1/8. Shattering the myths about male infertility. Treatment of male factors may be more successful and cost-effective than you think.Male factors play a role in up to half of subfertile couples, contrary to the myth that male factors rarely play a role. In this article, Dr Sandlow counters this and other myths about male infertility and suggests that primary care physicians can increase a couple's chance of conceiving by evaluating for male as well as female factors. This article will also help primary care physicians provide appropriate education and treatment, as well as determine when to make a referral to a male-infertility specialist.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/8. Ultrasonographic diagnosis of testicular torsion by emergency physicians.Testicular torsion has an incidence of one case per 4,000 men/boys. Most frequently affected are pubescent boys. Average testicular salvage rate is only 50%, and infertility can result Testicular torsion remains problematic for emergency physicians (EPs) as clinical diagnosis can be difficult and other testicular pathology can present similarly. In many institutions there are delays in obtaining Doppler or Scintigraphy studies during off-hours. We report two cases of testicular torsion diagnosed by the treating EPs using power Doppler in the emergency department (ED). Rapid diagnosis of torsion led to successful salvage of the affected testicle in both cases. These represent the first cases for emergency screening ultrasound examinations (ESUEs) of testicular torsion in the literature. Rapid technological advances over the last decade have brought portable equipment with high-resolution capability to the bed-side for EPs, who should consider using it more frequently to evaluate testicular torsion.- - - - - - - - - - ranking = 2.5keywords = physician (Clic here for more details about this article) |
3/8. diagnosis and treatment of klinefelter syndrome.Many physicians underestimate the prevalence of klinefelter syndrome and so fail to recognize its more obvious features. Increased awareness of its effects on physical, psychological, and social development should help to dispel persistent misconceptions about the condition and enable earlier diagnosis and more effective treatment.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
4/8. Long-term medical care of testicular cancer survivors.Testicular cancer is the most common solid tumor diagnosed in men 20 to 35 years of age. Because of highly effective treatments that may include surgery, chemotherapy, and radiation therapy, most patients become long-term survivors. health-related issues that confront testicular cancer survivors include the late medical effects of chemotherapy, the late relapse of disease, the development of second cancers, the effect of the disease and treatment on fertility, and the psychosocial consequences. This case-based discussion focuses on the primary care physician's evaluation and management of a long-term survivor of testicular cancer who was previously treated with surgery and chemotherapy.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
5/8. Male infertility and avascular necrosis of the femoral head.Corticosteroids are an important part of the pharmacological armamentarium against a wide spectrum of diseases. They are powerful drugs that effect all aspects of human metabolism and, although often life-saving, they have a plethora of important side-effects and a narrow therapeutic window. Most side-effects are well known to physicians but we would like to highlight the problem of avascular necrosis associated with cyclical steroid therapy of short duration using moderate doses for an unusual indication.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
6/8. Detection of an inguinal ovary at controlled ovarian stimulation that was successfully treated by repositioning.OBJECTIVE: To report a rare case of an ectopic ovary placed in the inguinal canal that was detected while performing a controlled ovarian hyperstimulation (COH). DESIGN: Case report. SETTING: A university hospital. PATIENT(S): A couple with primary infertility for 4 years was referred to our infertility clinic. The woman's medical history revealed a left inguinal operation at age 7. On vaginal ultrasound, only the right ovary could be seen. An infertility workup conducted for the man revealed teratospermia. The couple was subsequently admitted to the in vitro fertilization (IVF) program. While having a COH, the woman experienced a painful swelling in the inguinal area, and an ovarian image with follicular growth on the left inguinal region was observed with ultrasound. Afterward, surgery was performed, and the ectopic ovary in the left inguinal region was detected. INTERVENTION(S): Detection of an inguinal ovary with a controlled ovarian hyperstimulation procedure and surgical repositioning of the ectopic ovary. MAIN OUTCOME MEASURE(S): Controlled ovarian hyperstimulation, transabdominal ultrasound, transvaginal ultrasound. RESULT(S): The ectopic ovary was successfully repositioned with surgery. CONCLUSION(S): patients must be closely monitored while performing COH. In patients who do not have a unilateral ovary, a painful inguinal mass should alert the physician to the possible presence of an ectopic ovary in the inguinal canal.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
7/8. life-threatening conditions associated with male infertility.Most urologists' clinical experience is that infertility is a rare presenting sign of life-threatening medical disorders in men. Considering the current practice of infertile couples presenting to the gynecologist for initial evaluation and the popularity of assisted reproductive technology, many men are evaluated with a semen analysis alone and treatment instituted without urologic consultation. This may cause a delay in the diagnosis of a significant medical illness or misdiagnosis of a potentially treatable cause of male factor infertility. We reviewed the records of 1236 new male infertility patients presenting to Bowman Gray School of medicine and Baylor Medical College in an attempt to determine the frequency of significant medical disease in men presenting with infertility and whether any pattern of semen analysis findings was predictive of these disorders. Thirteen men, or 1.1% of the total population, were found to have a significant medical illness upon full urologic evaluation (Table 5). Testicular tumors were found in six, spinal cord tumor in one, brain tumors in three, genitourinary malformation in two, and a chromosomal abnormality in one. Interestingly, one of these patients was a physician with bilateral testicular cancer who had an abnormal semen analysis and had undergone multiple cycles of intrauterine insemination before referral. We could not identify a pathognomonic pattern on semen analysis that would allow us to predict the presence of medical illnesses in these 13 patients. Sperm counts ranged from azoospermic to almost normal semen parameters.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
8/8. Ovarian abscess after ovum retrieval for in-vitro fertilization.An ovarian abscess is an uncommon surgical emergency that could be lethal. The causes of an ovarian abscess vary, and treatment thereof may unfortunately lead to an oophorectomy. In order to draw the attention of physicians to this rare entity, we present a case of ovarian abscess resulting from follicle aspiration for in-vitro fertilization. Furthermore, with correct preoperative diagnosis and prompt surgical intervention at an early stage, the affected ovary may be salvageable.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |