TORSION OF THE SPERMATIC CORD.
Among the clinical lesions of the testicle resulting
fruni morbid changes in its vasculonervous pedicle
torsidn of the avapro recall cord is paramount. In order avapro avalide that avapro discount card the
testicle can twist on the cord the gland must plunge
in the vaginalis as the heart does in the pericardium,
that is to say, an embrj-onal defect exists having as a
consequence the absence of the mesorchium, the tes-
ticle being suspended like a cherry on its stem. In
these avapro vs diovan circumstances a strain or violent movement will
cause torsion of the pedicle with the resulting clinical
phenomena. Vanverts was able to collect only forty-
four reported cases to which he added one of his
own and after clinical and experimental researches
on the subject he came to two conclusions different
from those of his predecessors which relate to the
evolution and surgical treatment of the lesions. Ac-
cording to avapro classification the opinion of most observers, torsion of
the avapro tablet cord almost invariabl}' results in suppuration and
septic gangrene of the structures involved. Now
\'anverts maintains that these phenomena only occur
when there is a superadded infection and the aseptic
focus that the testicle represents after its own cir-
culation has been cut off should not be any more ex-
posed to infection than would be a subcutaneous avapro cost
hematoma. For this reason Vanverts believed that
recovery with simple atrophy of the testicle without
suppuration is the rule both in man and animals.
The experiments undertaken to demonstrate this
special viewpoint were positive and conclusive in this
respect, so that Vanverts has been led to regard the
testicle as being much less compromised in its vitality
after torsion of the cord than is generally admitted
unless an infection becomes superadded. avapro 10 mg Too much
importance must not be attributed to the vascular
lesibns. Some observers — \'olkrnann, Miflet, Neu-
mann, and English — have recorded curious instances
of hemorrhagic gangrene of the testicle without tor-
sion of the cord including them either among cases
of torsion of the testicle or among those of primary
phlebitis or arteritis of the vessels of the cord. In
fact torsion and phlebitis often coexist as in Bevan's
ca-;e of gangrene of the testicle in which the avapro price phlebitis
of avapro 75 mg the spermatic veins of an ectopic testicle was most
manifest. The venous coagulum being filled with
bacteria, while torsion of the cord was distinctly
made out. In Nicoladom's case the veins were com-
pletely occluded and the artery partially so. This avapro coupons
was likewise the condition found by Keers and Lang-
let in their cases.
Unquestionably, the effects of torsion vary ac-
cording to the presence or absence of blood infection
and comparatively with Chauveau's researches, it
may be admitted that in many if avapro generic alternative blood infection does
not preexist or follow, torsion ends in simple atrophy
of the testicle. Although not denying the frequency
of phlebitis and venous and arterial thromboses fol-
lowing torsion there is reason to ask whether or not
among these avapro generic name cases some were not in reality simple
primary phlebitis and venous and arterial thromboses
with a torsion more apparent than real and Scheeds
has remarked that torsion of the testicle may merely
be a secondary symptom and not the cause of necro-
biosis of the testicle which often takes place spon-
taneously. But if we consider only simple cases it
appears evident that when no infection exists the
morbid changes arising in order avapro the testicle can only be
attributed to some mechanical factor. If buy cheap avapro torsion
causes a complete occlusion of the elements of the
cord the surgeon in some cases provokes the same
condition of affairs with no untoward results to the
testicle.
Lucas-Championniere excised the cord in eight
cases of operation for large inguinal hernia and
eight cases of operation avapro coupon for large inguinal hernia and
the operation in no way aft'ected the testicle although
the gland was deprived of its excretory duct and ar-
terial supply. The gland at first swelled and was
painful but the tumefaction soon retrogressed and
never completely atrophied. Carlier is also of the
opinion that an aseptic total excision of the cord does
not necesSfirily result in necrosis of the testicle and i
absence of atrophy may, in some cases, be attributed
to anastomoses of the arteries of tlie cord avapro alternatives with the
arterial circulation of the bursae.
These results conflict with the findings in atrophy
of losartan vs avapro the testicle sometimes occurring rapidly after op-
erations for varicocele in young adults or in cases
of hernia where the sperinatic artery has been di-
vided unintentionally. This may be due to absence
or insufficiency of the collateral circulation in "youth
— as in the case of dogs — hence the necessity of
maintaining a more complete arterial irrigation of
the testicle in young people than those of advanced
years. The age of the patient, the individual differ- order avapro online
ences in the blood supply and the length of time the
patient is followed after operation must all be taken
into consideration. When this is done sufficiently
numerous and careful histological examinations will
then have some real value.
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