ABSTRACT
Mesothelioma of the tunica vaginalis testis (MTVT) is a rare tumour and a cause of hydrocele. This case report concerns a 26-year-old male with hydrocele treated with left hydrocelectomy. Histopathology revealed MTVT, and left radical orchiectomy was performed followed by chemotherapy. Fluorescence in situ hybridization, DNA and RNA next-generation sequencing showed no mesothelioma-associated tumour suppressor gene mutations, but deletion of CDKN2A and a rare TFG-ADGRG7 fusion both reported in pleural mesotheliomas, were detected. Clinicians should consider malignancy in case of discrepancy between symptoms and objective findings in scrotal conditions.
Subject(s)
Mesothelioma, Malignant , Mesothelioma , Testicular Hydrocele , Testicular Neoplasms , Male , Humans , Adult , Testis/pathology , In Situ Hybridization, Fluorescence , Testicular Neoplasms/diagnosis , Testicular Neoplasms/genetics , Testicular Neoplasms/surgery , Mesothelioma/diagnosis , Mesothelioma/genetics , Mesothelioma/surgery , Mesothelioma, Malignant/complications , Mesothelioma, Malignant/pathology , Testicular Hydrocele/complications , Testicular Hydrocele/pathologyABSTRACT
The testis develops in the abdominal cavity and descends into the scrotum. Although numerous theories have been proposed, the mechanism of descent and the reason for its inhibition remain unknown. Furthermore, none of the explanations account for the other occurrences related to the descent, such as failed obliteration of the processus vaginalis, or the reasons for the decrease in fertility and increase in the risk of malignancy associated with an undescended testis. The gubernaculum is a primitive mesenchymal tissue that was first described in 1786. However, the role of the gubernaculum in the descent process remains obscure. The testis descends through the processus vaginalis. Although the processus vaginalis (PV) is usually defined as a simple peritoneal protrusion, it actively develops into the gubernaculum. The gubernaculum gives rise to the smooth muscles that surround the processus vaginalis. The striated cremaster muscle (CM) is also derived from the gubernaculum. Because the testis descends through the processus vaginalis, the muscles develop to propel the testis. After propelling the testis, the smooth muscle (SM) undergoes programmed cell death. The initiation of programmed cell death through the intrinsic pathway requires activation of phospholipase C. A transient shift in the autonomic balance via a decrease in the sympathetic tonus and an increase in the parasympathetic tonus is essential for initiating this programmed cell death. Programmed cell death in the SM is the physiological pathway for the obliteration of the processus vaginalis. Differences in the timing, intensity, or duration of this physiological pathway result in pathological conditions. A shift before testicular descent diminishes the SM content that is required to propel the testis, and thus inhibits descent. The early shift persists throughout childhood and results in the decrease in fertility and increase in the risk of malignancy because of the differences in signal transduction. Despite a successful descent, persistence of the shift alters the contractility of the CM by increasing the cytosolic calcium levels. Contracted CMs retracts or even ascends the testis. Inadequate intensity or duration of the shift of autonomic tonus causes failure of the programmed cell death. Persistence of the SM hinders the obliteration of PV and gives rise to hydroceles or inguinal hernias depending on the amount of residual smooth muscles. Similar findings from different countries support these explanations. Thus, our proposed mechanism satisfactorily explains the process of descent while considering all the factors related to the process of testicular descent.
