Ultrassonografia testicular no modo color Doppler∕ espectral e avaliação andrológica de garanhões tratados com gonadotrofina coriônica humana (hCG) em diferentes estações do ano / [Testicular ultrasonography in the doppler / spectral color mode and andrological evaluation of stallions treated with human corionic gonadotrofin (hCG) in different seasons of the year]

Utilizaram-se quatro garanhões nos meses de janeiro, abril, julho e outubro de 2016, em dois protocolos, em que: GI (n=4; 5mL de solução salina, i.v.) e GII (n=4; 5000UI de hCG, i.v.) e subdividiram-se esses protocolos em ciclos (C1 e C2), seguindo o esquema crossover, sendo: CI=animais 1 (GI) e 2 (GII), avaliados nos dias D1, D3 e D5, e animais 3 (GI) e 4 (GII), em D2, D4 e D6; CII= animais 1 (GII) e 2 (GI), em D1, D3, D5, e animais 3 (GII) e 4 (GI), em D2, D4 e D6. Realizou-se o tratamento em D1 e D2 de cada ciclo e a ultrassonografia testicular no modo color Doppler e Doppler espectral, uma hora antes de cada coleta de sêmen e imediatamente após. Avaliou-se: número de reflexo de Flehmen, de montas sem ereção, início da monta, tempo de reação à ereção e total da monta e análises de qualidade seminal. Estatisticamente foram utilizados os testes de qui-quadrado e ANOVA. Não houve diferenças estatísticas (P>0,05) entre os parâmetros analisados. Concluiu-se que uma única dose de 5000UI de hCG em garanhões não causou alterações significativas nos parâmetros avaliados em diferentes estações do ano.(AU)

Four stallions were used in January, April, July and October 2016 in two protocols: GI (n=4; 5ml saline, iv) and GII (n=4; 5000 hCG, iv), and these protocols were subdivided into cycles (C1 and C2) following the cross over scheme, as follows: CI=animal 1 (GI) and 2 (GII) evaluated on days D1, D3 and D5 and animal 3 (GI) and 4 (GII) at D 2, D 4 and D 6; CII=animal 1 (GII) and 2 (GI) at D1, D3, D5 and animal 3 (GII) and 4 (GI) at D2, D4 and D6. Treatment was performed on D1 and D2 of each cycle and testicular ultrasound in color Doppler and spectral Doppler mode, one hour before each semen collection and immediately after. We evaluated: Flehmen's reflex number, mounts without erection, start of the mount, reaction time to erection and total mount and seminal quality analyzes. Statistically, the Chi-square and ANOVA tests were used. There were no statistical differences (P>0.05) between the analyzed parameters. It was concluded that a single dose of 5000IU hCG in stallions did not cause significant changes in the parameters evaluated in different seasons of the year.(AU)

Does total testicular volume predict testicular volume difference in adolescent males with varicocele?

ABSTRACT Introduction: We evaluated the relationship between total testicular volume (TTV) and testicular volume differential (TVD) in adolescent males with varicocele. Both low TTV and high TVD have been independently associated with higher incidences of infertility later in life, but a predictive relationship between TTV and TVD directly has yet to be described. Materials and Methods: We retrospectively analyzed a database of Tanner 5 boys ages 16-21 who presented with varicocele at a single institution between 2009 and 2017. All patients had a scrotal sonogram prior to surgical intervention. TTV and TVD were calculated for each individual and four non-exclusive groupings of patients were created for statistical analysis. We chose 30 cc as a cut off value for low TTV based on prior studies. Results: 209 patients met our inclusion criteria. Mean age was 18.3 years (16-21, SD 1.7) with a mean total testicular volume of 36 cc (13.5-78.2, SD 11.1). Cut off points of TVD of 20% and TTV of 30 cc were used to separate patients. There were 65 boys (31%) with TTV < 30 cc and 58 boys (28%) with TVD ≥ 20%. Among males with TTV < 30 cc, 23 (35%) had a TVD ≥ 20%. Among males with TTV ≥ 30 cc, 35 (24%) had a TVD ≥ 20%. The relationship between TVD and TTV was found to be non-significant (p > 0.05). Discussion: Adolescent varicoceles continue to pose a challenge to pediatric urologists. The dilemma of over-aggressive treatment has proven difficult to balance with the risk of infertility. We hoped that elucidating the relationship between TTV and TVD could be useful in identifying patients who are at greater risk for infertility while decreasing the need for more intrusive testing, such as semen analysis, in an adolescent population. We looked at the direct relationship between low TTV and high TVD. In our population, there was a non-significant relationship between TTV < 30 cc and TVD ≥ 20% (p > 0.05) indicating that in adolescents with varicocele, TTV and TVD are independent variables. Our study limitations include the inherent user dependent bias of ultrasound measurements and data collection at a single institution with high ethnic diversity, possibly not comparable to all patient populations. Conclusions: Low TTV (< 30 cc) itself is not predictive of high TVD (≥ 20%) in adolescent boys with varicocele, despite their reported independent associations with impaired fertility in other studies.

