Penile-scrotal erythrodysesthesia among rectal cancer patients receiving fluoropyrimidine-based chemoradiation: a case report series.

BACKGROUND: Palmar-plantar erythrodysesthesia (PPE) is a slowly developing cutaneous reaction commonly experienced by patients treated with fluoropyrimidines. While erythrodysesthesia normally presents in a palmar-plantar distribution, it can also present with genital involvement, but this presentation is likely underreported and incorrectly attributed to an acute reaction from radiation therapy. This article aims to define erythrodysesthesia of the penis and scrotum as a rare but significant side effect of capecitabine. CASE PRESENTATION: We identified five cases of moderate to severe penis and scrotal erythrodysesthesia over a 2-year period at a large tertiary cancer center, representing an estimated incidence of 3.6% among male patients with rectal cancer who were treated with fluoropyrimidine-based chemoradiation within our institution. CONCLUSIONS: Improved understanding of erythrodysesthesia involving the penis and scrotum can facilitate early identification and treatment of symptoms, and possibly prevent the discontinuation or delay of cancer treatment in patients treated with capecitabine and similar drugs. These clinical advances would improve and prolong patient quality of life during cancer treatment and prevent complications that result in hospitalization.

Use of thermography in the long-term evaluation of scrotal surface temperature and its impact on seminal quality in stallions.

Scrotal surface thermography is a non-invasive method for assessing testicular thermoregulation in stallions; however, few studies have explored the application of this technique concerning the thermal physiology of equine reproductive systems. This study aimed to evaluate the consistency of testicular thermoregulation in stallions over a year using thermography to measure the scrotal surface temperature (SST). Moreover, we assessed the best region for measuring the surface body temperature compared with the SST. Ten light-breed stallions were used in the experiment. Thermographic images of the scrotal and body surfaces (neck and abdomen) were captured. Fresh, cooled and frozen-thawed semen samples were evaluated to verify the impact of thermoregulation on semen quality. Testicular thermoregulation was maintained throughout the year in stallions amidst changes in the external temperature, as evidenced by the weak correlation between the SST and ambient temperature. A lower correlation was observed between the environmental temperature and body surface temperature (BTS) obtained from the abdomen (BTS-A; R = .4772; p < .0001) than with that obtained from the neck (BTS-N; R = .7259; p < .0001). Moreover, both BTS-A and SST were simultaneously captured in a single image. The consistent quality of the fresh, cooled and frozen semen suggests efficient thermoregulation in stallions throughout the year.

Clinical Characteristics and Pathogen Spectrum of Male Genital Fungal Infections in Nanchang Area, South China.

The cutaneous fungal infections in male genitalia are relatively rare, and often present with various atypical clinical symptoms. It was mainly reported in a small number of case reports, while data with large number of patients were rarely reported. In this study, we reported 79 male patients with cutaneous fungal infections on scrotum or penis. The fungal infections were confirmed by microscopic examination directly and fungus culture. Clinical characteristics and predisposing factors were also collected. Of these 79 patients, 72 has lesions on scrotum, 5 on penis and 2 on both scrotum and penis. Trichophyton (T.) rubrum is the most common pathogen, found in 50 (67.6%) patients, which presented diverse clinical manifestation such as majorly erythematous, dry diffused scaly lesions without a clear border, slightly powdery and scutular scalings. Candida (C.) albicans is the secondly common pathogen, found in 21 (28.4%) patients, which also presented diverse lesions such as erythematous with dry whitish scaly lesions and erythematous erosion. The predisposing factors mainly included concomitant fungal infections on sites other than genitalia, especially inguinal region (tinea cruris), application of corticosteroid and high moisture. In conclusion, cutaneous fungal infections in male genitalia could be caused by different fungi, showed atypical or mild clinical appearances in most cases and might be a fungus reservoir, emphasizing the necessity to timely perform the fungi examinations and corresponding therapy.

Contrast-enhanced ultrasound (CEUS) for the characterization of intra-scrotal lesions.

Contrast-enhanced ultrasound (CEUS) has emerged as a promising imaging modality for the characterization of hepatic and renal lesions. However, there is a paucity of data describing the use of CEUS for the evaluation of intra-scrotal pathology. In the following review, we describe the clinical utility of CEUS for the characterization and differentiation of common and uncommon intra-scrotal conditions, including testicular torsion, infection, trauma, and benign and malignant intratesticular and extratesticular neoplasms. In addition, we outline key principles of CEUS and provide case examples from our institution.

A Giant Scrotal Neurofibroma in a Child Masquerading as Filariasis: Uncommon Presentation of a Common Disease.

