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Effect of Varicocelectomy on Gonadal Function among Patients Reporting with Sexual Dysfunction in Ghana

Open Journal of Urology 2022年第6期12卷 305-330页

作者： Yussif Adams Akisibadek Alekz Afoko Nafiu Amidu Lawrence Quaye simon bannison bani Peter Paul M. Dapare Vivian Afoko Department of Biomedical Laboratory Science School of Allied Health Sciences University for Development Studies Tamale Ghana Department of Surgery School of Medicine University for Development Studies Tamale Ghana Urology Unit Tamale Teaching Hospital Tamale Ghana Department of Paediatric Nursing School of Nursing and Midwifery University for Development Studies Tamale Ghana

Background: Long-standing varicocele is often associated with testicular hypoxia and that might worsen Leydig cell function, a significant risk factor for hypogonadism. This may affect both the secretory and endocrine functions of the testis. This study aims to determine the effect of microsurgical sub-inguinal varicocelectomy on gonadal function among men reporting sexual dysfunction in Ghana. Methods: This was an intervention study conducted at the Tamale Teaching Hospital from September 2017 to August 2021. A total of 103 participants were randomized into two groups;the surgery group (n = 52) and the observed group (n = 51). Venous blood samples were collected at baseline, varicocelectomy was performed for the surgery group, and no intervention was given to the other. Blood samples were subsequently collected at 12-, 24-, 36-, and 48-month intervals for assay of serum total testosterone, FSH, and LH. The data were analyzed in GraphPad Prism (v8.0) at an alpha value of 0.05. Results: All the participants had varicocele and were aged between 55.0 to 69.0 years old. At the baseline of the study, all participants presented with sexual dysfunction but a significant improvement (p Conclusions: Microsurgical sub-inguinal varicocelectomy improved gonadal function among varicocele patients reporting sexual dysfunction. It is recommended to use this choice for similar patients;however, these findings should be verified by a multi-institutional study to provide more evidence for this choice.

关键词： Varicocele Sub-Inguinal Varicocelectomy Gonadal Function Sexual Dysfunction

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Upper esophageal sphincter abnormalities are strongly predictive of treatment response in patients with achalasia

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World Journal of Clinical Cases 2014年第9期2卷 448-454页

作者： simon C Mathews Maria Ciarleglio Yamile Haito Chavez John O Clarke Ellen Stein bani Chander Roland Department of Medicine Johns Hopkins University School of MedicineBaltimore MD 21224 United States School of Public Health Yale UniversityNew Haven CT 06520 United States Division of Gastroenterology and Hepatology Johns Hopkins University School of MedicineBaltimore MD 21224 United States

AIM: To investigate the relationship between upper esophageal sphincter abnormalities achalasia treatment METHODS: We performed a retrospective study of 41 consecutive patients referred for high resolution esophageal manometry with a final manometric diagnosis of achalasia. Patients were sub-divided by presence or absence of Upper esophageal sphincter(UES) abnormality, and clinical and manometric profiles were *** between UES abnormality and sub-type(i.e.,hypertensive, hypotensive or impaired relaxation) and a number of variables, including qualitative treatment response, achalasia sub-type, co-morbid medical illness,psychiatric illness, surgical history, dominant presentingsymptom, treatment type, age and gender were also ***: Among all 41 patients, 24(58.54%) had a UES abnormality present. There were no significant differences between the groups in terms of age, gender or any other clinical or demographic profiles. Among those with UES abnormalities, the majority were either hypertensive(41.67%) or had impaired relaxation(37.5%) as compared to hypotensive(20.83%), although this did not reach statistical significance(P = 0.42). There was no specific association between treatment response and treatment type received; however, there was a significant association between UES abnormalities and treatment response. In patients with achalasia and concomitant UES abnormalities, 87.5% had poor treatment response, while only 12.5% had favorable response. In contrast, in patients with achalasia and no UES abnormalities, the majority(78.57%) had good treatment response, as compared to 21.43% with poor treatment response(P = 0.0001). After controlling for achalasia sub-type, those with UES abnormality had 26 times greater odds of poor treatment response than those with no UES abnormality(P = 0.009). Similarly, after controlling for treatment type, those with UES abnormality had 13.9 times greater odds of poor treatment response compared to those w

关键词： Upper esophageal sphincter Achalasia Motility Dysphagia Esophageal disorders

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