ABSTRACT Purpose: The aim of this paper is to propose a modified surgical technique for immediate intravaginal prosthesis implantation in patients undergoing orchiectomy due to testicular torsion, and to evaluate the wound healing process and patient’s satisfaction. Material and methods: We prospectively analyzed 137 patients with testicular torsion admitted to our facility between April 2018 and May 2020. Twenty-five patients who underwent orchiectomy were included in this study. Fifteen had a testicular prosthesis implanted at the same time as orchiectomy using a modified intravaginal technique (summary figure) and 10 received implants 6 to 12 months after orchiectomy. Wound healing was evaluated at a minimum of four checkpoints (on days 15, 45, 90 and 180 after surgery). At the end of the study, a questionnaire was administered to measure patients’ satisfaction rate. Student’s t test was used for comparison of quantitative data between negative vs. positive cultures (p <0.05). The chi-square test was used to verify associations between categorical variables and immediate vs. late prosthesis implantation (p <0.05). Results: Patient’s ages ranged from 13 to 23 years (mean 16.44 years). Overall time lapse from symptoms to orchiectomy ranged from 10 hours to 25 days (mean 7.92 days). Only one extrusion occurred and it happened in the late implant group. All wounds were healed in 72%, 88%, 95.8% and 100% of the cases on the 15th, 45th, 90th and 180th days after implant, respectively. At the end of the study, all patients stated they would recommend it to a friend or relative. The only patient that had prothesis extrusion asked to have it implanted again. Conclusion: There was no prosthesis extrusion using the modified intravaginal surgical technique for immediate testicular prosthesis implantation, which proved to be an easily performed and safe procedure that can avoid further reconstructive surgery in patients whose testicle was removed due to testicular torsion.

ResumoO objetivo do presente trabalho é comparar a utilização da meta-heurística Rede Neural Artificial Aumentada (RNAA) com a heurística Minimum Bin Slack (MBS) para resolução de Problemas de Otimização Combinatória, mais especificamente, em problemas de Bin Packing, uma classe de Problemas de Corte e Empacotamento (PCE). PCEs são vastamente encontrados em diversos ramos da indústria e o tratamento adequado deste tipo de problema pode gerar impactos diretos na economia de matérias-primas e/ou espaço físico das empresas. Para a otimização dos parâmetros da RNAA, fez-se uso de um projeto de Delineamento de Experimento (DOE) do tipo Fatorial Completo. Os testes, realizados em diversos problemas benchmark da literatura, mostraram que, de uma forma geral, a heurística MBS foi superior tanto em relação à qualidade das respostas (cerca de 70% melhor), quanto em relação ao tempo computacional (aproximadamente 90% menor).

AbstractThe objective of this work is to compare the Augmented Neural Network (AugNN) metaheuristic with Minimum Bin Slack (MBS) heuristic to solve Combinatorial Optimization Problems, specifically, in this case, the bin packing problem, a class of Cutting and Packing Problems (CPP). CPPs are easily found among various industry sectors and its proper treatment can impact directly in savings of raw material and/or physical space of enterprises. In order to optimize the parameters of AugNN, a Full Factorial Design of Experiment (DOE) was applied. The tests, developed in many benchmark problems found in the literature, showed that MBS heuristic was generally superior, both in terms of quality of solution (approximately 70% better) and computational time (about 90% shorter).