Radiological patterns of incidental epididymitis in mild-to-moderate COVID-19 patients revealed by colour Doppler ultrasound.

The testis is a potential target organ for SARS-CoV-2 infection. Our study intended to investigate any testicular involvement in mild-to-moderate COVID-19 men. We conduct a cross-sectional study in 18 to 55-year-old men hospitalised for confirmed COVID-19. A senior radiologist executed the ultrasound with multi-frequency linear probe in all participants, regardless of any scrotal complaints. Exclusion criteria involved any situation that could impair testicular function. Statistical analysis compared independent groups, classified by any pathological change. Categorical and numerical outcome hypotheses were tested by Fisher's Exact and Mann-Whitney tests, using the Excel for Mac, version 16.29 (p < .05). The sample size was 26 men (mean 33.7 ± 6.2 years; range: 21-42 years), all without scrotal complaints. No orchitis was seen. Eleven men (32.6 ± 5.8 years) had epididymitis (42.3%), bilateral in 19.2%. More than half of men with epididymitis displayed epididymal head augmentation > 1.2 cm (p = .002). Two distinct epididymitis' patterns were reported: (a) disseminated micro-abscesses (n = 6) and (b) inhomogeneous echogenicity with reactional hydrocele (n = 5). Both patterns revealed increased epididymal head, augmented Doppler flow and scrotal skin thickening. The use of colour Doppler ultrasound in mild-to-moderate COVID-19 men, even in the absence of testicular complaints, might be useful to diagnose epididymitis that could elicit fertility complications.

The challenging sonographic inguinal canal evaluation in neonates and children: an update of differential diagnoses.

Bulging of the inguinal region is a frequent complaint in the pediatric population and sonographic findings can be challenging for radiologists. In this review we update the sonographic findings of the most common disorders that affect the inguinal canal in neonates and children, with a focus on the processus vaginalis abnormalities such as congenital hydroceles, indirect inguinal hernias and cryptorchidism, illustrated with cases collected at a quaternary hospital during a 7-year period. We emphasize the importance of correctly classifying different types of congenital hydrocele and inguinal hernia to allow for early surgical intervention when necessary. We have systematically organized and illustrated all types of congenital hydrocele and inguinal hernias based on embryological, anatomical and pathophysiological findings to assist readers in the diagnosis of even complex cases of inguinal canal ultrasound evaluation in neonates and children. We also present rare diagnoses such as the abdominoscrotal hydrocele and the herniation of uterus and ovaries into the canal of Nuck.

Minimally access versus conventional hydrocelectomy: a randomized trial.

OBJECTIVE: To compare our previously published new minimally access hydrocelectomy versus Jaboulay's procedure regarding operative outcome and patient's satisfaction. MATERIALS AND METHODS: A total of 124 adult patients were divided into two groups: A and B. Group A patients were subjected to conventional surgical hydrocelectomy (Jaboulay's procedure) and group B patients were subjected to the new minimal access hydrocelectomy. The primary endpoint of the study was recurrence defined as a clinically detectable characteristic swelling in the scrotum and diagnosed by the two surgeons and confirmed by ultrasound imaging study. The secondary endpoints were postoperative hematoma, wound sepsis and persistent edema and hardening. RESULTS: The mean operative time in group B was 15.1 ± 4.24 minutes and in group A was 32.5 ± 4.76 minutes (P ≤ 0.02). The mean time to return to work was 8.5 ± 2.1 (7-10) days in group B while in group A was 12.5 ± 3.53 (10-15) days (P=0.0001). The overall complication rate in group B was 12.88% and in group A was 37%. The parameters of the study were postoperative hematoma, degree of scrotal edema, wound infection, patients' satisfaction and recurrence. CONCLUSION: Hydrocelectomy is considered the gold standard technique for the treatment of hydrocele and the minimally access maneuvers provide the best operative outcomes regarding scrotal edema and hardening and patient's satisfaction when compared to conventional eversion-excision hydrocelectomies.

