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The best surgical approach for varicocoelectomy is still unknown, however more and more physicians favour subinguinal microsurgery. The aim of this study was to find whether microsurgical approach is superior to laparoscopic varicocoelectomy in terms of pregnancy rate, fertility potential, endocrinological function of the testis, erectile dysfunction and testicle volume increase. It was a prospective, non-masked, parallel-group randomized controlled trial with one to one allocation. It was conducted at authors' institution and designed as per protocol study. From 2012 till 2015 84 patients were randomly allocated to two groups. First group consisted of 42 patients who underwent laparoscopic varicocoelectomy, whereas patients from the second group underwent microsurgical varicocoelectomy. The indications for varicocoelectomy consisted of infertility >1 year, palpable left-sided varicocoele and at least one impaired semen parameter (sperm concentration <15 mln/mL; total motility<40%; progressive motility <32%, vitality <58% or normal morphology <4%). The primary goal was to show superiority of microsurgical varicocoelectomy over laparoscopic varicocoelectomy in terms of pregnancy rate. The secondary endpoints comprised assessment of sperm parameters in three-month intervals after intervention until one year. Other points included, LH, FSH and testosterone levels as well as testicle volume and International Index of Erectile Function. From each group five patients were lost during the follow-up period. The primary endpoint was not achieved - pregnancy rate in first and second group was 29.7% and 40.5% respectively (p = 0.34). Analysis of the sperm parameters after surgery revealed significant statistical difference in total motility, progressive motility and morphology in favour of microsurgical approach. Both methods showed improvement in all sperm parameters. There were no differences in hormonal levels as well as in erectile function and testicle volume between groups. Small number of patients in both groups are the main limitation of our study.

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The aim of this article was to investigate septal branches of the right coronary artery in order to create both their typologies and to evaluate the usefulness of the vessels mentioned above for revascularisation procedures on the interventricular heart septum. The clinical studies were performed on 58 human hearts aged 28-80. Technical method of direct preparation, corrosive preparation and coronarographic picture assessment. The tests showed that the number of septal branches ranged from 5 to 11, their diameter from 0.7 to 1.2 mm. There were no main trunk or vessels with different dimensions than other arteries. Creation of septal vascularisation model was not possible because of rapid changes in studied vessels, their distribution and small diameters (about 1 mm) disqualifying them for direct revascularised operations on interventricular heart septum.

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The aim of the present work was to determine vascularisation varieties of diaphragmatic heart surface which would be useful in cardiology and cardiosurgery, in particular. The methods used in the present study included morphological investigations (direct preparations) and clinical examinations (coronarography). The study was performed on posterior coronary vessels of 163 human hearts aged 28-88. Ninety-one of these heats were analysed on the basis of intra vitam angiography. Three coronary vascularisation varieties of posterior heart surface were distinguished and the criteria of their determination in selective coronarography were postulated. Both research methods revealed that the right variety of coronary vascularisation occurred most often, while left variety was the least frequent. Symmetric variety which is optimal from the point of view of myocardial haemodynamics was found in 0.25% cases. The frequency of the right and symmetric varieties observed in the studies following both methods are comparable. In the case of left variety, the interpretation of blood supply to posterior surface on the basis of coronarography is much more difficult when compared with the remaining varieties. Coronarography may often be insufficient to determine the range of vascularisation of particular coronary arteries.

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Laparoscopic colpoureterosuspension is a feasible surgical procedure for correcting the stress incontinence in women. A total of 41 patients underwent pelvis laparoscopic procedure. The average age of the patients was 55.4 years (range between 40 and 68 years). The mean operative time was 65 minutes. Laparoscopic intraperitoneal ureterocolposuspension is characterized by 87.6% early postoperative success rate. To carry out laparoscopic Burch's is operation is not more difficult than open surgery, but early optimistic results need a longer follow-up to estimate efficacy of this procedure.

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Comparative estimation of potential fertility in 66 adolescents with varicocele shows: 1. Improvement of semen parameters in adolescents with over 20 x 10(6) spermatozoa in 1 cc. before operation and preserved spermatogenesis. 2. Increase of ipsilateral testicular volume in 86.4% of boys. 3. Apart from Ivanisevisch technique all applied surgical procedures demonstrate comparatively good results.

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The study aimed at determining types of interventricular septal branches stemming from the anterior interventricular branch of the left coronary artery. The studies were performed on 28 preparations of human heart aging 29 to 88 years. The technique of direct preparation was applied using a dissecting microscope. The conducted observations indicate that septal vessels of the anterior interventricular branch follow one of the three main patterns. Type I involves a dominant septal trunk, exhibiting its own branching and few fine septal branches, type II exhibits a single dominant unbranched ramus and multiple fine branches, while type III includes two dominant, unbranched septal rami of the septum and small number of fine septal branches. In the cases examined by us type III pattern was most frequent. No relationship was detected between the type of coronary vessels of the heart and the type of septal vessels of the anterior interventricular branch.

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Blood vessels were examined within epineurium of 38 ischiadic nerves from corpses of men and women aging 26 to 65 years. The studies demonstrated that large eyeholed and fine meshed vascular plexuses are formed in both components of ischiadic nerve. The plexus maintain communication with axial arterial and venous vessels which run in the outer layer of epineurium and with interfascicular vessels located in connective tissue of interfascicular epineurium.

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