Subject(s)
Cryptorchidism , Neoplasms , Testicular Hydrocele , Male , Humans , Child , Cryptorchidism/etiology , Inguinal Canal , Testicular Hydrocele/complicationsABSTRACT
No disponible
Subject(s)
Humans , Male , Child, Preschool , Testicular Hydrocele/complications , Peritonitis/complications , Peritonitis/diagnosis , Peritonitis/surgery , Cefotaxime/therapeutic use , Metronidazole/therapeutic use , Drainage/methods , Scrotum/pathology , Scrotum , Hyperemia/complications , Hyperemia , Echocardiography, Doppler/instrumentation , Echocardiography, Doppler/methodsABSTRACT
ABSTRACT Objectives: To assess the incidence of anatomical anomalies in patients with retractile testis. Materials and Methods: We studied prospectively 20 patients (28 testes) with truly retractile testis and compared them with 25 human fetuses (50 testes) with testis in scrotal position. We analyzed the relations among the testis, epididymis and patency of the processus vaginalis (PV). To analyze the relations between the testis and epididymis, we used a previous classification according to epididymis attachment to the testis and the presence of epididymis atresia. To analyze the structure of the PV, we considered two situations: obliteration of the PV and patency of the PV. We used the Chi-square test for contingency analysis of the populations under study (p <0.05). Results: The fetuses ranged in age from 26 to 35 weeks post-conception (WPC) and the 20 patients with retractile testis ranged in ages from 1 to 12 years (average of 5.8). Of the 50 fetal testes, we observed complete patency of the PV in 2 cases (4%) and epididymal anomalies (EAs) in 1 testis (2%). Of the 28 retractile testes, we observed patency of the PV in 6 cases (21.4%) and EA in 4 (14.28%). When we compared the incidence of EAs and PV patency we observed a significantly higher prevalence of these anomalies in retractile testes (p=0.0116). Conclusions: Retractile testis is not a normal variant with a significant risk of patent processus vaginalis and epididymal anomalies.
Subject(s)
Humans , Male , Infant , Child, Preschool , Child , Testis/abnormalities , Cryptorchidism/complications , Epididymis/abnormalities , Fetus/embryology , Testicular Hydrocele/complications , Testis/embryology , Prospective Studies , Gestational Age , Cryptorchidism/surgery , Cryptorchidism/embryology , Epididymis/surgery , Testicular Hydrocele/surgeryABSTRACT
Objectif general : evaluer la prise en charge des hydroceles dans les hopitaux de Mbujimayi. Materiel et methodes : la methode utilisee a ete transversale et retrospective. Ce travail a porte sur 76 patients traites et hospitalises pour hydrocele dans les services de chirurgie des structures hospitalieres Bonzola; Dipumba; MIK Geller et Saint Jean Baptiste de janvier 2008 a Decembre 2012. Resultats : La frequence la plus elevee des hydroceles a ete observee dans la tranche d'age de plus de 60 ans suivie de celle comprise entre 0 et 20 ans avec respectivement 38;2 et 31;6. Les hydroceles communicantes ont ete exclusivement observees dans la tranche d'age de 0 a 20 ans (58;3) alors que les hydroceles simples ont ete diagnostiquees dans toutes les tranches d'age. Le retournement de la vaginale a ete le type de traitement le plus frequent pour les hydroceles simples (85;5) alors que les hydroceles simples ont ete diagnostiquees dans toutes les tranches d'age. Le retournement de la vaginale a ete le type de traitement le plus frequent pour les hydroceles simples (85;5) tandis que les hydroceles communicantes ont ete surtout traitees par la ligature du canal peritoneo-vaginal avec resection de la vaginale (92;9). Les complications sont apparues dans 6;6 des cas; les suites operatoires ayant ete simples dans la plupart des cas. L'hematome scrotal a ete la complication la plus frequente dans le retournement de la vaginale.Conclusion : la prise en charge des hydroceles a ete realisee couramment dans les hopitaux de Mbujimayi integres dans l'etude. Elle nous a paru conforme aux normes de bonne pratique rapportees dans la litterature
Subject(s)
Disease Management , Testicular Hydrocele/complications , Testicular Hydrocele/surgeryABSTRACT
OBJETIVO: Presentación de un caso de hematocele secundario a un hidrocele abdomino escrotal en la edad adulta. MÉTODO Y RESULTADO: Presentamos el caso de un paciente que presentó este inusual tipo de hidrocele que tras un mínimo traumatismo escrotal ocasionó un importante hematocele. Se trata de un hidrocele que se extiende a través del canal inguinal hacia el espacio retroperitoneal, reseñando su aproximación diagnóstica así como el tratamiento quirúrgico. CONCLUSIONES: El hidrocele abdomino escrotal es una patología infrecuente en niños y lo es aún más en adultos. La presencia de un hematocele exige un tratamiento quirúrgico precoz (AU)