Prospective ultrasonographic study of blood flow and testicular volume in patients submitted to surgical repair of inguinal hernia without using prosthesis

Abstract Purpose: To evaluate the behavior of arterial circulation and testicular volume in patients submitted to conventional inguinal hernia repair without the use of a synthetic prosthesis to reinforce the posterior wall. Methods: A prospective observational clinical trial was performed on 26 male patients with unilateral inguinal hernia types I and II by the Nyhus classification, who underwent surgical correction using the modified Bassini technique. Bilateral Doppler ultrasonography was performed preoperatively, at the third and at the sixth postoperative month. The studied variables were: systolic peak velocity (SPV), diastolic peak velocity (DPV), resistance index (RI), pulsatility index (PI) and testicular volume. Results: There were no statistically significant changes over time in the variables studied on the operated side: SPV (p = 0.916), DPV (p = 0.304), RI (p = 0.879), PI (p = 0.475), and testicular volume (p = 0.100). The variables on the control side also did not change statistically until the sixth postoperative month: SPV (p = 0.784), DPV (p = 0.446), RI (p = 0.672), PI (p = 0.607), and testicular volume (p = 0.413). Conclusion: Surgical correction of the inguinal hernia without the use of a prosthesis does not cause alterations in vascularization and testicular volume in the first six months postoperatively.

Bilateral low origin of testicular artery: a case report / Origem bilateral baixa de artéria testicular: relato de caso

The testicular artery is frequently subjected to radiographic imaging techniques such as angiography for diagnosis and treatment of conditions like epididymitis, testicular torsion, tumor, hematoma, and hydrocele and in cases of undescended testis. Radiologists and surgeons should therefore be aware of testicular artery variants. Although there are numerous studies and case reports that mention testicular artery variants, this is probably the first case, reporting a bilateral low origin of the testicular artery and discussing its probable embryological etiology

A artéria testicular é frequentemente examinada por técnicas de imagem como angiografia, para o diagnóstico e tratamento de condições como epididimite, torsão testicular, tumor, hematoma e hidrocele, e também em casos de criptorquidia. Sendo assim, radiologistas e cirurgiões devem estar cientes de variantes anatômicas da artéria testicular. Embora numerosos estudos e relatos de caso mencionem variantes da artéria testicular, este provavelmente é o primeiro caso a descrever origem bilateral baixa da artéria testicular e a discutir sua provável etiologia embriológica

Measurement of testicular volume in Wistar rats using a caliper and ultrasonography in experimental surgery

ABSTRACT PURPOSE: To compare the measurement of the testicular volume of Wistar rats using a caliper and ultrasonography. METHODS: Forty Wistar rats were randomly assigned into four groups. A tensile force of 1.6 Newton (N) and 1.0 N was applied to the right spermatic cord in group I and group II, respectively. Group III was the sham group, and group IV served as a control. The initial and final testicular volumes were measured using a caliper and ultrasonography and compared. A significance level of 5% was used. RESULTS: The Kappa coefficient was equal to 0.292 (p = 0.006). The Pearson correlation coefficient obtained for the percent reduction in the right testicular volume using ultrasonography and a caliper was equal to 0.696 (p < 0.001). CONCLUSION: There was reasonable agreement and a significant positive correlation between the percent reduction in the right testicular volume using ultrasonography and a caliper.

