Realtime-elastosonography of the penis in patients with Peyronie's disease.

OBJECTIVE: To evaluate the performance of real time elastosonography (RTE) in the identification of different types of penile lesions in patients with Peyronie's disease. MATERIALS AND METHODS: Seventy four consecutive patients with complaints of Peyronie's disease underwent B-Mode ultrasonography (US) and RTE of the penis in the same sitting. In each patient all sequences of elastosonography and B-Mode US were recorded and compared to evaluate the diagnostic performance of the new imaging technique. RESULTS: B-Mode US detected penile plaques in 64 patients (86.41%) and elastosonography confirmed these data. In the remaining 10 patients elastosonography documented, in five of them, areas of reducing elasticity suggesting the presence of initialfibrosis. Cohen's K was used to evaluate the discordances between B-Mode US and Elastosonography scan. A p value < 0.05 (two tailed) was considered statistically significant. The penile curvature (K = 0.353; p = 0.125) and the painful erection (K = 0.500; p = 0.248) evaluations were discordant: the B-mode US underestimated the positive cases. Instead the penile plaque and curvature > 30 degrees, and the penile plaque evaluations were completely concordant. CONCLUSIONS: RTE is a simple, non invasive, rapid complementary imaging technique that may improve the accuracy of B-Mode US in detecting penile lesions in patients with Peyronie's disease.

Successful multiple pregnancy achieved after transfer of frozen embryos obtained via intracytoplasmic sperm injection with testicular sperm from an AZFc-deleted man.

OBJECTIVE: To describe a case of successful triplet pregnancy after testicular sperm extraction (TESE) from a man with AZFc deletion and intracytoplasmic sperm injection (ICSI). DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 38-year-old man affected by complete AZFc deletion and azoospermia. INTERVENTION(S): Spermiogram, Y-chromosome microdeletion screening, TESE for sperm recovery from testicular tissue on the same day as ICSI, transfer of frozen-thawed embryos, vaginal ultrasound examination. MAIN OUTCOME MEASURE(S): The Y chromosome genetic status of an azoospermic patient who underwent TESE and ICSI, the fertilization and pregnancy outcome. RESULT(S): The patient was found to be azoospermic, and the deletion screening showed complete AZFc deletion. After TESE, the recovered testicular sperm were selected for ICSI. Three good quality embryos were obtained and were frozen due to ovarian hyperstimulation syndrome in the female partner. After transfer of the thawed embryos, a triplet pregnancy was diagnosed by vaginal ultrasonography at the seventh week of gestation. Two male and one female healthy babies were born. CONCLUSION(S): This is the first report of a successful triplet pregnancy after the transfer of frozen-thawed embryos in a couple in whom the male partner was azoospermic and a carrier of complete AZFc deletion. This deletion should not adversely affect a man's TESE retrieval prognosis or the fertilization, cleavage, and implantation of embryos. The offspring were healthy, although the two sons inherited the AZFc deletion.

[Extratesticular intraescrotal neurofibroma: case report]. / Neurofibroma intraescrotal extratesticular: aportación de un caso.

OBJECTIVES: We report a rare case of intrascrotal neurofibroma in an adult patient not affected by neurofibromatosis (NF1). METHODS: Clinical diagnosis of asymptomatic right scrotal lipoma and left symptomatic inguinal hernia carried the patient to the surgical treatment. After the first surgical step of left hernia repair, we proceeded to the excision by an inguinoscrotal approach of a voluminous whitish neoplastic mass occupying the whole left scrotum and not involving homolateral testis. RESULTS/CONCLUSIONS: The histopathologic diagnosis was of neurofibroma, a benign neoplasm of peripheral nerves which rarely occurs at genital level.