Vesicles Of Men Research Articles

Early postoperative complications and 90-day mortality in patients undergoing radical cystectomy

Introduction: The standard treatment method of muscle-invasive bladder cancer is radical cystectomy. This complex procedure consists of removing the urinary bladder with distal ureters and regional lymph nodes. Additionally, the prostate with seminal vesicles in men and uterus with ovaries in women should be excised. Therefore, this demanding oncological surgery is associated with a high occurrence of complications. The aim of this study was to assess the complications after radical cystectomy and identify the factors associated with severe complications and high mortality rate. Materials/Methods: We retrospectively analyzed medical data of 213 patients who underwent a radical cystectomy. Preoperative risk factors were assessed based on American Society of Anesthesiologists classification (ASA) and the Charlson Comorbidity Index (CCI). Clavien-Dindo classification was also included in our analysis. We investigated various factors associated with 30-day and 90-day mortality. Results: Complications after surgery were reported in 38% (n = 81) of patients in the studied group. Excluding perioperative high fever, the complication rate was 18%. The following complications were observed in 30-day postoperative period: wound infection (n = 6), wound dehiscence (n = 4), mechanical bowel obstruction (n = 3), hemorrhage (n = 2), cardiological (n = 8), stroke (n = 3). Observed 30-day mortality was 2.3% (n = 5), while 90-day mortality was 8.9% (n = 19). The mortality rate was associated with the stage of cancer and the type of urinary diversion. Conclusions: Radical cystectomy is a complex and traumatic urological surgery. It is associated with a significant complication rate and mortality, and it negatively affects quality of life. Therefore, all known risk factors should be thoroughly assessed preoperatively to select optimal treatment. Furthermore, the patient should be carefully informed about the risks associated with the surgery.

Novel use of fine needle aspiration of seminal vesicles for sperm retrieval in infertile men

Fine needle aspiration of the seminal vesicles under transrectal ultrasound guidance was performed in a man with primary anorgasmy. The procedure included local anesthesia to the apex of the prostate and a 21-gauge needle for aspiration. A total of 3 mL of seminal fluid could be aspirated. Semen analysis showed a sperm count of 40 million/mL and 2% motility. Intracytoplasmic sperm injection was performed, pregnancy resulted, and a healthy girl was born. This is the first successful report of fine needle aspiration of the seminal vesicles in men whose infertility is caused by ejaculatory disorders or distal obstructive azoospermia. This finding could lead to an expansion of our armamentarium in assisted reproductive technology.

A Dose-Volume Histogram Analysis of the Seminal Vesicles in Men Treated with Conformal Radiotherapy to ‘Prostate Alone’

ABSTRACT: Background and purpose: There is no consensus on whether the seminal vesicles should be included in the clinical target volume (CTV) for radiotherapy of localized prostate cancer. To inform the debate, we have undertaken a dose-volume histogram (DVH) analysis of the seminal vesicles in patients treated with escalated dose conformal radiation to ‘prostate alone’.Material and methods: Twenty-five consecutive patients receiving conformal radiation to the prostate, to a dose of 75.6Gy in 42 daily fractions, were studied. The CTV was defined as the prostate only, and the planning target volume (PTV) was defined by a 10mm margin, except posteriorly where the margin was 7mm. DVHs were calculated for the entire seminal vesicles, and for 6mm segments through the seminal vesicles.Results: Incorporating a correction for organ motion, the D90 (minimum dose received by 90% of the volume of interest) for the most inferior 6mm volume of the seminal vesicles (SV1) ranged from 25 to 70Gy, and the percentage volume of SV1 receiving 50Gy ranged from 47–100%. Using a D90 of 50Gy as a cut-off, eight of the 25 patients had unacceptably low-dose coverage of SV1.Conclusions: Escalated dose conformal radiation to the ‘prostate alone’ does not ensure adequate dose coverage of even the most inferior 6mm of the seminal vesicles. We consider such treatment acceptable in patients at low risk of seminal vesicle involvement (T1/2ab, Gleason ≦7, PSA <10ng/ml). In higher risk patients, if it is deemed necessary to treat the possibility of sub-clinical seminal vesicle involvement, this should be reflected in the definition of the CTV.\\

Total mesenteric excision in the treatment of rectal carcinoma: methods and outcomes

The American Cancer Society estimates that there are approximately 40,000 new cases of rectal cancer in the United States per year, representing 30% of all colorectal cancers.Of these, approximately three-fourths will undergo resection with the intent to cure with a 5-year local recurrence rate of 8.5%, 16.3%, and 28.6% for stage pT1, pT2, and pT3 rectal cancer, respectively [1]. Overall 5-year survival data are only 22–26% for pT3 disease [2–5]. Like colon cancer, the majority of rectal cancers are adenocarcinoma.Achieving adequate resection margins in rectal cancer is more difficult due to the anatomic location of the rectum in the pelvis.Whereas wide margins of resection can be obtained in colon cancer by mobilization of the mesentery, rectal cancer is anchored by the non-mobile mesorectum to the bony pelvis and is closely surrounded by somatic structures such as the hypogastric nerve plexus, the prostate and seminal vesicles in men, and the uterus and vagina in women. The inability to remove tissue en bloc in rectal cancer excision leads to a three-fold more common local recurrence rate for rectal cancer compared to colon cancer [6]. Fortunately rectal adenocarcinomas are well suited for cure by resection based on several of their inherent characteristics.The majority have histologic criteria favorable for resection and rarely does intramural spread occur further than a centimeter from its palpable margin [7].The metastatic routes of rectal cancer are usually limited to the draining lymph nodes and liver.In one study, o5% of patients had distal bone, pulmonary, or cerebral metastase [7].In many ways, rectal cancer behaves as a local rather than a systemic disorder, which makes it more readily cured by surgical methods. The boundaries of the margin of resection that will optimally reduce local recurrence rates, increase patient survival, and minimize co-morbidities are currently debated.The aim of this article is to review the technique of total mesenteric excision (TME) used in conjunction with low anterior resection (LAR) and abdominoperineal resection (APR) of rectal adenocarcinomas.Analysis of the routes of rectal cancer spread will be used to rationalize choices of adequate boundaries of resection to optimize outcomes (i.e. should the lateral borders include the entire mesorectum, what constitutes an adequate distal margin, and how proximal should the lymphovascular structures be divided). Favorable outcomes not only reflect cure of disease and prevention of recurrent disease, but also take into account the prevention of undesired co-morbidities such as anastomotic leaks, compromise of sphincter function, loss of bowel control, and the impairment of bladder and sexual function.

