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1.
An Bras Dermatol ; 95(4): 477-479, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32482545

RESUMO

Lymphangioma is a rare and understudied pathology that is usually detected in the first decade of life, and its appearance in adults is rare. This report details a 51-year-old man with morbid obesity who presented, for the last eight months, multiple asymmetric tumor lesions with extension to the scrotal region. The diagnosis of circumscribed lymphangioma with associated infection was confirmed. This case report demonstrates an unusual presentation of the characteristics of the lymphangioma that are seldom described in the literature.


Assuntos
Hiperceratose Epidermolítica , Linfangioma , Obesidade Mórbida , Adulto , Células Endoteliais , Humanos , Masculino , Pessoa de Meia-Idade , Escroto
2.
Life Sci ; 254: 117767, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32407848

RESUMO

OBJECTIVE: Heat stress shock affects the generation of free radicals and can have a harmful effect on spermatogenesis. Photobiomodulation (PBM) is very effective in andrology for treating male infertility. This research aimed at the evaluation of the impacts of PBM on spermatogenesis on the transient scrotal hyperthermia-induced oligospermia mouse model. MATERIALS AND METHODS: This experimental research divided 24 mice into the following four groups: (1) Control, (2) Scrotal hyperthermia, (3) Scrotal hyperthermia receiving laser 0.03 J/cm2 for 30 s for each testis, 35 days after induction of scrotal hyperthermia every other day for 35 days, and (4) Scrotal hyperthermia receiving laser 0.03 J/cm2 for 30 s for each testis, immediately after induction of scrotal hyperthermia every other day for 35 days. Scrotal hyperthermia was induced by water bath with 43 °C for 30 min. Then, the mice were euthanized, and their sperm samples were collected for sperm parameters analysis. Then, we took the testis samples for histopathological experimentations, serum testosterone level, reactive oxygen species (ROS), RNA extraction for the examination of IL1-α, IL6 and TNF-α genes expression as well as production and glutathione disulfide (GSH) activity. KEY FINDINGS: Our outputs indicated that PBM could largely improve the sperms parameters and stereological parameters, like spermatogonia, primary spermatocyte, round spermatid and Leydig cells together with an increasing level of the serum testosterone and GSH activity compared to the scrotal hyperthermia induced mice. In addition, it was found that the diameter of seminiferous tubules, ROS production, as well as the expression of IL1-α, IL6, and TNF-α genes significantly decreased in the treatment groups by PBM compared to the scrotal hyperthermia induced mice, but there was not a significant difference in terms of testis weight and Sertoli cells between the studied groups. SIGNIFICANCE: It could be concluded that PBM may be regarded as an alternative treatment for improving the spermatogenesis process in the scrotal hyperthermia induced mice.


Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Escroto/metabolismo , Espermatogênese/efeitos dos fármacos , Animais , Febre/metabolismo , Resposta ao Choque Térmico/fisiologia , Temperatura Alta , Hipertermia Induzida/métodos , Infertilidade Masculina/patologia , Células Intersticiais do Testículo/metabolismo , Masculino , Camundongos , Estresse Oxidativo/efeitos dos fármacos , Escroto/patologia , Células de Sertoli/metabolismo , Espermatozoides/patologia , Testículo/efeitos dos fármacos
3.
Anticancer Res ; 40(5): 2861-2864, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32366435

RESUMO

BACKGROUND/AIM: Hydrocele testis is a common disease with a prevalence of 1% in adults. Although it can be diagnosed by physical examination, scrotal ultrasound represents a standard diagnostic tool, to exclude underlying pathologies among them testicular or scrotal malignancies. PATIENTS AND METHODS: We conducted a retrospective analysis of 156 patients aged between 20 and 60 years who underwent surgical hydrocelectomy between 2003 and 2018. Pre-surgical ultrasound, histological results, complications and patients' characteristics were analysed. RESULTS: Malignancies were found in 0% of patients in the pre-surgical ultrasound. Interestingly, we found a higher incidence of hydrocele testis in patients with increasing age and 27% presented with symptoms other than painless enlargement of the scrotum. Among them recurrent pain was the most common. Surgical complications occurred in only 3.2%. CONCLUSION: Testicular cancer is an important differential diagnosis of hydrocele testis. However, in our study no case of incidental testicular cancer or scrotal malignancy was found in the pre-surgical ultrasound.


