Resume L'oligozoospermie (ou OAT) est un tableau biologique souvent observé chez les hommes... more Resume L'oligozoospermie (ou OAT) est un tableau biologique souvent observé chez les hommes inféconds. Cette OAT peut être la conséquence de différents facteurs mis en évidence par l'anamnèse, l'examen clinique et le spermogramme. L'anamnèse révèle les antécédents infectieux, de cryptorchidie, de cure chirurgicale d'hydrocèle ou de hernie inguinale, facteurs potentiels d'OAT. L'examen clinique peut montrer l'existence d'un varicocèle dont le traitement est à envisager en cas d'association avec une OAT. Enfin l'infection du sperme est un tableau dont le diagnostic et le traitement restent difficiles. En l'absence de ces facteurs potentiels d'OAT, le diagnostic d'OAT idiopathique est facilement posé, comme le montrent trois exemples d'OAT faussement idiopathiques: les obstructions unilatérales des épididymes ou des déférents, les obstructions partielles des canaux éjaculateurs et les pathologies thermiques des...
We evaluated the prevalence of carcinoma in situ (CIS) in orchiectomy specimens performed for ger... more We evaluated the prevalence of carcinoma in situ (CIS) in orchiectomy specimens performed for germ cell tumors smaller than 40 mm in diameter to propose an appropriate conservative approach to bilateral tumors or tumor of a solitary testis. Of 127 patients treated with orchiectomy between 1990 and 2002, 41 who presented with a tumor of less than 40 mm in diameter were selected for histological analysis of testicular parenchyma. The morphological items assessed were CIS, spermatogenesis and Leydig cell hyperplasia. CIS was observed in 39 of the 41 patients (95%). CIS was evenly distributed throughout the testicular parenchyma (ie around and beyond the tumor) in all 39 cases. Spermatogenesis was observed in 12 of 41 specimens (29%), spermatogenesis without spermatozoa was noted in 14 (34%) and absent germ cells were found in 15 (37%). Leydig cell hyperplasia was observed in 24 cases (58%). Histological analysis of whole orchiectomy specimens showed that CIS is almost always present in testicular parenchyma adjacent to germ cell tumor. In bilateral testis cancer or cancer occurring in a solitary testis tumorectomy plus radiotherapy appears to be the appropriate treatment in patients with a small tumor and no other risk factors. In patients who wish to father a child and have preserved spermatogenesis the natural history of CIS allows the postponement of testicular radiotherapy after orchiectomy, giving the double advantage of preserving testicular endocrine function and maintaining the possibility of natural fatherhood.
Cryptorchidism is the most frequent abnormality of male sexual differentiation. Recently, numerou... more Cryptorchidism is the most frequent abnormality of male sexual differentiation. Recently, numerous reports have increased concerns that exposure to certain types of chemicals in the environment, including in utero exposure to compounds with estrogenic or antiandrogenic activities, may be linked with recently observed deleterious effects on male reproductive health, especially cryptorchidism and also decrease in sperm production and increased in
Resume L'oligozoospermie (ou OAT) est un tableau biologique souvent observé chez les hommes... more Resume L'oligozoospermie (ou OAT) est un tableau biologique souvent observé chez les hommes inféconds. Cette OAT peut être la conséquence de différents facteurs mis en évidence par l'anamnèse, l'examen clinique et le spermogramme. L'anamnèse révèle les antécédents infectieux, de cryptorchidie, de cure chirurgicale d'hydrocèle ou de hernie inguinale, facteurs potentiels d'OAT. L'examen clinique peut montrer l'existence d'un varicocèle dont le traitement est à envisager en cas d'association avec une OAT. Enfin l'infection du sperme est un tableau dont le diagnostic et le traitement restent difficiles. En l'absence de ces facteurs potentiels d'OAT, le diagnostic d'OAT idiopathique est facilement posé, comme le montrent trois exemples d'OAT faussement idiopathiques: les obstructions unilatérales des épididymes ou des déférents, les obstructions partielles des canaux éjaculateurs et les pathologies thermiques des...
We evaluated the prevalence of carcinoma in situ (CIS) in orchiectomy specimens performed for ger... more We evaluated the prevalence of carcinoma in situ (CIS) in orchiectomy specimens performed for germ cell tumors smaller than 40 mm in diameter to propose an appropriate conservative approach to bilateral tumors or tumor of a solitary testis. Of 127 patients treated with orchiectomy between 1990 and 2002, 41 who presented with a tumor of less than 40 mm in diameter were selected for histological analysis of testicular parenchyma. The morphological items assessed were CIS, spermatogenesis and Leydig cell hyperplasia. CIS was observed in 39 of the 41 patients (95%). CIS was evenly distributed throughout the testicular parenchyma (ie around and beyond the tumor) in all 39 cases. Spermatogenesis was observed in 12 of 41 specimens (29%), spermatogenesis without spermatozoa was noted in 14 (34%) and absent germ cells were found in 15 (37%). Leydig cell hyperplasia was observed in 24 cases (58%). Histological analysis of whole orchiectomy specimens showed that CIS is almost always present in testicular parenchyma adjacent to germ cell tumor. In bilateral testis cancer or cancer occurring in a solitary testis tumorectomy plus radiotherapy appears to be the appropriate treatment in patients with a small tumor and no other risk factors. In patients who wish to father a child and have preserved spermatogenesis the natural history of CIS allows the postponement of testicular radiotherapy after orchiectomy, giving the double advantage of preserving testicular endocrine function and maintaining the possibility of natural fatherhood.
Cryptorchidism is the most frequent abnormality of male sexual differentiation. Recently, numerou... more Cryptorchidism is the most frequent abnormality of male sexual differentiation. Recently, numerous reports have increased concerns that exposure to certain types of chemicals in the environment, including in utero exposure to compounds with estrogenic or antiandrogenic activities, may be linked with recently observed deleterious effects on male reproductive health, especially cryptorchidism and also decrease in sperm production and increased in
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