Neurofibroma of the scrotum is a very uncommon benign neoplasm, specifically when it affects teenagers and is not associated with neurofibromatosis type I. To the best of our knowledge, only a couple of cases of neurofibroma in children have been documented. Here, we report a case study of a 17-year-old boy who had a giant scrotal lump for ten years masquerading clinically as filariasis. A provisional diagnosis of benign nerve sheath neoplasm was made based on cytology findings. The lump was surgically removed from the patient, and a histopathological and immunohistochemistry examination established the diagnosis of neurofibroma. The combined clinical, preoperative cytological, histological, and immunohistochemistry findings were not presented in the literature in any of the formerly documented cases of scrotal neurofibroma. The current case expands the spectrum of differential diagnoses for scrotal tumours that clinicians have previously observed.

Neonatal pyocele originating from a urinary tract infection: a case report.

BACKGROUND: The origins of pyocele are primarily idiopathic, with reports suggesting the spread from intraperitoneal or hematogenous infection. However, we found no information in the literature regarding the pathogen's spread from the urinary tract. CASE PRESENTATION: We report here a case of a 23-day-old term Iranian boy (Fars ethnicity) with complaints of new-onset fever, irritability, poor feeding, right hemiscrotal erythema, and edema. Moreover, the physical examination revealed an enlarged, erythematous, tender right hemiscrotum and edematous scrotal walls. Along with leukocytosis and elevated C-reactive protein levels, the urine culture indicated an infection with Escherichia coli. However, as the color Doppler ultrasonographic examination was inconclusive, he underwent surgical exploration on which a hydrocele sac with reddish cloudy pus fluid was noted, with its culture indicating growth with the same mentioned pathogen. Therefore, an appropriate antibiotic regimen was administered, and the patient was discharged a few days later after achieving full recovery and demonstrating no urinary tract structural abnormalities. CONCLUSION: In neonatal pyocele, the spectrum of evaluating the source of the infection should also be extended to the urinary tract. Moreover, administering suitable antibiotics would produce favorable results in cases with no structural abnormalities.

Ultrasound diagnosis of Mondor's disease involving the superficial scrotal veins: Unveiling a rare mimicker of acute scrotal emergencies.

We describe a rare case of Mondor disease of the superficial scrotal veins, which can clinically mimic acute testicular pathologies such as testicular torsion or epididymo-orchitis, and highlight the value of grayscale/Doppler ultrasound examination in distinguishing these entities, which have different management implications.

Mullerian Serous Cystadenoma Occurring in the Scrotum Post-Orchidopexy: A Rarely Reported Yet Distinctive Entity.

Serous cystadenoma is a rare lesion in the para-testicular tissue, with even rarer reports of this entity occurring in the scrotum post-orchidopexy. We present such an occurrence, adding support for its existence as a distinct entity.

The effect untreated right subclinical varicocele on the outcomes of contralateral left clinical varicocelectomy in infertile patients.

PURPOSE: The management of infertile patients with unilateral subclinical varicocele (SCV) and contralateral clinical varicocele (CV) remains controversial. We aimed to evaluate the effect of untreating SCV on the outcome of contralateral clinical varicocelectomy in infertile patients with oligoasthenozoospermia (OA). MATERIALS AND METHODS: Infertile patients with the diagnosis of OA who underwent left varicocelectomy were retrospectively evaluated. While all patients in the study had left clinical varicocele (LCV), some patients had concomitant right SCV. Patients were divided into two groups according to the presence or absence of a right SCV accompanying LCV as group 1; (LCV n = 104) or group 2; (LCV with right SCV, n = 74). Patients were evaluated with spermiogram parameters, pregnancy rates and serum levels of follicle stimulating hormone, luteinizing hormone, total testosterone at the first year of the follow-up. RESULTS: The mean sperm concentration increased significantly in both groups. However, group 1 showed significantly greater improvement than group 2. The ratio of progressive motile sperm in group 1 was increased significantly whereas no significant change was shown in group 2. Both the spontaneous pregnancy rate and the pregnancy rate with ART were statistically lower in the group of patients with right SCV. No statistically significant difference was detected in serum hormone levels in both groups after varicocelectomy operations. CONCLUSIONS: Untreated right SCV may have adverse impact on the outcomes of left clinical varicocelectomy. In this context, the right testis can be considered in terms of treatment in patients with right SCV accompanying left CV.

Structured Examination of the Scrotum and Penis.

Primary care pediatricians, family practitioners, and primary care advanced practice clinicians frequently need to examine male adolescent genitalia as part of a comprehensive physical examination. Although this part of the examination may be uncomfortable for clinicians, taking a structured approach to the examination can mitigate clinicians' apprehension as well as enhance their ability to use this evaluation to identify potential pathology for the patient. Familiarity with the male genitourinary examination will also allow clinicians to definitively identify medical urgencies and emergencies for timely intervention. This review will provide the clinician with a structured approach to the male genitourinary examination while highlighting common pathology that may be encountered during the examination. [Pediatr Ann. 2024;53(1):e5-e9.].

The Bull Breeding Soundness Examination and Its Application in the Production Setting.

breeding soundness for several reasons and at several times during their life span. These include before sale for the reason of affirming their sale ability or before a breeding season to determine their readiness for breeding. Bulls may also be evaluated for diagnostic purposes. The breeding soundness examination (BSE) is universally promoted as an important management tool, but there continues to be a level of inconsistency in its performance. A complete bull BSE consists of a thorough physical examination including internal and external reproductive tract, measurement of the circumference of the scrotum and evaluation of individual sperm motility and morphology.