Assuntos
Escroto/diagnóstico por imagem , Hidrocele Testicular/complicações , Neoplasias Testiculares/etiologia , Ultrassonografia/métodos , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Período Pré-Operatório , Hidrocele Testicular/patologia , Neoplasias Testiculares/patologia , Adulto Jovem
4.
Urologe A ; 59(7): 825-828, 2020 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-32472223

RESUMO

Aphallia is an extremely rare congenital malformation of unknown cause. The incidence is reported in the literature to be 1 in 10-30 million live births. Almost 100 cases have been described to date. Aphallia is associated with other congenital malformations (in particular urogenital and gastrointestinal anomalies) in >50% of cases. The diagnosis is made clinically and shows the complete absence of the corpora cavernosa and the corpus spongiosum with a urethral opening along the perineal midline (most frequently ventral to the anus and in the ventral rectal wall). Two case reports from the authors' department: The first child was a male newborn (46,XY) with penis agenesis and additional bilateral intraabdominal testis, an anorectal malformation (ARM) with a rectovesical fistula, as well as left renal duplication and grade III vesico-ureteral reflux on the right side. The second child was a male newborn (46,XY) with aphallia without further urological or anorectal malformation. Only right inguinal hernia was present. In the first patient, several corrective surgeries were performed in the further course in view of the additional malformations. With regard to the aphallia, the various temporary treatment options (scrotal or parascrotal phalloplasty or penis prosthesis) were discussed with the parents. Masculinizing surgery by means of definitive phalloplasty was planned once the patient has reached puberty. Due to the technical demands of phallus reconstruction, feminization is still favored in some countries in the literature, which nowadays, however, cannot be justified medically or legally.


Assuntos
Anormalidades Múltiplas/patologia , Malformações Anorretais , Doenças dos Genitais Masculinos , Rim/anormalidades , Pênis/anormalidades , Anormalidades Urogenitais/patologia , Androgênios , Criança , Humanos , Recém-Nascido , Masculino , Escroto , Maturidade Sexual , Uretra
5.
Plast Reconstr Surg ; 145(5): 984e-987e, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32332553

RESUMO

Penile inversion vaginoplasty involves creation of vulva and a vaginal canal. Few studies describe techniques for creating aesthetic vulvar components, particularly the clitoral hood and labia minora. The authors present their approach to primary vulvoplasty, aiming to achieve the following: (1) labia minora that are well-defined and three-dimensional; (2) labia minora that frame the introitus; (3) sufficient clitoral hooding; (4) a patent introitus that appears closed at rest; and (5) prominent labia majora. In this technique, the labia majora are created by first pulling the superolateral scrotal skin inferiorly and medially toward the perineum. The labia majora incisions may be made laterally, medially, or both laterally and medially, dependent on the amount of penile and scrotal skin available. Initial approximating sutures are placed to anchor the labia inferiorly, and then excess skin is removed medially. The surgeon should avoid excess defatting of the labia majora, which are subject to initial edema and often atrophy with time. The preputial or distal penile shaft skin is used for the clitoral hood and medial aspect of the labia minora, with proximal penile shaft skin used for the lateral surface. The penile skin used for the lateral aspect of the labia minora must be pulled inferomedially toward the perineum, to create a narrow, tapered appearance and avoid effacement of the labia minora. Interrupted horizontal mattress quilting sutures are used to define the labia minora as distinct subunits. By considering homologous structures and anatomical subunits, we are able to create well-defined, aesthetic vulva in trans women and nonbinary individuals.


Assuntos
Pênis/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Escroto/transplante , Cirurgia de Readequação Sexual/métodos , Transexualidade/cirurgia , Vulva/cirurgia , Estética , Feminino , Humanos , Masculino , Satisfação do Paciente , Retalhos Cirúrgicos/transplante , Resultado do Tratamento
6.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(4): 505-508, 2020 Apr 15.
Artigo em Chinês | MEDLINE | ID: mdl-32291990

