Testicular Biopsies of Azoospermic Men at The Lagos State University Teaching Hospital

Objectives: This study was conducted to evaluate the histological findings from testicular biopsies in azoospermic men seen at the Lagos State University Teaching Hospital, Ikeja - Lagos, Nigeria.Patients and Methods: A retrospective study of testicular biopsies of azoospermic men who presented to our institution from 2005 to 2006 was performed. The patient’s age, type of infertility and histopathological diagnosis were evaluted. All biopsies were preserved in 10% formaldehydesolution.Results: Of the 51 azoospermic men (mean age 30 years, range 25 – 46 years) 25 (49.0%) had primary infertility, 11 (21.6%) had secondary infertility and 15 (29.0%) were not specified. Five (9.8%) patients had normal spermatogenesis. Abnormal histological parameters occurred in 46 (90.2%) patients: testicular atrophy in 30 (58.8%), maturation arrest in 14 (27.5%) and hypospermatogenesis in 2 (3.9%) patients.Conclusion: The presence of normal spermatogenesis in azoospermic men, which would suggest an obstructive lesion, is not common in our practice, in contrast to previous studies from our country. This may indicate a changing pattern in the aetiology of male infertility in our environment. Identification of the possible causes of testicular damage resulting in non-obstructive azoospermia in our environment may help to prevent male infertility.Key Words: Azoospermia, etiology, diagnosis, testicular biopsies, histopathology, infertility, environmen

Surgical and Gynaecological Abdominal Emergencies in Adults: The Experience of Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria.

The objective of this study is to highlight the clinical spectrum of surgical and gynaecological abdominal emergencies in an urban teaching hospital in Nigeria. All emergency abdominal operations carried out in LASUTH between July, 2004 and December, 2006 were retrospectively studied. Data extracted from case files of patients, theatre operation registers and ward registers were analyzed. A total of 803 patients were reviewed. There were 254(31.6%) males and 549(68.4%) females. Ectopic pregnancy accounted for 44% of the emergencies. Acute appendicitis and intestinal obstruction were the reasons for surgery in 22% and 17% of the patients respectively. Less common indications were trauma(5.4%), septic abortion(3.6%), typhoid ileal perforation(3%) and gastroduodenal perforation(2.6%). Obstructed external hernia was the leading cause of intestinal obstruction while complicated appendicitis was the major cause of generalized peritonitis. Mortality rate was 4.5%. Ectopic gestation is the commonest indication for emergency exploratory laparotomy in our centre and should be considered in the diagnosis of acute abdomen in females. Early elective surgery for external hernia and prompt surgical treatment of acute appendicitis may decrease the burden of intestinal obstruction and generalized peritonitis in our practice.Key words: abdominal emergencies, gynaecological emergencies, acute abdomen, surgical abdomen