TA and thus shortens operation time in comparison with its lateral counterpart.

关键词： congenital penile curvature lateral dissection medial dissection nesbit neurovascular bundle ventral curvature

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Evaluation of gonadotropireplacement therapy in male patients with hypogonadotropic hypogonadism

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Asian Journal of Andrology 2019年第6期21卷 623-627页

作者： Mazhar Ortac Muhammed Hidir emre salabas Abubekir Boyuk Caner Bese Yasar Pazir Ates Kadioglu Haseki Training and Research Hospital Department of UrologyIstanbul 34096Turkey Department of Urology Istanbul Faculty of MedicineIstanbul UniversityIstanbul 34104Turkey Department of Urology Biruni University HospitalIstanbul 34295Turkey.

Hypogonadotropic hypogonadism(HH)is a rare disease in which medical treatment has a high success rate to achieve *** study aimed to an a lyze the efficacy of horm one replacement therapy and determi ne predictive factors for successful spermatogenesis and spontaneous pregnancy in patients with idiopathic HH.A total of 112 patients with low testosterone(T),luteinizing hormone(LH)and follicle-stimulating hormone(FSH),and normal prolactin levels were diagnosed with HH and administered LH and FSH analogs as hormone replacement *** treatment,96(85.7%)patients had sperm present in ejaculate *** these patients,72 were married and wanted a *** these 72 patients,48(66.7%)of couples had pregnancies from natural *** initiation of treatment,the mean time for the appearance of sperm in semen was 9.48 *** were no significant differences between baseline FSH,T,and LH levels;however,older age,larger testicular size,and low rate of undescended testes were favorable factors for successful *** testicular size and older age were also the main predictive factors for natural *** found that patients with undescended testes had a younger age,smaller testes,and lower T levels compared with patients exhibit!ng descended *** rate of sperm found in the ejaculate was not significantly decreased in patients with undescended compared with descended testis(73.7%vs 87.6%,P=0.261).The medical approach for males with HH and azoospermia provides a successful treatment modality in regard to successful spermatogenesis and achievement of pregnancy.

关键词： gonadotropins infertility male hypogonadotropic hypogonadism pregnancies spermatogenesis

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