RESUMO

Objective: To investigate the effectiveness of concealed penis correction surgery based on the principle of midline symmetry. Methods: Between January 2016 and September 2018, 18 children with concealed penis were treated with correction surgery based on the principle of midline symmetry. All children were 3-12 years old, with an average age of 8.3 years. Physical examination showed that the penis was short; the penis body could not be exposed or be exposed too limited; the corpus cavernosum developed well. The pressure dressing was removed at 3 days after operation and the urethral tube was removed. The color of the glans, the swelling and congestion of penis and scrotum, and the blood supple of the prepuce flap were observed. Results: The operation time ranged from 47 to 54 minutes, with an average of 50 minutes. All children were followed up 3 months after operation. There was no hemorrhage and necrosis of the glans and no infection or ischemic necrosis of the flap. All patients had different degree of prepuce edema at 3 days after operation, 5 patients still had prepuce edema at 2 weeks, and the prepuce edema in all patients subsided at 3 months. All penises were exposed well after midline symmetric anastomosis with no bulky prepuce and scrotum. Conclusion: The correction surgery based on the principle of midline symmetry can be used to correct the appearance of the concealed penis effectively.


Assuntos
Pênis/cirurgia , Procedimentos Cirúrgicos Reconstrutivos , Procedimentos Cirúrgicos Urológicos Masculinos , Criança , Pré-Escolar , Prepúcio do Pênis , Humanos , Masculino , Escroto , Retalhos Cirúrgicos
7.
Br J Radiol ; 93(1110): 20200063, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32271626

RESUMO

Multiparametric ultrasound (MPUS), combining conventional techniques (greyscale and colour Doppler ultrasound), ultrasound strain elastography, and contrast-enhanced ultrasound (CEUS), has been successfully used in the assessment of adult scrotal pathology. Contrast-enhanced ultrasound can confidently establish testicular tissue vascularity even in the small-volume paediatric testis. Elastography provides further assessment of tissue stiffness, potentially adding useful diagnostic information. In children, ultrasonography is particularly advantageous, being safe, radiation-free and negating the need for sedation or general anaesthesia during the imaging evaluation. In this review article, we aim to familiarise readers with the MPUS scanning protocol used for paediatric scrotal examination and provide an overview of scrotal MPUS features, with particular focus to clinical indications where MPUS may be advantageous over conventional ultrasonography.


Assuntos
Doenças dos Genitais Masculinos/diagnóstico por imagem , Escroto/diagnóstico por imagem , Ultrassonografia/métodos , Abscesso/diagnóstico por imagem , Adolescente , Fatores Etários , Criança , Contraindicações de Medicamentos , Meios de Contraste/administração & dosagem , Meios de Contraste/efeitos adversos , Cistos/diagnóstico por imagem , Ecocardiografia Doppler em Cores , Técnicas de Imagem por Elasticidade/métodos , Epididimite/diagnóstico por imagem , Humanos , Recém-Nascido , Infarto/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Masculino , Fosfolipídeos/administração & dosagem , Fosfolipídeos/efeitos adversos , Escroto/lesões , Torção do Cordão Espermático/diagnóstico por imagem , Hexafluoreto de Enxofre/administração & dosagem , Hexafluoreto de Enxofre/efeitos adversos , Neoplasias Testiculares/diagnóstico por imagem , Testículo/irrigação sanguínea , Testículo/diagnóstico por imagem , Testículo/lesões
8.
Urologe A ; 59(5): 559-564, 2020 May.
Artigo em Alemão | MEDLINE | ID: mdl-32274542

RESUMO

With an incidence of 0.7-3% in male infants, undescended testicles is one of the most common congenital anomalies. In the first 6 months of life, the testicles may spontaneously descend in up to 70% of individuals. If the testicle is not in a scrotal position afterwards, fertility can gradually be reduced and the risk of a testicular tumor increases. Therefore, the current German guideline for undescended testis recommends that therapy should be take place between 6 and 12 months of life. After extensive information on the advantages and disadvantages, hormone therapy with the aim of a descensus or in those with bilateral anomaly with the aim of improving the germ cell pool can be offered. After the first year of life, hormone therapy is obsolete. Otherwise, surgical intervention is the treatment of choice. In the case of gliding or deep inguinal testis via scrotal or inguinal access, in the case of nonpalpable and sonographically undetectable testis, laparoscopy is carried out for diagnosis and simultaneous therapy. In the first postoperative year, adequate follow-up should be done to detect a re-ascensus and/or insufficient growth. Regular self-examinations from the age of 15 serve for the early detection of a testicular tumor that occurs only very rarely (approximately 0.003%).


