Acute scrotum -etiology, clinical presentation and seasonal variation.

OBJECTIVE: The aim of the present study was to evaluate the etiology, history, physical examination findings, and seasonal variation of acute scrotal problems in children. METHODS: A retrospective review of all boys, presenting with acute scrotum to the Pediatric Surgery Clinic of the University Hospital Heraklion between January 1989 and December 2006 was performed. RESULTS: A total of 140 boys presented with scrotal pain were included. Overall the commonest cause of acute scrotum was epididymo-orchitis (35%, 95%CI: 27%-43%), followed by torsion of appendages. In contrast the most common cause in boys of preschool age was spermatic cord torsion (P<0.020). All cases of spermatic cord torsion were characterized by severe testicular pain and an absent cremasteric reflex. The interval between pain initiation and presentation to our clinic was 11.4 hours (SD:3.07) when the testis was salvaged by detorsion, and 19.0 hours (SD:6.32) when the testis was removed. The difference between means was statistical significant (p<0.001). The incidence of torsion of appendages (p<0.036) and/or spermatic cord (p<0.047) was increased in winter. CONCLUSION: The absence of cremasteric reflex in association with testicular tenderness strongly suggests testicular torsion. The low temperatures during winter may account for the increased incidence of the torsion of both the spermatic cord torsion and the appendages.

Acute epididymo-orchitis a retrospective study of 189 cases and review of literature

To analyze the clinical features, laboratory results and response to treatment of patients with acute epididymo-orchitis who presented to our urology unit from June 2005 to July 2006 and to review the pathogenesis and outcome. Retrospective study. Urology Department, Al-Sabah Hospital - Kuwait. The medical records of all patients admitted with a diagnosis of epididymo-orchitis from June 2005 to July 2006 were reviewed. Ultrasonography of the scrotum was performed in every case as an aid to make a diagnosis or to exclude other testicular pathologies. Studying the hospital records of 189 patients with acute scrotal swellings due to epididymitis or epididymo-orchitis, admitted at Urology Department Al-Sabah Hospital, Kuwait from June 2005 to July 2006 were reviewed. Epididymo-orchitis is a common clinical syndrome in Urological practice, in men younger than 35 years of age epididymo-orchitis is most often caused by sexually transmitted pathogens such as Chlamydia trachomatis and Neisseria gonorrhea. In men older than 35 years of age epididymo-orchitis is most often caused by non-sexually transmitted Gram negative enteric organisms causing urinary tract infections. In our retrospective study, we define the exact pathogenesis of acute scrotal swellings and methods to diagnosis and management of acute epididymo-orchitis along with appropriate treatment strategy according to causative organisms

Polyangiitis epididymo-orchitis secondary to hepatitis C

This is a case report a of hepatitis C-positive 43-year-old male who presented with small vessel involvement resulting in infarction of the testis, kidney and fingers in addition to multiple and painful aneurysms of arteries. The diagnosis, features and management of the patient are discussed briefly