OBJECTIVE: To describe one case of hematocele secondary to rupture of an abdominoscrotal hydrocele in an adult patient. METHODS AND RESULTS: We report a huge hematocele in a patient with this unusual type of hydrocele that suffered a minimal scrotal trauma. It was a hydrocele that extended through the inguinal canal to the retroperitoneal space. CONCLUSIONS: Abdominoscrotal hydrocele is a rare condition in children and even rarer in adults. The presence of a hematocele requires early surgical treatment (AU)
Subject(s)
Humans , Male , Testicular Hydrocele/complications , Abdominal Neoplasms/diagnosis , Hematocele/etiology , Testis/injuriesABSTRACT
Objetivos: Los procesos proliferativos benignos testiculares se conocen con el nombre de pseudotumors, al no ser considerados en la actualidad verdaderas neoplasias. El Pseudotumor Fibroso Paratesticular (PFP) es una entidad sobre las que existe gran confusión en su definición y etiopatogenia. Se trata de un proceso que confunde al clínico al aparecer simulando neoplasias. La presente comunicación puede ayudar a conocer mejor este proceso no tumoral y evitar confusiones diagnósticas. Métodos/Resultados: Revisamos nuestra serie de PFP (tres casos) sobre esta rara entidad, por lo que dada su rareza puede considerarse significativa. Analizamos su clínica, su comportamiento antes los estudios diagnósticos por imagen, hallazgos operatorios y evolución. Conclusiones: El PFP es una rara entidad que puede confundir al clínico al ser diagnosticado como una neoplasia, y conllevar tratamientos agresivos (orquiectomía) que de realizar un exacto diagnóstico podrían obviarse. El análisis de una serie de tres casos, con sus aportaciones, y la revisión de la literatura efectuada pueden ayudar en la practica clínica al urólogo a reconocer esta enfermedad (AU)
Objective: Benign testicular proliferative processes are known by the name of pseudotumors, because currently they are not considered real neoplasias. The paratesticular fibrous pseudotumor (PFP) is a rare entity, the definition and etiopathogenesis of which is under great confusion. It is a process that misleads the clinical because they simulate neoplasias. This paper aims to help a better knowledge of this non-tumoral process and to avoid diagnostic confusions. Methods/Results: We review our series of PFP (three cases), which can be considered significant due to its oddity. We analyze the clinical picture, its behavior, imaging diagnostic tests, operative findings and outcomes. Conclusions: PFP is a rare entity which may misleads the clinical because it may be diagnosed as a neoplasia and lead to aggressive treatment (orchiectomy) which in case of a proper diagnosis could be avoided. The analysis of our series of three cases, with their contribution, and a literature review may help the clinical practice of urologists by recognizing this disease (AU)
Subject(s)
Humans , Male , Middle Aged , Aged , Female , Testicular Neoplasms/complications , Testicular Neoplasms/diagnosis , Testicular Neoplasms/surgery , Testicular Hydrocele/complications , Testicular Hydrocele/surgery , Scrotum/pathology , Scrotum/surgery , Diagnosis, Differential , Testicular Neoplasms/pathology , Testicular Neoplasms , Neoplasms, Fibrous Tissue/complications , Testis/pathology , Testis/surgeryABSTRACT
Objetivo: Comparar tres diferentes abordajes para la realización de varicocelectomia en la población pediátrica, analizando su efectividad y complicaciones secundarias. Métodos: En 8 años 90 varicocelectomias fueron realizadas en 89 niños con una media de edad de 12 años (Rango 8-16). Los pacientes se dividieron en 3 grupos, en 21 casos se realizo laparoscópico (Grupo 1), en 55 abordaje retroperitoneal de palomo (Grupo 2) y en 14 casos abordaje inguinal (grupo 3). Se analizaron características demográficas prequirúrgicas, datos intraoperatorios, seguimiento y complicaciones. Resultados: La edad, la indicación y el tiempo de seguimiento fueron similares en los tres grupos. El tiempo quirúrgico fue en promedio de 36 min, 34 min y 30 min en cada uno de los grupos. Recurrencias se presentaron en 1(4%), 5(9%) y 0 respectivamente. Hidrocele postoperatorio que requirió manejo quirúrgico se presento en 2(9%), 4(7%), 0 respectivamente y en 2(9%), 5(9%), 1(7%) se presentaron hidroceles en cada grupo los cuales resolvieron con el tiempo de seguimiento. Se presento en un paciente sangrado del sitio de inserción del trocar el cual se resolvió intraoperatoriamente y en un caso infección de herida quirúrgica en el grupo de laparoscopia. Conclusiones: La comparación de los tres grupos revela que no se presentaron diferencias significativas aunque se presentaron algunos resultados mejores con el inguinal. Cualquier técnica realizada provee resultados adecuados y en nuestra serie se presento recurrencia total del 6% e hidrocele del 6%. El desarrollo de métodos que permitan disminuir el hidrocele como la preservación linfática podrá dar mejores resultados generales (AU)