Confidence degree and skill development in undergraduate medical students using male urogenital training simulators.

INTRODUCTION: medical training should provide the future professional, in addition to theoretical knowledge, general and specific skills. In urology, urogenital training simulators have been presented as an ally in improving the degree of confidence and development of competencies for undergraduate medical students. METHODS: exploratory descriptive research with a quantitative approach, of an experimental nature, of the randomized controlled type with cross-sectional cut. Conducted with the students of the 4th year of medicine of a Higher Education Institution in the West of Paraná. RESULTS: 91 students attended a theoretical class with a complete explanation of the activities to be performed and answered the initial questionnaire about the degree of confidence to perform tasks in three stations with male urogenital training simulators (prostatic touch, bladder catheterization and scrotal evaluation). Of these, 45 received guidance and training with the simulators prior to the stations, while 46 should demonstrate skills directly in the three stations, mimicking patient care, only with information from the theoretical classes. The students who received previous guidance with the simulators had their scores in the development of competence higher. And, when they repeated the questionnaire about the degree of confidence to demonstrate skills with the mannequins, there was a higher degree of confidence in performing the tasks, except for the execution of a task considered more difficult. CONCLUSION: there was an improvement in the degree of confidence and in the development of competencies of undergraduate medical students with the orientations in the male urogenital training simulators.

Polymorphism in IGFALS gene and its association with scrotal circumference in Hu lambs.

Scrotal circumference is an important reproductive index of breeding rams, which has a high genetic correlation with ejaculation volume and semen quality. In this study, the scrotal circumference of 1353 male Hu sheep at different stages of development was measured and descriptive statistical analysis was performed. The results showed that the coefficient of variation of scrotal circumference at each stage was greater than 10%, and its heritability were moderately to high, ranging from 0.318 to 0.719. We used PCR amplification and Sanger sequencing to scan the polymorphisms of the IGFALS gene, and performed association analysis with the circumference of the scrotum at different stages. We identified a synonymous mutation g.918 G > C in exon 1 of the IGFALS gene, and this mutation was significantly associated with scrotal circumference at 100, 120, 140, 160 and 180 days (p < 0.05). Therefore, IGFALS gene polymorphism can be used as a molecular marker affecting scrotal circumference of Hu sheep, which can provide a reference for future molecular marker-assisted selection of scrotal circumference in sheep.

A pictorial review of scrotal and penile pathology on computed tomography.

Computed tomography (CT) may show a variety of scrotal and penile pathologic finding, but is usually not used as a first-line imaging due to its limited soft tissue contrast. Nonetheless, there are three main scenarios for imaging of the scrotum and penis with CT. Pathologies may be found incidentally in patients undergoing abdominal and pelvic CT scanning for different reasons. In emergency settings, CT is frequently performed, and the recognition of scrotal and penile pathologies by the reporting radiologist is crucial to ensure optimal patient treatment and outcome. If MRI scanning cannot be performed due to contraindications or is unavailable in resource, limited CT may be used for the further characterization of scrotal and penile pathology found on ultrasound. This pictorial review wants to familiarize general and emergency radiologists with the anatomy and possible pathological findings of the scrotum and penis on CT.

Genital elephantiasis in men.

Penoscrotal elephantiasis (PSE) is defined as an increase, sometimes considerable, in the volume of the external genitalia, which will be responsible for an unsightly appearance, a sexological impact and a psychological harm. The cause may be primary or secondary to a parasitic disease (filarsiosis) or to intrinsic or extrinsic lymphatic obstruction. The diagnosis is essentially clinical, with penoscrotal involvement being the most frequent. The etiological research implies the realization of certain complementary examinations according to the circumstances. Surgical treatment ideally consists of excising the mass. followed by reconstruction using grafts or local flaps of healthy skin, which is an important way of restoring comfort to the patient. We report two cases of penoscrotal elephantiasis treated surgically with good functional and aesthetic results. We update, through our own experience, aspects of the diagnostic and therapeutic care of penoscrotal elephantiasis.

Inguinal Polyorchidism Found Incidentally During Orchiopexy in 9-Year-Old Male: A Case Report and Review of Orchiopexy of Nonscrotal Supernumerary Testes.

Polyorchidism, the presence of more than two testes, usually presents as a painless scrotal mass or is diagnosed incidentally during the management of another condition.1 It is a rare congenital abnormality with approximately 200 reported cases in the literature. Most cases are found on the left side within the scrotum. We report a case of right-sided polyorchidism in a 9-year-old patient found incidentally during inguinal orchiopexy. As there is debate on the management of polyorchidism, a careful approach is required as the surgeon must decide between either scrotal fixation or the removal of the supernumerary testis. This case report will discuss the anatomical and clinical considerations when making this decision.