Assuntos
Criptorquidismo/cirurgia , Orquidopexia/métodos , Guias de Prática Clínica como Assunto , Criptorquidismo/patologia , Alemanha , Humanos , Lactente , Laparoscopia , Masculino , Escroto , Testículo , Procedimentos Cirúrgicos Urológicos Masculinos
9.
Can Vet J ; 61(3): 247-250, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32165746

RESUMO

An 18-hour-old colt was presented for abdominal discomfort, preputial swelling, and frequent posturing to urinate. Examination of the scrotum confirmed 2 testes and no scrotal or inguinal hernia. Transabdominal ultrasound identified a distended bladder and no free fluid in the peritoneal cavity. Inspection of the preputial cavity revealed that the internal lamina of the prepuce was mostly attached to the glans penis. The preputial cavity was lubricated and manual traction was applied to detach the internal lamina of the prepuce from the glans penis. The colt urinated spontaneously 1 hour after the procedure, and the preputial swelling slowly resolved over 7 days. Key clinical message: Congenital phimosis in a newborn foal was resolved by manual separation of the penile epithelium and preputial lamina.


Assuntos
Doenças dos Cavalos , Fimose/veterinária , Animais , Animais Recém-Nascidos , Cavalos , Masculino , Pênis , Escroto , Testículo
12.
Can Vet J ; 61(2): 173-177, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32020937

RESUMO

Castration of pet pigs is becoming a commonly performed procedure. However, little information is available regarding surgical techniques and complications. Medical records of 106 pet pigs admitted to 3 teaching hospitals for castration were reviewed. All descended testicles were approached via pre-scrotal skin incisions, which were either closed (59.4%) or left open (22.6%). The inguinal rings were closed in 42% of cases. Of the 106 pet pigs, 4.7% developed a complication after surgery, which consisted of peri-incisional swelling. Pigs which underwent inguinal ring closure were 6.6 times more likely to develop a post-operative complication (confidence interval: 1.16 to infinity, P = 0.035). Age and weight at time of castration were not significantly associated with complications (P = 0.698 and P = 0.685, respectively). The results from this retrospective study suggest that castration in pet pigs is a safe procedure with a minimal rate of complications.


Assuntos
Orquiectomia/veterinária , Doenças dos Suínos , Animais , Masculino , Complicações Pós-Operatórias/veterinária , Estudos Retrospectivos , Fatores de Risco , Escroto , Suínos
13.
Urologe A ; 59(3): 266-270, 2020 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-32060579

RESUMO

Considering that Quist et al. first described the acute idiopathic scrotal edema (AISE) already in 1956, there are not many studies published in literature concerning the etiology, the development, and the progress of the disease since then. According to the literature the incidence of AISE is about 20%. Although it is an important differential diagnosis for acute scrotum, it remains extensively unknown. Therefore, AISE should be kept in mind by urologists, pediatric surgeons and pediatricians to avoid needless surgery or antibiotic therapy.


Assuntos
Edema/diagnóstico , Escroto/patologia , Torção do Cordão Espermático/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Doença Aguda , Criança , Diagnóstico Diferencial , Edema/etiologia , Humanos , Masculino , Escroto/diagnóstico por imagem , Torção do Cordão Espermático/diagnóstico
16.
Urology ; 135: 133-135, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31586472

RESUMO

Malignant peripheral nerve sheath tumors (MPNSTs) are soft tissue sarcomas that arise from peripheral nerve fibers and primarily occur in the setting of neurofibromatosis (NF1). MPNST arising from the penis is very rare and may require mutilating surgery to achieve surgical cure. We previously reported a case of MPNST involving the penis in a 14-month-old boy treated with neoadjuvant chemotherapy, total penectomy, and adjuvant radiation. Here we report intermediate follow-up of the same patient, describe his subsequent genitourinary reconstruction, and discuss management dilemmas that arise following treatment of penile MPNST.