Abdominoscrotal hydrocele: its particular characteristics.

Abdominoscrotal hydrocele (ASH) is an unusual condition characterized by a large scrotal hydrocele which communicates in an hourglass fashion with an abdominal component through the inguinal canal. Based on previous clinical observations, we believed that ASH is a condition that begins as a large scrotal hydrocele during the neonatal period and later expands first into the inguinal canal and finally into the abdominal cavity during the next few months of life. We report a case series of ASH and point out its distinctive characteristics.

A rare case of malignant hydrocele in a young patient.

Malignant mesotheliomas of the tunica vaginalis are extremely rare tumors, especially in young patients. We report a case of a 15-year old patient presenting with clinical signs of hydrocele. Preoperative ultrasound scanning revealed two papillary lesions. Initially, before mesothelioma was suspected, the patient was submitted to focal resection of the macroscopic lesions. Following diagnosis by histopathology, the patient was submitted to radical orchiectomy and hemiscrotectomy. The patient presents no signs of local or systemic recurrence at the time of writing. A review of the literature on the subject has been included.

Utilidad ultrasonido en la evaluación de la patología escrotal benigna / Sonographic findings in benign scrotal diseases

La utilización de la ecografía tanto en escala de grises como Doppler color resulta una práctica de mucha utilidad en la caracterización de diversas entidades a nivel del escroto y su contenido. Para su realización se utilizaron transductores lineales con frecuencia entre 7,5-10 MHz en cortes transversales y sagitales de testículo y epidídimo, incluyendo imágenes comparativas del tamaño y ecogenicidad de ambos testículos. Este ensayo iconográfico intenta revisar el aporte del ultrasonido en la patología escrotal benigna más frecuente (AU)

[Pathology of the peritoneo-vaginal complex in the child. Communicating hydrocele, cord cyst, simple hydrocele]. / Patologá del conjunto peritoneo-vaginal en el niño. Hidrocele comunicante, quiste de cordon, hidrocele simple.

The abnormal persistence of the patent processus vaginalis determines the appearance of four types of pathology, depending on the grade and sort of communication: communicating hydrocele, hydrocele of cord, scrotal hydrocele and intrafunicular hernia. We have revised our casuistry of children with patent processus vaginalis pathology for the two last years (1995-1996), and we have found 75 communicating hydrocele cases, 5 hydrocele of cord and 16 scrotal hydrocele cases, on children between 1 month and 13 years old. The diagnostic was done after physical exploration with transillumination and inguino-scrotal ultrasound. Initially, conservative treatment was followed, which was enough for 58 patients (60.4%). In the 38 cases (39.6%) in which there were no improvement, surgical treatment via inguinal was carried out, with good results in nearly all cases. As a conclusion, we can assert that ultrasound is an excellent diagnostical method for patent processus vaginalis pathology and conservative treatment must have priority upon surgery, since a great number of spontaneous resolutions are observed, most of all on children aged less than two years old.

Trombosis de la vena porta e hidrocele purulento secundario a diverticulitis con peritonitis: informe de un caso y discusión / Thrombosis of the portal vein and purulent hydrocele following diverticulitis with peritonitis

Se presenta paciente de 53 años de edad con antecedentes de enfermedad diverticular colónica de dos años de evolución al diagnóstico, que ingresa por síndrome febril prolongado. Se constata en su evolución trombosis de la vena porta. A las 48 horas presenta aumento de volumen de la bolsa escrotal derecha. Una ecografía abdominal y testicular evidenció trombosis de ambas ramas de vena porta y un piohidrocele. La TC abdominal demostró además engrosamiento de las paredes del colon en fosa ilíaca izquierda con persistencia del conducto peritoneo vaginal, permeable e hidrocele. La punción testicular corroboró el diagnóstico de piohidrocele y los hallazgos intraoperatorios confirmaron la presencia de una diverticulitis colónica perforada y bloqueada con peritonitis. Se presenta el caso por la rareza de la asociación entre patología abdominal, hepática y testicular (AU)