Objectives: To compare three different surgical approaches for the performance of varicocelectomy in the pediatric population, analyzing their effectiveness and secondary complications. Methods: Over an eight year period 90 varicocelectomies were performed in 89 children with a mean age of 12 years (range 8-16). Patients were divided into three groups, in 21 cases laparoscopic approach was performed (Group 1), in 55 the Palomo's retroperitoneal approach (Group 2) and inguinal approach in 14 cases (Group 3). Preoperative demographic characteristics, and intraoperative data, follow-up and complications were analyzed. Results: Age, indication and follow-up time were similar in all three groups. Average surgical time were 36 minutes,34 minutes and 30 minutes respectively. Recurrences appeared in one (4%), 5 (9%) and 0 patients respectively. Postoperative hydrocele requiring surgical treatment appeared in 2 (9%), 4 (7%) and 0 respectively, with an incidence of hydrocele of 2 cases (9%), 5 (9%) and 1 (7%) which resolved during follow-up. One patient presented bleeding at the site of trocar insertion which was solved intraoperatively, and another patient in the laparoscopy group had a wound infection. Conclusions: Comparisons between the three groups reveal that there were not significant differences, although the results were somewhat better in the inguinal approach group. Any technique has adequate results, with a total recurrence rate in our series of 6%, and 6% of hydroceles. The development of methods that will make possible to diminish hydrocele, such as lymphatic preservation, will give better general results (AU)
Subject(s)
Humans , Child , Adolescent , Male , Varicocele/diagnosis , Varicocele/surgery , Testicular Hydrocele/complications , Testicular Hydrocele/diagnosis , Intraoperative Care/methods , Urologic Surgical Procedures/methods , Varicocele/complications , Laparoscopy , Urologic Surgical Procedures/instrumentation , Urologic Surgical Procedures/trends , Urologic Surgical Procedures, Male/methods , Postoperative Complications/diagnosisABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Testicular Hydrocele/complications , Testicular Hydrocele/diagnosis , Testicular Hydrocele/surgery , Calcinosis/complications , Diagnosis, Differential , Scrotum/pathology , Scrotum/surgery , ScrotumABSTRACT
Introducción. La herniotomía inguinal es un procedimiento quirúrgico común en cirugía pediátrica y como en cualquier intervención quirúrgica es fundamental el control del dolor. El objetivo de este estudio es comprobar el efecto de la anestesia local junto a la anestesia general, en el control del dolor postquirúrgico. Material y método. Se realiza un estudio prospectivo en 60 pacientes sometidos a reparación de hernia inguinal e hidrocele unilateral, bajo anestesia general. Los pacientes fueron designados al azar en tres grupos iguales después de la inducción anestésica. En el grupo I se realiza bloqueo ilio-inguinal, antes de la incisión quirúrgica. En el grupo IIse realiza infiltración local tras el cierre de la aponeurosis y en el grupo III no se infiltra anestésico local. La edad de los pacientes estuvo comprendida entre 1 y 13 años. Para la valoración del dolor y comparación entre los tres grupos utilizamos: 1) Mediciones de tipo conductuales.2) Mediciones de tipo biológico antes y después de la intervención: Tensión arterial, frecuencia cardiaca, frecuencia respiratoria 3)Mediciones de laboratorio: niveles de cortisol, prolactina, insulina y glucosa. Se realizan dos extracciones, la primera después de la inducción anestésica y la segunda 60 minutos después de la intervención. Los resultados fueron analizados empleando el programa informático-estadístico SPSS. Un valor de probabilidad < 0,05 fue considerado significativo. Resultados. 1) Mediciones de tipo conductuales: Las diferencias entre los grupos I y II en relación con el III fueron significativas. Esta diferencia conductual también estuvo relacionada con la edad de los pacientes. 2) Mediciones de tipo biológico. En los grupos I y II la tensión arterial media postoperatoria fue menor, pero solo en el grupo Il a diferencia fue significativa. La frecuencia cardiaca disminuyó en los tres grupos, pero significativa solo en el grupo I, al igual que la frecuencia respiratoria. 3) Mediciones de laboratorio: En los grupos I y II los niveles de cortisol y glucosa disminuyeron en el postoperatorio, pero sólo en el grupo I la diferencia fue significativa. Los valores de prolactina sólo disminuyeron en el postoperatorio en el grupo I pero no fue significativo. La insulina experimentó un aumento en los tres grupos, aunque menor en el grupo I. Conclusiones. 1) Los resultados del estudio demuestran que la infiltración local de anestésico disminuye la respuesta metabólica y reduce la intensidad del dolor postoperatorio, especialmente cuando se realiza antes del comienzo de la cirugía. 2) En la respuesta conductual al dolor no solo influye la utilización de anestésico local si no también la edad del paciente (AU)
