Purpose Cryptorchidism is one of the most common causes of non-obstructive azoospermia (NOA) in adulthood. Even if early orchidopexy is performed to preserve fertility potential, some patients still suffer from azoospermia. Fertility potential is significantly lower in bilateral than unilateral cryptorchidism. The aims of this study were to identify clinical parameters that predict the likely success of sperm recovery by microscopic testicular sperm extraction (micro-TESE) and also the likely outcome of intracytoplasmic sperm injection using sperm from NOA patients who submitted to bilateral orchidopexy. Methods Fifty-two NOA patients with a history of bilateral cryptorchidism underwent micro-TESE. The following clinical parameters were evaluated as predictive factors for successful sperm recovery: age at micro-TESE; age at orchidopexy; period from orchidopexy to micro-TESE; luteinizing hormone (LH); follicle-stimulating hormone (FSH); testosterone; average testicular volume; and body mass index. Results In the successful sperm retrieval group, average testicular volume was significantly greater, while serum LH and FSH, and body mass index were significantly lower. In a multivariate analysis, average testicular volume was positively correlated with successful sperm recovery. Conclusion Our results indicate that testicular volume in NOA patients with bilateral cryptorchidism is a predictor for successful sperm recovery.

Varicocele is a common cause of male infertility. It is reported that low sperm concentration, motility and morphology are indicative of increased sperm DNA fragmentation index (DFI) in men with varicocele. Although research has been conducted into the relationship between varicocele and DFI, little is known about seminal oxidation-reduction potential (ORP) in varicocele patients. We assessed the relationship between varicocele with seminal ORP and sperm DFI in both fertile and infertile men. This prospective case-control study compared the findings from infertile men with varicocele to those of men with normal spermatogenesis without varicocele. Semen samples were collected and assessed using the WHO (2010) guidelines. ORP was measured (mV) and normalized to sperm concentration (mV/10(6) sperm/mL). DFI was measured using the sperm chromatin structure assay (SCSA) method. For group comparisons, only samples with a concentration >1 x 10(6) sperm/mL were included. Infertile men with varicocele had significantly lower mean sperm concentration, motility and total sperm count. Conversely, infertile men with varicocele had a significantly higher mean serum FSH level, and higher ORP and DFI values than fertile controls. ORP was higher in patients with varicocele and positively correlated with DFI (p < 0.01). ORP and DFI showed significant negative correlations with semen parameters (sperm concentration, motility and total sperm count) in infertile men with a varicocele.

A uterine artery pseudoaneurysm (UAP) can occur after a traumatic event to the uterus, and cause massive bleeding. A uterine manipulator has been widely used for gynecologic laparoscopic surgery as basically an atraumatic instrument. We describe here a woman with a UAP caused by a uterine manipulator. She underwent laparoscopic ovarian cystectomy with a uterine manipulator due to torsion of a left ovarian cyst. Eleven days later, she came to our hospital with massive vaginal bleeding. Transvaginal Color Doppler ultrasound showed an intrauterine cystic mass with swirling blood flow, and three-dimensional arterial imaging from computed tomography revealed a UAP on the left side. Selective uterine artery angiography demonstrated a pseudoaneurysm in the distal portion of the left uterine artery, and embolization was performed successfully. A UAP should be taken into consideration in uterine bleeding after the use of a uterine manipulator.

Massive ovarian edema is a rare condition in which intermittent torsion of the ovary at its pedicle obstructs venous and lymphatic drainage and results in the development of edema in the ovarian stroma. Massive ovarian edema occurs in young women, and most women undergo oophorectomy or wedge resection of the ovary to verify the presence of a neoplasm. We report a case of massive ovarian edema with torsion in a patient who underwent laparoscopic surgery with preserved ovarian function. It is clinically important to make a diagnosis appropriately and rapidly to prevent unnecessary oophorectomy and preserve ovarian function.

Objective: This study aimed to investigate the utility and safety of 2-port laparoscopic-assisted myomectomy (2P-LAM), performed without a morcellator, in comparison with conventional laparoscopic-assisted myomectomy (C-LAM). Methods: We performed 41 laparoscopic-assisted myomectomies from January 2012 to July 2015. Ten patients underwent the 2P-LAM procedure, whereas the others underwent the C-LAM procedure. We performed a statistical analysis of differences in patient characteristics, size and number of myomas, surgery time, blood loss, white blood cell count, hemoglobin level, and C-reactive protein level between the two groups. Results: There were no significant differences in patients background between the two groups. Furthermore, there were no significant differences in all perioperative variables. Conclusion: Our results suggests that 2P-LAM is a useful reduced-port surgical method and a valid alternative to C-LAM. Therefore, as some procedures can be performed under direct vision, our new technique is easier to perform than the conventional technique.