Triplex Doppler evaluation of the testes in dogs of different sizes / Avaliação Triplex Doppler dos testículos de cães de tamanhos diferentes

This study aimed to assess whether there are differences in Doppler velocimetry parameters between different sizes. Twenty dogs were equally divided into small and large groups used in this study. The dogs were evaluated using Triplex ultrasound. Testicular artery was located by Colour Doppler in the spermatic cord, marginal to the testes and intratesticular segments and then, spectral Doppler were used to calculate: peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index (RI) and pulsatility index (PI). The mean testicular volume in the left side was significantly higher than the right side, in both groups. Doppler examination showed higher velocities (EDV) at spermatic cord in large dogs; marginal to the testes was observed higher velocities in small dogs; intratesticular region no differences were observed (P < 0.05) and within the groups differences between segments of the artery were also observed for each parameter. The results showed that there are differences in Doppler velocimetry parameters between different sizes.(AU)

Este trabalho teve como objetivo verificar se existem diferenças nos parâmetros dopplervelocimétricos entre cães de diferentes portes. Para tanto, foram utilizados 20 cães, sendo 10 cães de pequeno porte e 10 cães de grande porte. Foram avaliados pelo Triplex Doppler para localização da artéria testicular nos segmentos de cordão espermático, marginal ao testículo e intratesticular. Após isso, o Doppler espectral foi acionado para cálculo dos parâmetros de velocidade de pico sistólico (VPS), velocidade diastólica final (VDF) e índices de resistência (IR) e pulsatilidade (IP). O volume testicular médio do testículo esquerdo foi significativamente maior que o direito em ambos os grupos. Ao Doppler, foram observadas diferenças dos valores entre os portes, sendo as velocidades no cordão espermático superiores nos animais de grande porte (P < 0,05) e dentro dos grupos também foram observadas diferenças entre as regiões da artéria testicular. Diante do exposto, conclui-se que existem diferenças nos parâmetros dopplervelocimétricos quando comparados animais de diferentes portes, além disso, os parâmetros dopplervelocimétricos são diferentes dependendo da região em que são mensurados.(AU)

Precocidade sexual em bovinos Nelore avaliada por ultrassonografia testicular / Sexual precocity in Nelore bovines evaluated by testicular ultrasonography

The present study aimed to evaluate if there are differences in testicular parenchyma echogenicity between pre-pubescent and pubescent animals at the same age. Ultrasound examinations were performed in longitudinal and transversal planes of the testicles of 111 healthy Nelore bovines, at the ages of nine, 13 and 15 months. The EIV software calculated the echogenicity of the testicular parenchyma, which ranged from 0 (anechoic) to 100% (hyperechoic). Animals that had reached puberty at 15 months of age presented higher testicular echogenicity than the animals that had not reached puberty at the same age. These results suggest that testicular ultrasonography can be used as a predictor of sexual precocity.(AU)

[adult's cryptorchidism: clinical and therapeutic aspects about 100 cases]

Cryptorchidism is a pathological condition defined as the failure of the testis descending into the scrotum. It is a rare condition in adults. To study clinical and therapeutic aspects of cryptorchidism in adults. A retrospective study of a series of 100 adult patients [mean age: 25.1 years; 19-50 years] with cryptorchid testis admitted in an urology department in Tunis. The main reasons for consultation were the finding of an empty purse, inguinal pain and primary sterility. The testicle was palpable in 84 cases. The treatment consisted of an orchidopexy in most cases and in 14 cases orchydectomy. Finding of cryptorchidism in adult is a real diagnostic failure. Surgical treatment is indicated to facilitate surveillance

Accuracy of ultrasound diagnosis after blunt scrotal trauma (10 years experience)

Objectives:To evaluate the role of ultrasonography (US) and its accuracy; sensitivity and specificity for the diagnosis of testicular rupture after blunt scrotal trauma. Moreover; tunica albuginea breach; testicular hematoma; testis avulsion; epididymal injuries and hematocele are particularly examined. Patients and Methods: Between 1998 and 2008; 24 patients presented to Suez Canal University Hospital after blunt scrotal trauma and underwent surgical exploration. All patients had an emergency scrotal US examination with the use of a 7.5-10 MHz linear transducer. US findings were compared with the surgical findings to calculate the sensitivity and specificity of US for each type of lesion. Results: Out of 24 patients; 12 were diagnosed as having testicular rupture and tunica albuginea breach was visualized on US in 6 patients. Sensitivity and specificity of US were 92and 50for testicular rupture; 85and 75for hematocele; 80and 79for testicular hematoma; and 100 and 96 for testicular avulsion; respectively. US diagnosis of epididymal injuries was poor as it failed to detect 3 out of 5 epididymal lesions. Conclusion: US was highly sensitive in the diagnosis of testis rupture. This can provide information on the integrity of the scrotal contents that can help the physician to determine the optimal treatment

Testicular microlithiasis: report of two cases and overview

Testicular microlithiasis is a rare asymptomatic disease of the testis. It is associated with testicular tumors and a wide variety of other pathologies. The sonographic image which is the main tool for diagnosis is characteristic. Because of its high association with malignant testicular tumors incidentally discovered cases of testicular microlithiasis should be followed up