Introduction. The inguinal herniotomy is a surgical procedure common in pediátric surgery and as in any operation the control of the pain is fundamental. The aim of this study is to verify the effect of the local anesthesia next to the general anesthesia, in the control of postsurgicalpain. Material and method. A prospective study is made in 60 patients submitted for unilateral repair of hernia inguinal and hydrocele, undergeneral anesthesia. The patients were designated at random in three equal groups after the anesthetic induction. In group I ilio-inguinal blockade is made, before the surgical incision. In group II local infiltration is made after the closing of the aponeurosis and in group III the anesthetic is not infiltrate. The age of the patients included was between 1and 13 years. For the valuation of the pain and comparison between the three groups we used: 1) Measurements of conductual type. 2) Measurements of biological type before and after the intervention: Arterial tension, cardiac frequency, respiratory frequency 3) Laboratory measurements: cortisol levels, prolactose, insulin and glucose. Two extractions are made, first after the anesthetic induction and second60 minutes after the intervention. The results were analyzed using computer statistical program SPSS. A probability value of < 0,05 was consideredsignificant. Results. 1) Conductual measurements: The differences between groups I and II in relation to the III were significant. This conductual difference also was related to the age of the patients. 2) Measurements of biological type. In groups I and II the postoperative arterial tension average was smaller, but only in group I the difference was significant. The heart rate decreased in the three groups, but was significant only in group I, like the respiratory frequency. 3) Laboratory measurements: In groups I and II the levels of cortisol and glucose diminished in the postoperative period, but only in group I the difference was significant. The values of prolactose diminished in the postoperative period in group I but was not significant. Insulin experienced an increase in the three groups, although smaller in group I. Conclusions. 1) The results of the study demonstrate specially that the local infiltration of anesthetic diminishes the metabolic answer and reduces the intensity of the post operating pain, when is made before the beginning of the surgery. 2) In the conductual answer to the pain not only influences the use of the anaesthetics but the age of the patient (AU)
Subject(s)
Humans , Male , Female , Child , Child, Preschool , Anesthesia, Local/methods , Hernia, Inguinal/diagnosis , Hernia, Inguinal/therapy , Hernia, Inguinal/surgery , Mepivacaine/therapeutic use , Hydrocortisone/therapeutic use , Prolactin/therapeutic use , Insulin/therapeutic use , Glucose/therapeutic use , Pain/etiology , Pain/therapy , Postoperative Complications/drug therapy , Prospective Studies , Testicular Hydrocele/complications , Heart Rate/physiologyABSTRACT
Operating time for idiopathic hydroceles and epididymal cysts is scarce as these conditions compete with an increasing caseload of more consequential surgical disease. Therapy is often relegated to repeated aspiration. Sclerotherapy appears to be effective in a majority of published trials, but comparative effectiveness, efficacy and safety of most agents, including phenol versus tetracycline, has not been established A deliberate strategy of re-treatment until cure is not universally practised, with surgery still being offered after single-treatment failures. Two trials, the first consisting of 53 scrotal cysts treated with 5% phenol-in-water and the second, 42 cysts treated with tetracycline, are compared for effectiveness, efficacy and safety of sclerotherapy per se and of re-treatment. Intention-to-treat analysis yields similar cure rates (no re-accumulation three months after last injection) for phenol and tetracycline (83% and 81% respectively, p = 0.8). Per-protocol analysis also yields similar cure rates (100% and 97% respectively, p = 0.26) and mean number of injections to cure (1.34 and 1.12 respectively, p = 0.069), with range 1-4 and 1-3 respectively. Severe pain following tetracycline injection required administration of pre-injection cord block. Other complications occurred equally (25% and 25.7% respectively, p = 0.94) and were trivial except for one case of chronic haematocele treated by orchiectomy in the tetracycline group. Phenol (5%) and tetracycline are equally efficacious sclerosants for idiopathic scrotal cysts, achieving almost 100% cure with re-treatment and matching the efficacy of surgery. Concern about post-treatment fertility applies equally to surgery and demands informed consent for both modalities.