Assuntos
Assistência ao Convalescente/métodos , Neoplasias da Bainha Neural/terapia , Neoplasias Penianas/terapia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Criança , Humanos , Masculino , Terapia Neoadjuvante , Neoplasias da Bainha Neural/patologia , Neoplasias Penianas/patologia , Pênis/patologia , Pênis/cirurgia , Escroto/cirurgia , Resultado do Tratamento , Uretra/cirurgia
17.
Urology ; 135: 159-164, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31626858

RESUMO

OBJECTIVE: To describe a minimal-incision modified fenestration technique (MIMFeT) for symptomatic hydroceles utilizing local anesthesia. METHODS: A database was maintained for men undergoing in-office MIMFeT for symptomatic hydroceles between June 2015 and August 2018. Following local anesthesia, the hydrocele was sequentially everted through a small upper hemiscrotal incision, excised, and oversewn without delivering the testicle through the wound. Patient demographics and clinical outcomes were subsequently reviewed. RESULTS: A total of 54 men (median age 67) underwent MIMFeT under local anesthesia for symptomatic hydrocele. Median estimated hydrocele size was 250 mL (IQR 150;500). Medical comorbidities included coronary artery disease (12%), hypertension (43%), diabetes (13%), and current antiplatelet or anticoagulant (44%) use. Six patients (11%) were deemed unsafe for monitored or general anesthesia. About 48 patients had follow-up data available (median 9 months; IQR 2-18). Mild recurrent scrotal swelling occurred in 4 patients (8%) and 9/48 (18%) experienced postoperative complications including hematoma (n = 2), prolonged pain (n = 3), wound infection (n = 2), and partial incisional separation (n = 2). No patient required repeat hydrocelectomy. CONCLUSION: Our early results suggest that the MIMFeT for management of symptomatic hydroceles can be safely performed in the office setting under local anesthesia, including in those patients who are determined to be unsafe for monitored and general anesthesia.


Assuntos
Anestesia Local , Complicações Pós-Operatórias/epidemiologia , Escroto/cirurgia , Hidrocele Testicular/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/efeitos adversos , Idoso , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Recidiva , Técnicas de Sutura , Resultado do Tratamento , Procedimentos Cirúrgicos Urológicos Masculinos/métodos
20.
Theriogenology ; 142: 414-420, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31711707

RESUMO

The aim of this study was to evaluate the potential reproductive, antioxidant and metabolic effects of kisspeptin-10 (KP-10) on Ossimi rams. Twelve Ossimi rams (1.5-2 years old) were divided randomly into two groups (six per group). The first one served as a control group, while the second one served as a treated group. Rams of the treated group were injected once weekly with KP-10 (5 µg/kg body weight) for one month. There were no significant differences in all measured parameters between rams of control group at pre-treatment period and those at post-treatment period. However, most examined parameters in the same rams in the treated group were affected by injection of KP-10 when comparing pre-treatment values in treated group with its post-treatment values. At the pre-treatment period, there were no significant differences between the treated and control groups regarding semen pH, mass motility, sperm concentration/mL, live and dead spermatozoa, total sperm abnormality, testosterone and oxidative stress and metabolic parameters. However, all semen characteristics were significantly improved in the treated group compared with the control group at the post-treatment period and in the treated group at the post-treatment period compared with that at the pre-treatment period. In addition, scrotal circumference, ejaculate volume and total sperm concentration/ejaculate showed higher significant improvements when comparing the treated group with the control one at the post-treatment period than when comparing the two groups at the pre-treatment period and also when comparing the treated group at the post-treatment period with that at the pre-treatment period. Serum testosterone, total antioxidant capacity, lipid peroxides, nitric oxide, total protein, albumin, glucose and high density lipoprotein-cholesterol levels significantly increased when comparing the treated group with the control one at the post-treatment period and also when comparing the treated group at the post-treatment period with that at the pre-treatment period. In conclusion, KP-10 led to potential improvement in the reproductive efficacy and metabolic capacity of Ossimi ram.


Assuntos
Antioxidantes/metabolismo , Metabolismo Energético/efeitos dos fármacos , Kisspeptinas/farmacologia , Reprodução/efeitos dos fármacos , Ovinos , Animais , Metabolismo Energético/fisiologia , Masculino , Reprodução/fisiologia , Escroto/efeitos dos fármacos , Escroto/fisiologia , Sêmen/efeitos dos fármacos , Sêmen/fisiologia , Análise do Sêmen/veterinária , Ovinos/fisiologia , Carneiro Doméstico , Motilidade Espermática/efeitos dos fármacos , Testículo/efeitos dos fármacos , Testículo/fisiologia
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