Correlation between sonographic and clinically palpable varicoceles with their effects on semen quality and testicular size

To evaluate the effects of different grades of palpable varicoceles, on the testicular volume and semen quality in men with infertility. This prospective study included 90 infertile patients presenting to Urology Department El-Sahel Teaching Hospital from May 2006 to May 2009. Their ages ranged between 22-35 years with a mean of 25.7 +/- 3.15 years. After excluding female factor and taking informed consent, evaluation started and included complete history, clinical and sonographic examination, and semen analysis. Scrotal colour Doppler ultrasound using 6 - 12 MHz transducer, was done to detect veins calibers, testicular dimensions on the ipsilateral and contralateral sides of varicocele, presence or absence of venous reflux and its degree. Postoperatively, scrotal ultrasound and semen analysis were done, 6 - 9 months after varicocelectomy. There were 42 [46.6%], 30 [33.3%] and 18 [20%] patients with veins calibers 6 - 9 mm, 5 - 6 mm and 4mm in grades III, II, I varicocele respectively. Patients with grades III and II varicoceles, had a significant reduction of testicular volume on the affected side in addition to impaired semen quality as regards sperm motility and concentration. Patients with grade I varicocele showed no significant change of testicular volume in addition to normal semen analysis. Varicocelectomy improved sperm motility and concentration in grades Ill, II varicocele patients. Venous reflux was present in all patients with grades III and II varicocele but in none of grade I varicocele patients. Scrotal colour Doppler Ultrasound is highly valuable in detecting varicoceles, testicular volumes, venous reflux and determining its degree. Varicocele exerts a deleterious effect on the ipsilateral testicular volume, sperm motility and concentration so careful evaluation and early surgical intervention is recommended in grades III and II varicocele patients to improve sperm motility and concentration. Varicocelectomy improved sperm motility and concentration in grades III, II varicocele patients but the reduction of the ipsilateral testicular volume [caused by varicocele], did not significantly change 6 - 9 months postoperatively

unusual case of extensive xanthogranulomatous orchitis in a diabetic patient

We report an unusual case of extensive xanthogranulomatous orchitis [XGO] in association with poorly controlled diabetes mellitus. A 65-year-old Kuwaiti man with poorly controlled diabetes mellitus presented with a painful left testicular swelling of 1 year duration. Testicular tumor markers were normal. Scrotal ultrasonography showed a mass lesion of mixed echotexture, which almost replaced the testicular parenchyma. Left-sided orchiectomy was performed with the clinical diagnosis of testicular neoplasia. Subsequent examination revealed the diagnosis of XGO, and the patient is well 2 years after the operation. Extensive tumorous XGO associated with diabetes mellitus has not been previously reported. We offer this case to highlight the implied role of poorly controlled diabetes mellitus in the pathogenesis of XGO

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

Beta thalassemia major, a cause of testicular microlithiasis

Testicular microlithiasis is a rare condition characterized by deposition of calcium in the Lamina of semineferous tubules of testis. The ultrasound of testicular microlithiasis shows bright 1-3 mm echogenic foci in parenchyma. Herein, we report a first case of testicular microlithiasis in major beta thalassemia that was demonstrated in testicle's ultrasound

Effect of tension free inguinal hernia repair with mesh on testicular perfusion

Tension-free inguinal hernia repair with mesh was reported to have the best results as regards postoperative pain, patient's comfort and hospital stay, with the lowest recurrence rates ever reported. Few reports were concerned with the local effects of the mesh shrinkage and the resulting fibrosis on the adherent cord structures including testicular vessels. Seventy-eight males with unilateral uncomplicated primary inguinal hernia were included in this prospective study, underwent tension-free repair with polypropylene mesh. Operative and postoperative data were recorded. Pre- and postoperative testicular ultrasound and colored duplex study were performed to all patients to compare testicular volume and perfusion before, three months and every 6 months after the repair and with the contralateral non-operated side. The mean operative time was 42 +/- 12 minutes, hospital stay was 1.3 +/- 0.5 days and pain score 1.9 +/- 0.4. There was no recurrence. There was no significant difference as regards testicular volume and perfusion before and after tension-free repair of inguinal hernia. Tension-free inguinal hernia repair with mesh is confirmed to be a simple, effective and safe technique. With no to date proved effect on testicular perfusion in spite of the proposed hypothesis of mesh shrinkage, fibrosis and adherence of the cord structures to the mesh