Biochemical characterization of prostaglandin 19-hydroxylase of seminal vesicles.

The microsomal fraction of homogenates of seminal vesicles of men and monkeys, Macaca fascicularis, were analyzed for prostaglandin (PG) 19-hydroxylase activity. The microsomes of the monkey seminal vesicles, supplemented with 1 mM NADPH, metabolized 0.2 mM PGE1 to 19-hydroxy-PGE1 at a mean rate of 0.26 nmol/min/mg of protein (with an apparent Km and an apparent Vmax of 40 microM and 0.30 nmol/min/mg of protein, respectively). The enzyme catalyzed the incorporation of atmospheric oxygen into the substrate. Substituting NADH for NADPH reduced the prostaglandin E1 19-hydroxylase activity to 40%. Carbon monoxide and proadifen (SKF 525A) inhibited the enzyme. Prostaglandin E2 (0.2 mM) was metabolized to 19-hydroxyprostaglandin E2 (0.2 nmol/min/mg of protein), but PGE1 was preferred as a substrate. Prostaglandin B1 was metabolized to 18-hydroxy-, 19-hydroxy-, and 20-hydroxyprostaglandin B1 at a combined rate of approximately 25% of prostaglandin E1. 19-Hydroxyprostaglandin B1 was the main product. The microsomes of human seminal vesicles metabolized 0.2 mM PGE2 to 19-hydroxy-PGE2 in the presence of 1 mM NADPH, while carbon monoxide inhibited this reaction. These results suggest that prostaglandin 19-hydroxylase of seminal vesicles might be a cytochrome P-450. The biosynthesis of 19-hydroxyprostaglandin E1 and 19-hydroxyprostaglandin E2 was also studied in vivo in man by analysis of the product/substrate ratios (i.e. 19-hydroxyprostaglandin E1/prostaglandin E1 and 19-hydroxyprostaglandin E2/prostaglandin E2) in a series of consecutive ejaculates, which were obtained during short intervals. There was a 10-fold interindividual difference in these ratios. Although the product/substrate ratios decreased, the 19-hydroxylation of E prostaglandins appeared to be efficient in vivo, which was in contrast to the rather slow biosynthesis in vitro.

Early development of the cerebral vesicles in man

Two human embryos which were immediately before and soon after the appearance of the cerebral vesicle were cut into complete serial sections in almost the same direction and studied comparatively. The findings on these two sets of serial sections indicate that the rostral continuations of subthalamus and ventral thalamus along the ventral thalamic sulcus continuing from the sulcus limitans of the midbrain are destined to give rise to the formation of the cerebral vesicle. The rostral continuation of the subthalamus becomes the floor of the interventricular foramen, and that of the ventral thalamus the pallium. The rostral end of the continuation of the subthalamic matrix is not only the site of the beginning of evagination of the cerebral vesicle, but also the site of elevation of the ganglionic hill or striatum. As the evagination of the cerebral vesicle proceeds exceedingly dorsocaudolaterally from the rostral end of the continuation of the ventral thalamus, the elevation of the striatum occurs also in the same direction, getting in touch with the folding of the hemispheric stalk of Kuhlenbeck to enclose the interventricular foramen. Tt is noticed that, at the beginning of evagination, the grade of depression of the nasal pit was always parallel with that of evagniation of the cerebral vesicle.

Development of the cervical vesicles in man

Development of the cervical vesicles in man

Contribution to the discussion on the etiology of prostatic hypertrophy in man. I. The weight of the prostate and seminal vesicles in men of different ages.

Contribution to the discussion on the etiology of prostatic hypertrophy in man. I. The weight of the prostate and seminal vesicles in men of different ages.

The development of the seminal vesicles in man

American Journal of AnatomyVolume 24, Issue 4 p. 395-441 Article The development of the seminal vesicles in man Ernest M. Watson, Ernest M. Watson James Buchanan Brady Urological Institute, Johns Hopkins Hospital, and the Carnegie Laboratory of Embryology, Baltimore, MarylandSearch for more papers by this author Ernest M. Watson, Ernest M. Watson James Buchanan Brady Urological Institute, Johns Hopkins Hospital, and the Carnegie Laboratory of Embryology, Baltimore, MarylandSearch for more papers by this author First published: November 1918 https://doi.org/10.1002/aja.1000240402Citations: 9AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume24, Issue4November 1918Pages 395-441 RelatedInformation