The aim of this study was to evaluate the accuracy of different methods, including the Seager orchidometer (SO) and ultrasonography (US), for assessing testicular volume of smaller testes (testes volume less than 18 mL). Moreover, the equations used for the calculations—the Hansen formula (length [L] × width [W]² × 0.52, equation A), the prolate ellipsoid formula (L × W × height [H] × 0.52, equation B), and the Lambert equation (L × W × H × 0.71, equation C)—were also examined and compared with the gold standard testicular volume obtained by water displacement (Archimedes principle). In this study, 30 testes from 15 men, mean age 75.3 (±8.3) years, were included. They all had advanced prostate cancer and were admitted for orchiectomy. Before the procedure, all the testes were assessed using SO and US. The dimensions were then input into each equation to obtain the volume estimates. The testicular volume by water displacement was 8.1 ± 3.5 mL. Correlation coefficients (R²) of the 2 different methods (SO, US) to the gold standard were 0.70 and 0.85, respectively. The calculated testicular volumes were 9.2 ± 3.9 mL (measured by SO, equation A), 11.9 ± 5.2 mL (measured by SO, equation C), 7.3 ± 4.2 mL (measured by US, equation A), 6.5 ± 3.3 mL (measured by US, equation B) and 8.9 ± 4.5 mL (measured by US, equation C). Only the mean size measured by US and volume calculated with the Hansen equation (equation A) and the mean size measured by US and volume calculated with the Lambert equation (equation C) showed no significant differences when compared with the volumes estimated by water displacement (mean difference 0.81 mL, P = .053, and 0.81 mL, P = .056, respectively). Based on our measurements, we categorized testicular volume by different cutoff values (7.0 mL, 7.5 mL, 8.0 mL, and 8.5 mL) to calculate a new constant for use in the Hansen equation. The new constant was 0.59. We then reexamined the equations using the new 0.59 constant, and found that the equation Volume (V) = L × W² × 0.59 was the best for describing testicular volume among our subjects (difference between the new equation and the gold standard of water displacement = 0.19 mL, P = .726). We also found that US was more precise in measuring testicular dimensions. We propose a new formula, V = L × W² × 0.59, to assess the volumes of smaller testes.

An accurate diagnosis of the etiology of azoospermia is crucial, as sperm retrieval methods differ between patients with non-obstructive azoospermia (NOA) and obstructive azoospermia (OA). The aim of this study was to determine hormone and testes size cutoff values to identify the cause of azoospermia in Taiwanese patients. The medical records of azoospermic patients were retrospectively collected from April 2008 to July 2016, including hormone profile, physical examination findings, and testes size. Bilateral testes biopsies or microdissection testicular sperm extraction were performed in all patients for a definite diagnosis. The diagnostic parameters used to distinguish NOA from OA were analyzed using the t-test and receiver operating characteristic curves. A total of 51 patients with OA and 156 with NOA were included. The mean levels of testosterone (4.5 vs. 3.4 ng/ml) and E2 (26.3 vs. 19.2 pg/ml) were significantly higher in the OA group, whereas the levels of follicular stimulating hormone (FSH) (5.6 vs. 25.4 mIU/ml) and Leutinizing hormone (LH) (3.7 vs. 11.6 mIU/ml) were lower. Receiver operating characteristic curve analysis revealed that FSH and right testis size were the best individual diagnostic predictors. Using a combination of FSH >9.2 mIU/ml and right testis size 9.2 mIU/ml and right testis size <15 ml was a strong predictor of NOA in our Taiwanese patients.

Prostate vaporization and enucleation is a novel treatment option for bladder outlet obstruction caused by benign prostate enlargement. This surgical technique, however, has not yet been standardized. We present our findings of using a high-power thulium laser to accomplish vapoenucleation of the prostate (ThuVEP). We prospectively collected and analyzed data from 29 patients who underwent ThuVEP between August 2010 and May 2012. The control group included 30 patients who underwent traditional transurethral resection of the prostate (TURP). Operative variables, patient profiles, preoperative and postoperative urine flow rates, prostate volume (measured using transrectal ultrasonography), and the international prostate symptom score (IPSS) were recorded and analyzed using a two-tailed Student’s t-test and analysis of variance. The ages (mean ± SD) of the patients were 76.1 ± 9.4 and 72.6 ± 7.4 years (p = 0.28) in the ThuVEP and TURP groups, respectively. The average urinary flow rates before and 12 months after the operation (volume/maximum flow/average flow) were 243.3/10.5/5.0 and 302.8/17.6/9.4 (in mL, mL/s, mL/s, respectively) in the ThuVEP group and 247.2/10.8/4.6 and 369.9/20.8/12.0, respectively, in the TURP group. Preoperative and postoperative IPSSs were 17.1 ± 5.0 and 6.5 ± 3.8, respectively, in the ThuVEP group and 18.2 ± 4.5 and 6.2 ± 3.3, respectively, in the TURP group. The mean ratio of the estimated postoperative residual prostate volume to the preoperative total volume was 0.47 (p = 0.449) in both groups. The overall complication rate was 20.7% in the ThuVEP group and 30.0% in the TURP group. One year of follow-up showed that ThuVEP and TURP effectively alleviated subjective and objective voiding symptoms with a low rate of complications. Thus, vapoenucleation using a high-power laser is feasible in elderly patients. ISRCTN registry with study ID ISRCTN52339705 . Date assigned: 06/03/2015.

Chung E, et al. World J Mens Health. 2023 Oct;41:e81. https://doi.org/10.5534/wjmh.230180

Background: Renal oncocytoma has been reported mostly in the Western literature, and only a few cases have been reported in Eastern populations. In the present study, we review the clinical course of renal oncocytoma in our institution. Methods: We obtained the files of 13 cases of renal oncocytoma between 1988 and 2006 from the pathological archives of Taipei Veterans General Hospital. We retrospectively analyzed the patients’ characteristics, clinical manifestations, surgical technique and clinical outcome. Results: The study population comprised 10 men and 3 women, and the mean age at diagnosis was 59.6 years (range, 37–75 years). Twelve patients (92%) were asymptomatic at presentation and were incidentally diagnosed to have renal tumor by sonography (9 patients), computed tomography (1 patient) or magnetic resonance imaging (2 patients), and 1 presented with hematuria. The clinical impression of oncocytoma was made preoperatively in only 3 patients by imaging studies, and most of the patients (76.9%) were diagnosed with renal cell carcinoma before surgery. Ten were treated with radical nephrectomy, 2 with partial nephrectomy, and 1 received excisional biopsy. All patients had unilateral solitary renal tumor; the right kidney was involved in 7 cases (54%) and the left in 6 (46%). Mean tumor size was 5.3 cm (range, 2.7–8.5 cm). Three patients were lost to follow-up in our series, and there was no recurrence or death (100% disease-specific survival) in the remaining 10 patients (77%) who were followed-up for a mean duration of 53.2 months (range, 10–117 months). Conclusion: Renal oncocytoma has a benign clinical course with excellent long-term outcomes. Currently, nephron-sparing surgery is the mainstay of treatment, especially in patients with small tumors. However, accurate preoperative diagnosis based only on imaging studies is difficult, and radical nephrectomy was performed for most of the patients in our series. [J Chin Med Assoc 2008;71(5):254–258]