Wenbiao Ren

Problem: Varicocele may lead to testicular dysfunction and male infertility. Varicocelectomy can improve both semen quality and post‐operative spontaneous pregnancy. However, different patients benefit distinctly from the surgery. Therefore, the study aims at examining the possible factors of spontaneous pregnancy after laparoscopic varicocelectomy in infertile men.Method of study: Clinical data of 196 infertile men who underwent laparoscopic varicocelectomy at our institute were collected from December 2013 to February 2019. Follow‐up data were available for 148 patients. All the patients were treated with laparoscopic varicocelectomy performed by experienced urological doctors. Possible pre‐operative factors of spontaneous pregnancy after laparoscopic varicocelectomy were retrospectively analyzed.Results: After a mean follow‐up of 29.1 ± 12.6 months (range 12‐74 months), 74 (50%) of couples achieved spontaneous pregnancy. Univariate analysis revealed that short infertility duration, secondary infertility, and high sperm progressive motility were significant predictors of spontaneous pregnancy after laparoscopic varicocelectomy. Multivariate analysis revealed that short infertility duration (≤2 years) and high sperm progressive motility (>30%) were independent predictors.Conclusion: Both infertility duration and pre‐operative sperm progressive motility could serve as independent factors of spontaneous pregnancy after laparoscopic varicocelectomy.

Purpose To examine the possible prognostic factors in patients with type 1 and type 2 papillary renal cell carcinoma (pRCC) after surgical management and to identify the independent predictive factors of the prognosis. Methods From 2010 to 2017, 1405 patients underwent surgery for renal cell carcinoma, of whom 114 had type 1 or type 2 pRCC and follow-up data were available for 88 patients. Clinicopathological and prognostic parameters were compared between type 1 and type 2 pRCC. Possible prognostic factors were retrospectively analyzed by univariate and multivariate analyses with Cox regression. Results The study included 63 males and 25 females with a mean age of 54.27 ± 12.91. 53 patients were diagnosed by regular physical examination and others presented with hematuria or lumbago. 53 (60.2%) underwent radical nephrectomy and 35 (39.8%) underwent nephron sparing surgery. After a mean follow-up of 46.08 ± 22.65 months, 16 patients died of pRCC metastasis and the 5-year disease-specific survival was 79.3%. The comparison of the 39 (44.3%) type 1 and 49 (55.7%) type 2 pRCCs revealed that type 2 pRCC had significantly higher grade and worse prognosis. Univariate analysis showed that symptomatic diagnosis, type, grade, and tumor stage were prognostic factors. Multivariate analysis identified that type and tumor stage were independent factors of the prognosis. Conclusions Pathological type and tumor stage could serve as independent factors for the prognosis of patients with pRCC.