[Testicular Microlithiasis: Update on diagnosis and management.] / Actualidades sobre microlitiasis testicular.

Testicular microlithiasis (TM) is an uncommonurologic condition incidentally diagnosed byscrotal ultrasound. It has been associated with differentdiseases, such as Klinefelter`s syndrome, testicular atrophy,cryptorchidism, testicular torsion, and infertility.However, it can also present in healthy males that haveno associated risk factors. Currently, TM is most oftendetected thanks to the superior resolution of today's ultrasoundequipment, compared with former models. In the1990s, TM was considered a benign condition with noimportant clinical relevance, but later reports associatedit with the development of testicular neoplasias andinfertility. Thus, many authors recommended periodic surveillance with tumor markers and ultrasound imaging,with some even promoting the use of testicular biopsy.The aim of this article is to clearly and specifically presentcurrent information about testicular microlithiasis, toestablish both diagnostic and follow-up indications.

La microlitiasis testicular (MT) es un padecimiento urológico poco frecuente que se diagnostica de forma incidental mediante ltrasonografía escrotal. Ha sido asociado a diversas enfermedades como síndrome de Klinefelter, atrofia testicular, criptorquidia, torsión testicular e infertilidad. Sin embargo, también se puede encontrar en varones sanos sin factores de riesgo asociados. La microlitiasis testicular es detectada con mayor frecuencia en la actualidad, debido a la resolución superior de los equipos de ultrasonido actuales en comparación a los anteriores.  En la década de los  noventa la MT fue considerada una condición benigna sin gran relevancia clínica. Sin embargo, reportes posteriores asociaron este padecimiento al desarrollo de neoplasias testiculares e infertilidad. Por tal motivo muchos autores recomendaban la vigilancia periódica con marcadores tumorales y ultrasonido, e incluso algunos preconizaban el uso de la biopsia testicular. El objetivo del presente articulo de revisión es exponer de manera clara y especifica la evidencia actual de la microlitiasis testicular para así establecer las pautas tanto diagnósticas como de seguimiento.

Actualidades sobre microlitiasis testicular / No disponible

La microlitiasis testicular (MT) es un padecimiento urológico poco frecuente que se diagnostica de forma incidental mediante ltrasonografía escrotal. Ha sido asociado a diversas enfermedades como síndrome de Klinefelter, atrofia testicular, criptorquidia, torsión testicular e infertilidad. Sin embargo, también se puede encontrar en varones sanos sin factores de riesgo asociados. La microlitiasis testicular es detectada con mayor frecuencia en la actualidad, debido a la resolución superior de los equipos de ultrasonido actuales en comparación a los anteriores. En la década de los noventa la MT fue considerada una condición benigna sin gran relevancia clínica. Sin embargo, reportes posteriores asociaron este padecimiento al desarrollo de neoplasias testiculares e infertilidad. Por tal motivo muchos autores recomendaban la vigilancia periódica con marcadores tumorales y ultrasonido, e incluso algunos preconizaban el uso de la biopsia testicular. El objetivo del presente articulo de revisión es exponer de manera clara y especifica la evidencia actual de la microlitiasis testicular para así establecer las pautas tanto diagnósticas como de seguimiento

Testicular microlithiasis (TM) is an uncommon urologic condition incidentally diagnosed by scrotal ultrasound. It has been associated with different diseases, such as Klinefelter's syndrome, testicular atrophy, cryptorchidism, testicular torsion, and infertility. However, it can also present in healthy males that have no associated risk factors. Currently, TM is most often detected thanks to the superior resolution of today’s ultrasound equipment, compared with former models. In the 1990s, TM was considered a benign condition with no important clinical relevance, but later reports associated it with the development of testicular neoplasias and infertility. Thus, many authors recommended periodic surveillance with tumor markers and ultrasound imaging, with some even promoting the use of testicular biopsy. The aim of this article is to clearly and specifically present current information about testicular microlithiasis, toestablish both diagnostic and follow-up indications

Comparison of three analgesic drug regimens with twelfth subcostal nerve block for pain control during extracorporeal shock wave lithotripsy.

INTRODUCTION AND OBJECTIVE: Extracorporeal shock wave lithotripsy (ESWL) is the first-line treatment in the majority of cases of upper urinary tract stones. Since its introduction, attempts have been made to establish the ideal accompanying analgesic method to enable the application of shock waves of adequate duration and intensity for efficacious stone fragmentation. An open, randomized, prospective, longitudinal, comparative, and experimental clinical study was conducted to evaluate the efficacy of subcostal nerve block with lidocaine, comparing it in combination with tramadol or diclofenac for pain control during ESWL. MATERIALS AND METHODS: Seventy patients of both sexes were included in the study. Thirty-five were men and 35 were women, all above 18 years of age, with kidney stones or ureteral stones smaller than 20 mm. The patients were randomly assigned to one of the following groups: Group 1 (24 patients) Twelfth subcostal nerve block with 10 ml of lidocaine 2%, 5 min before ESWL. Group 2 (25 patients) Twelfth subcostal nerve block with 10 ml lidocaine 2% + intramuscular diclofenac sodium 45 min before ESWL. Group 3 (21 patients) Twelfth subcostal nerve block with 10 ml of lidocaine 2% + tramadol at 1 mg/Kg of weight, 45 min before ESWL. The visual analog scale (VAS) for pain was applied at minutes 10, 20, and 30 of the procedure. RESULTS: No statistically significant differences were reported by the ANOVA test for comparing the mean pain values between the three groups at minutes 10, 20, and 30 of the ESWL. There were no adverse effects. CONCLUSIONS: Even though there were no statistically significant differences between the three groups, the analgesic regimen of twelfth subcostal nerve block with lidocaine 2%, alone, was as efficacious as its combination with other analgesics and therefore can be used as a sole analgesic method during ESWL.