Volume 2, Number 3Review ArticlesTherapeutic StrategyCase ReviewMichael GrassoChristian TwissCryptorchidismFertilityOrchiectomy
Volume 10, Number 2Case ReviewLeydig Cell Hyperplasia Revealed by GynecomastiaCase ReviewMohamed Jamal El FassiMoulay Hassan FarihMohamed Fadl TaziSoufiane MellasLeydig cell tumors are rare and represent 1% to 3% of all tumors of the testis. Leydig cell tumors affect males at any age, but there are 2 peak periods of incidence: between 5 and 10 years and between 25 and 35 years. Their main clinical presentation is a testicular mass associated with endocrinal manifestations that are variable according to age and appearance of the tumor. Our patient, a 17-year-old adolescent, presented with an isolated and painless hypertrophy of the right mammary gland. Clinical examination found gynecomastia and no testicular mass. Hormonal levels and tumor markers were normal. Testicular sonography showed an ovular and homogeneous right intratesticular mass 6 mm in diameter. We treated the patient with an inguinal right orchidectomy. The anatomopathological study found a nodule of Leydig cell hyperplasia. The patient recovered without recurrence at 8-month follow-up. The patient opted for mammoplasty 2 months after his orchidectomy rather than wait for the spontaneous gradual regression of his gynecomastia, which requires at least 1 year. Leydig cell hyperplasia manifests in the adult by signs of hypogonadism, most frequently gynecomastia. Although many teams prefer total orchidectomy because of the diagnostic difficulty associated with malignant forms, simple subcapsular orchidectomy should become the first-line treatment, provided it be subsequently followed by close surveillance, as it preserves maximum fertility, and these tumors usually resolve favorably. [Rev Urol. 2008:10(2):164-167]FertilityTesticular tumorLeydig cell hyperplasiaNonseminomatous germ celltumorsGynecomastia
Volume 13, Number 4Review ArticlesFertility and the Aging MaleCondition ReviewRandall B MeachamIsiah HarrisCarolyn FronczakLauren RothIn the United States since 1980, the birth rate in women aged > 35 years has increased by nearly 60%, whereas the birth rate for women aged 20 to 34 years has increased by only 10%. The trend in parenthood at an older age has also been seen in men. Since 1980, the fertility rate for men in their 30s has increased by 21% and for men aged 40 years and older, the rate has increased nearly 30%. In contrast, the fertility rate in men younger than age 30 years has decreased by 15%. Age-related infertility will continue to be a problem. A basic understanding of the issues is critical for health care professionals so that they can effectively counsel patients who are considering a delay in childbearing for social reasons or for those seeking fertility treatments. This review details the changes in fertility seen in the aging male. [Rev Urol. 2011;13(4):e184-e190 doi: 10.3909/riu0538] © 2011 MedReviews®, LLCAging maleFertilityMiscarriage ratesAge-related infertility