RESUMO
BACKGROUND: Varicocele is cause of fertility disorders. The objective was to evaluate usefulness of testicular percutaneous biopsy in the fertility prognosis in patients, who undergone varicocelectomy. METHODS: A cohort study of 50 patients having undergone varicocelectomy due to varicocele was carried out. Five groups were formed according to testicular damage evaluated by percuta-neous biopsy (stage I through V histological lesions). Pregnancy rate and sperm count results were evaluated per group. ANOVA and Fisher exact test were used. RESULTS: Patients aged 30.5 +/- 5 years. Spermatic density and motility had improved one year after varicocelectomy. Pregnancies were achieved 13 +/- 9 months later. Fifteen patients impregnated their partners. Fourteen of them (93 %) had stage I, II or III histological damage and only one case had stage IV. Pregnancy probability was greater in the stage I, II or III testicular damage (OR = 9.3, 95 % CI = 11-79, p < 0.021). CONCLUSIONS: The proposed histological classification of testicular damage allows evaluating fertility prognosis as well as the magnitude of testicular damage in patients with varicocele.
Assuntos
Infertilidade Masculina/etiologia , Infertilidade Masculina/patologia , Testículo/patologia , Varicocele/complicações , Varicocele/patologia , Adulto , Biópsia/métodos , Estudos de Coortes , Estudos Transversais , Humanos , Masculino , PrognósticoRESUMO
PURPOSE: To determine disproportion in thicknesses of the vascular wall and vasa vasorum in eight fragments of human aorta because of the irregular distribution of atherosclerosis in arterial walls. METHOD: The length and thickness of the wall and its layers were measured and the vasa vasorum were conted. Vascular density, considered as the number of vessels per square millimeter in healthy and diseased areas, was calculated along with mean value, variance, standard deviation and the confidence interval for values and null hypotesis. Variances were analyzed, and the comparative and paired "t" test was applied. RESULTS: There were differences in thicknesses of the healthy (27 :m) and diseased (120.5 :m) intima (p < 0.001) and between the healthy (125.2 :m) and diseased (102.3 :m) media (P < 0.001). Vascular density was higher in healthy fragments (mean +/- Cl 99% = 4.40 +/- 1.4 vs 2.20 +/- 0.8, = < 0.001 for Ha; 0 +/- 1.0775 for Ho; paired "t" 2.1 +/- 1.1, P < 0.01), and higher compared to the healthy intima area (31.6 vs 5.1, P < 0.01). There were no differences compared to the media layer area. The relation between the number of vessels and the length of the vascular segments was greater in the healthy fragments (mean +/- Cl 95% = 4.9 +/- 1.02 vs 3.5 +/- 0.68; 1.4 difference, P < 0.05). CONCLUSION: Vascular density is lower in the atherosclerotic aortic wall than in the healthy aorta and this could initiate the pathologic process.
Assuntos
Doenças da Aorta/patologia , Arteriosclerose/patologia , Idoso , Aorta Torácica/patologia , Cadáver , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Antecedente: Por distribución irregular de aterosclerosis en paredes arteriales se buscó desproporción entre grosor de la pared vascular y vasa vasorum en ocho fragmentos de aorta humana. Método: Se midió longitud y grosor de pared y de sus capas y se contó vasa vasorum, se calculó densidad vascular como número de vasos por milímetro cuadrado en áreas sanas y enfermas, valor medio, varianza, desviación estándar e intervalo de confianza para valores y para hipótesis nula, se analizaron varianzas y se aplicó prueba "t" comparativa y pareada. Resultado: Hay diferencias de grosor entre íntima sana (27 micras) y enferma (120.5 micras), P < 0.001; y entre media sana (125.2 micras) y enferma (102.3 micras), P < 0.001. La densidad vascular es mayor en fragmentos sanos (media ± IC 99% = 4.4 ± 1.4 vs 2.2 ± 0.8, P < 0.001 para Ha; 0 ± 1.0775 para Ho; "t" pareada 2.1 ± 1.1, P < 0.01). Mayor ante íntima sana (31.6 vs 5.1, P < 0.01). No varía ante capa media. La relación entre número de vasos y longitud del segmento vascular es mayor en el fragmento sano (media ± IC 95% = 4.9 ± 1.02 vs 3.5 ± 0.68, diferencia 1.4, P < 0.05). Conclusión: La densidad vascular es menor en la pared de aorta aterosclerosa que en aorta sana lo que pudiera iniciar el proceso patógeno.
Purpose: To determine disproportion in thicknesses of the vascular wall and vasa vasorum in eight fragments of human aorta because of the irregular distribution of atherosclerosis in arterial walls. Method: The length and thickness of the wall and its layers were measured and the vasa vasorum were conted. Vascular density, considered as the number of vessels per square millimeter in healthy and diseased areas, was calculated along with mean value, variance, standard deviation and the confidence interval for values and null hypotesis. Variances were analyzed, and the comparative and paired "t" test was applied. Results: There were differences in thicknesses of the healthy (27 :m) and diseased (120.5 :m) intima (p < 0.001) and between the healthy (125.2 :m) and diseased (102.3 :m) media (P < 0.001). Vascular density was higher in healthy fragments (mean ± CI 99% = 4.40 ± 1.4 vs 2.20 ± 0.8, = < 0.001 for Ha; 0 ± 1.0775 for Ho; paired "t" 2.1 ± 1.1, P < 0.01), and higher compared to the healthy intima area (31.6 vs 5.1, P < 0.01). There were no differences compared to the media layer area. The relation between the number of vessels and the length of the vascular segments was greater in the healthy fragments (mean ± CI 95% = 4.9 ± 1.02 vs 3.5 ± 0.68; 1.4 difference, P < 0.05). Conclusion: Vascular density is lower in the atherosclerotic aortic wall than in the healthy aorta and this could initiate the pathologic process.