El tiempo de operación para los hidroceles y los quistes epididimales es escaso, ya que estas condiciones triviales compiten con una creciente carga de casos de enfermedades quirúrgicas de mayores consecuencias. La terapia es a menudo relegada a una aspiración repetida. La escleroterapiaparece ser efectiva en la mayoría de los ensayos publicados, pero no se han establecido la seguridad, eficacia y efectividad comparativa de la mayor parte de los agentes, incluyendo el fenol, frente a la tetraciclina. No se practica universalmente una estrategia deliberada de re-tratamiento hasta la cura, ofreciéndose todavía la cirugía, luego de fracasos con tratamientos individuales. Dos ensayos, el primero consistente en 53 quistes escrotales tratados con fenol acuoso al 5%, y el segundo, en 42 quistes tratados con tetraciclina, se comparan en cuanto a efectividad, eficacia y seguridad para laescleroterapia per se y para el re-tratamiento. El análisis de intención de tratamiento produce tasas de curación similares (no hay re-acumulación 3 meses después de la última inyección) para el fenol y la tetraciclina (83% y 81% respectivamente, p = 0.8). El análisis por protocolo también produce tasas de curación similares (100% y 97% respectivamente, p = 0.26) y el número medio de inyecciones paracurar (1.34 y 1.12 respectivamente, p = 0.069), con rangos de 14 y 13 respectivamente. El dolor severo tras la inyección de tetraciclina requirió hacer un bloqueo espinal de pre-inyec-ción. Asimismo ocurrieron otras complicaciones (25% y 25.7% respectivamente, p = 0.94) y fueron triviales, con excepción de un caso de hematoceles crónicos tratado mediante orquiectomía en el grupo de tetraciclina. El fenol (5%) y la tetraciclina poseen igual eficacia como esclerosantes de los quistes escrotales idiopáticos, ya que logran una curación de casi 100% con el re-tratamiento, e igualan la eficacia de la cirugía...
Subject(s)
Humans , Male , Sclerotherapy/methods , Spermatocele/therapy , Phenol/pharmacology , Testicular Hydrocele/therapy , Tetracycline/pharmacology , Pain/chemically induced , Sclerotherapy/adverse effects , Spermatocele/complications , Phenol/administration & dosage , Testicular Hydrocele/complications , Sclerosing Solutions , Tetracycline/administration & dosage , Tetracycline/adverse effectsABSTRACT
En este trabajo presentamos una revisión de los hallazgos de la ecografía escrotal mostrando variantes anatómicas escrotales (dilatación de la rete testis, apéndices testiculares y epididimarios) que simulan enfermedad. Revisamos la patología escrotal agrupada semiológicamente incluyendo lesiones con calcio (escrotolitos, calcificación de la albugínea, microlitiasis testicular, calcificaciones epididimarias, neoplasias testiculares con calcificaciones), lesiones con contenido líquido (quistes de epidídimo, de la albugínea, testiculares, varicocele intratesticular, abscesos y hematomas testiculares, varicocele extratesticular con contenido ecogénico), lesiones nodulares sólidas de testículo (infartos y neoplasias) y lesiones difusas del testículo (linfoma, leucemia, hiperplasia linfoide, orquitis). Otra de las utilidades de la ecografía escrotal es considerar determinados hallazgos escrotales como marcadores de patología extraescrotal. Mostramos la asociación de neoplasias extraescrotales con varicocele derecho y varios casos de Burn-out tumor con neoplasia testicular in situ y sus hallazgos de RM, TC y PET. Se concluye que el conocimiento de la anatomía normal ecográfica, de los diferentes patrones de presentación de las lesiones y de los hallazgos escrotales que indican patología extratesticular ayudan en el manejo de los pacientes y pueden evitar cirugías innecesarias
We present a review of the scrotal ultrasound findings showing normal anatomic variants that may simulate scrotal pathology (rete testis dilatation, normal testicle and epididymis appendages). US patterns of the scrotal pathology may be classified as: calcified (scrotal and albuginea calcifications, microcalcifications, epididymis calcifications, testicular tumors with calcium), cystic appereance (intratesticular and echogenic varicocele, epididymis cysts, albuginea cysts, haematoma, abscess), solid nodular testicular lesions (infarct, neoplasm) and diffuse lesions (orchitis, lymphoid hyperplasia lymphoma, leukemia). Testicular ultrasound may be helpful in detecting extraescrotal pathologies. There is a known relationship between right varicocele and extratesticular neoplasms. We also show some cases of Burn-out testicular tumor and their MR, CT and PET findings. The knowledge of normal US scrotal anatomy, US patterns of the scrotal lesions and scrotal findings that suggest extratesticular pathologies are crucial in the management of testicular pathology and if unnecessary orchiectomies want to be avoided
Subject(s)
Male , Humans , Scrotum/surgery , Scrotum , Castleman Disease/complications , Calcinosis/complications , Calcinosis/diagnosis , Varicocele/complications , Testicular Hydrocele/complications , Testicular Hydrocele/diagnosis , Testicular Neoplasms/complications , Testicular Neoplasms/diagnosis , Scrotum/pathology , Hyperplasia/complications , Hyperplasia/diagnosis , Ureteral Calculi/complications , Ureteral Calculi/diagnosis , Ureteral Calculi/surgery , Lithiasis/complicationsABSTRACT
Introducción. La ascitis quilosa es una entidad infrecuente que en raras ocasiones se diagnostica prenatalmente. Aunque la linfangiectasia intestinal se menciona como una de las causas de ascitis quilosa, en la práctica es difícil llegar a objetivar esta relación. Caso clínico. Se presenta el caso de un lactante diagnosticado prenatalmente de ascitis fetal e hidrocele por ecografía. Tras el parto se aprecian edemas generalizados, ascitis e hidrocele. La paracentesis muestra líquido de características quilosas. La biopsia yeyunal encuentra dilatación de los linfáticos con atrofia de vellosidades. Se instaura dieta mediante fórmula con aporte de lípidos como triglicéridos de cadena media, con lo que se consigue desaparición paulatina de la ascitis y el hidrocele. Conclusiones. Aunque lo más habitual es que se manifieste como una enteropatía con pérdida de proteínas, la linfangiectasia intestinal primaria suele considerarse parte de un trastorno que incluye todo el sistema linfático, lo cual explicaría su presentación como ascitis quilosa congénita (AU)
Chylous ascites is an infrequent entity that is rarely diagnosed in utero. Although intestinal lymphangiectasia is mentioned as one of the causes of chylous ascites, actually it is difficult to detect this relation. Clinical case. We report a case of an infant diagnosed in utero by ultrasonography of fetal ascites and hydrocele. Physical examination after birth was significant for generalized oedema, ascites, and hydrocele. Aparacentesis yielded liquid of chylous characteristics. Duodenal biopsy showed dilated lymphatics and villous atrophy. Aformula containing most lipids as medium chain triglycerides resulted in a paulatine cessation of ascites and hydrocele. Conclusions. Primary intestinal lymphangiectasia usually manifests as a protein-losing enteropathy, but it is also considered as part of a congenital disorder of the lymphatic system as a whole. This may explain its presentation as congenital chylous ascites (AU)
Subject(s)
Male , Infant , Humans , Lymphangiectasis, Intestinal/congenital , Chylous Ascites/congenital , Lymphangiectasis, Intestinal/complications , Ultrasonography, Prenatal , Chylous Ascites/complications , Testicular Hydrocele/complicationsABSTRACT
Presentamos el caso de un varón de 47 años diagnosticado meses antes de hidrocele izquierdo que en estudio sonográfico reciente, realizado por dolorimiento testicular, presentaba lesión sólida nodular sugestiva de neoplasia testicular izquierda. Fue sometido a orquiectomía radical. El análisis de la pieza quirúrgica demostró la presencia de infarto segmentario con ausencia de tumor. Revisamos la bibliografía sobre el tema
We report the case of a 47 years old man previously diagnosed of left hidrocele. After having a recent mild left testicular pain, an ultrasonografic study revealed a solid hipoecoic testicular lesion rounded by a big hidrocele, suggesting a testicular neoplasm. Radical inguinal orchiectomy was made and pathologic study showed segmental testicular infarction. No malignancy was found. We review the literature of the topic
Subject(s)
Male , Middle Aged , Humans , Infarction/diagnosis , Testicular Diseases/diagnosis , Testicular Hydrocele/complications , Orchiectomy , Testicular Neoplasms/diagnosisABSTRACT
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Subject(s)
Female , Male , Child , Humans , Hernia, Inguinal/complications , Hernia, Inguinal/diagnosis , Phimosis/complications , Phimosis/diagnosis , Cryptorchidism/complications , Cryptorchidism/diagnosis , Hernia, Umbilical/complications , Hernia, Umbilical/diagnosis , Nevus/complications , Nevus/diagnosis , Pilomatrixoma/complications , Varicocele/complications , Testicular Hydrocele/complications , Testicular Hydrocele/diagnosis , Hemangioma/complications , Granuloma, Pyogenic/complications , Granuloma, Pyogenic/diagnosis , Granuloma, Pyogenic/pathology , Labial Frenum/physiopathology , Fistula/complications , Cysts/complications , Epidermal Cyst/complications , Epidermal Cyst/physiopathology , Ranula/complications , Hernia/complications , Polydactyly/complications , Syndactyly/complications , Hypospadias/complications , Hypospadias/diagnosisABSTRACT
Se revisaron los expedientes de 34 pacientes con 38 hidroceles testiculares, con edades comprendidas entre los 20 y 70 años, que se trataron en el servicio en que trabajan los autores por cirugía abierta y seguimiento durante un periodo promedio de 10 meses. Se produjeron 23.5 por ciento de complicaciones en total, la más frecuente la orquiepididimitis (11.7 por ciento); le siguieron recaídas en 8.8 por ciento y hematomas en 2.9 por ciento
Subject(s)
Humans , Male , Adult , Middle Aged , Postoperative Complications/etiology , Reoperation , Testicular Hydrocele/complications , Testicular Hydrocele/surgeryABSTRACT
Fueron revisadas 201 historias clínicas con diagnóstico de espina bífida de las cuales, 25 ameritaron evaluación aftalmológica. De ellas, 19 presentaron transtornos en la motilidad ocular como complicación de la hidrocefalia (endotropias 52%, exotropias 8%, nistagmus 8%) presentó algún grado de atrofia óptica
Subject(s)
Humans , Spinal Dysraphism/complications , Testicular Hydrocele/complicationsABSTRACT
Hydrocoele, a common problem in Guyana, is regarded as mainly of nuisance value. We therefore investigated the effects of hydrocoele on seminal fluid analyses of patients (20-48 yrs) who had bilateral hydrocoele for 6 months to eight years. Three separate preoperative masturbation specimens were collected into glass jars and analysed within one hour from eight patients. Similar specimens were analysed within 3 months and after 3 months of Lord's repair of their hydrocoeles. The quantity of fluid at operation was measured. In five patients where each sac contained more than 100 ml (125-825 ml), the sperm count was consistently less than 20 million/ml and motility was less than 50 percent. The lowest counts and motility were seen in patients with long-standing hydrocoeles. In three patients, one of the two sacs contained less than 25 ml. The sperm count averaged 70 million/ml and motility was approximately 60 percent. Cross seminal fluid volume was similar in the two groups. Seminal analysis returned to preoperative or improved levels within 3 months. These findings suggest that hydrocoele is a potential cause of infertility and that early operation may preserve spermatogenesis (AU)