RESUMEN
Acquired undescended testes were once considered a sporadic disease. In recent years, reports suggest that they are not uncommon, with an incidence rate about 3 times that of congenital undescended testes. The etiology of acquired undescended testes remains inconclusive, clinical diagnostic standards are unclear, and treatment approaches are still controversial. There is ongoing debate about the mechanism of testicular ascent. The prevailing view is that acquired undescended testes occur due to the partial absorption of the gubernaculum, which forms part of the parietal peritoneum. The residual gubernacular fibers continuously pull on the spermatic cord, preventing the spermatic cord from elongating proportionately to somatic growth, leading to a re-ascent of the testis. Acquired undescended testes may increase the risk of testicular cancer, but this is still debated. The preferred treatment method is also controversial. However, surgical fixation has an immediate effect; no studies have proven that early surgery improves fertility in patients. The etiology of acquired undescended testes is closely related to the continuous pull of the residual gubernacular fibers on the spermatic cord, which prevents the cord from extending proportionately to body growth. There are no clear diagnostic standards for acquired undescended testes yet, and spontaneous descent is possible, so testicular fixation surgery may not be the preferred treatment method.
Asunto(s)
Criptorquidismo , Humanos , Masculino , Criptorquidismo/terapia , Criptorquidismo/diagnóstico , Criptorquidismo/etiología , Testículo , OrquidopexiaRESUMEN
PMDS (persistent Müllerian duct syndrome) is a rare disorder of sex development characterised by the presence of Müllerian duct remnants in a phenotypically male individual with a 46XY karyotype. Radiological investigations play a crucial role in diagnosing and characterising this condition. Ultrasound and MRI are the modalities of choice. They help to non-invasively localise the gonads and Müllerian duct derivatives. Broadly, PMDS has two anatomical variants: male type and female type. The case report presented here does not fit into these classically described variants and can be called a variant of the female type. There is a risk of infertility and malignant transformation of undescended testis and Müllerian duct derivatives in cases of PMDS. Hence, management is focused on preventing these risks. Surgical intervention involves orchidopexy, removal of Müllerian duct derivatives and inguinal hernia repair.
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Criptorquidismo , Trastorno del Desarrollo Sexual 46,XY , Hernia Inguinal , Humanos , Hernia Inguinal/cirugía , Hernia Inguinal/complicaciones , Hernia Inguinal/diagnóstico , Masculino , Criptorquidismo/cirugía , Criptorquidismo/diagnóstico , Criptorquidismo/complicaciones , Trastorno del Desarrollo Sexual 46,XY/cirugía , Trastorno del Desarrollo Sexual 46,XY/diagnóstico , Trastorno del Desarrollo Sexual 46,XY/complicaciones , Orquidopexia/métodos , Conductos Paramesonéfricos/anomalías , Conductos Paramesonéfricos/cirugíaRESUMEN
Undescended testis is the most common genital disorder identified at birth. Boys who do not have spontaneous descent of the testis at 6 months of age, adjusted for gestational age, should be referred to pediatric urology for timely orchiopexy. Retractile testes are at risk for secondary ascent of the testes and should be monitored by physical examination annually. If there is concern for ascent of the testis, pediatric urology referral is recommended. Most cases of phimosis can be managed medically with topical corticosteroids and manual retraction of the foreskin.
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Criptorquidismo , Fimosis , Humanos , Masculino , Criptorquidismo/terapia , Criptorquidismo/diagnóstico , Criptorquidismo/cirugía , Fimosis/terapia , Fimosis/diagnóstico , Niño , Orquidopexia , Lactante , Recién Nacido , PreescolarRESUMEN
This study aims to explore the optimal management strategy for pediatric vanishing testes syndrome (VTS) based on pathological characteristics. We retrospectively analyzed clinical data and pathological results of children with unilateral VTS who underwent surgical treatment at our center from July 2012 to July 2023. The children were categorized into the testicular excision group and testicular preservation group based on the surgical approach. Clinical characteristics and outcomes were compared between the two groups. Pathological examination results of excised testicular tissues were collected and analyzed, and long-term follow-up was conducted. A total of 368 children were included in this study. The age of the children at the time of surgery was 27 months (range, 6-156). Among them, 267 cases (72.6%) had VTS on the left side, and 101 cases (27.4%) on the right side. There were no statistically significant differences (P > 0.05) in age, affected side, contralateral testicular hypertrophy (CTH), testicular location, and preferred surgical incision between the testicular excision group (n = 336) and the testicular preservation group (n = 32). In the preservation group, two children experienced scrotal incision infections, showing a statistically significant difference compared to the excision group (P < 0.05). Pathological examination of excised tissues revealed fibrosis as the most common finding (79.5%), followed by vas deferens involvement (67%), epididymis involvement (40.5%), calcification (38.4%), and hemosiderin deposition (17.9%). Seminiferous tubules (SNT) was present in 24 cases (7.1%), germ cells (GC)in 15 cases (4.5%), and ectopic adrenal cortical tissue(EACT) in 1 case (0.3%). VTS belongs to a type of non-palpable testes (NPT) and requires surgical exploration. Considering the risk of scrotal incision infection after preserving atrophic testicular remnants and the unpredictable malignant potential, we recommend excision.
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Testículo , Humanos , Masculino , Estudios Retrospectivos , Preescolar , Niño , Testículo/cirugía , Testículo/patología , Lactante , Adolescente , Criptorquidismo/cirugía , Criptorquidismo/diagnóstico , Criptorquidismo/patologíaRESUMEN
BACKGROUND: Cryptorchidism is a condition in which one or both of a baby's testicles do not fully descend into the bottom of the scrotum. Newborns with cryptorchidism are at increased risk of developing infertility later in life. The aim of this study was to develop a novel diagnostic model for cryptorchidism and to identify new biomarkers associated with cryptorchidism. METHODS: The study data were obtained from RNA sequencing data of cryptorchid patients from Nantong University Hospital and the Gene Expression Omnibus (GEO) database. Differential expression analysis was used to obtain differentially expressed genes (DEGs) between the control and cryptorchid groups. These DEGs were analyzed for their functions by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment using GSEA software. Random Forest algorithm was used to screen central genes based on these DEGs. Neuralnet software package was used to develop artificial neural network models. Based on clinical data, receiver operating characteristic (ROC) was used to validate the models. Single-cell sequencing analysis was used for the pathogenesis of cryptorchidism. RESULTS: We obtained a total of 525 important DEGs related to cryptorchidism, which are mainly associated with biological functions such as supramolecular complexes and microtubule cytoskeleton. Random forest approach screening obtained eight hub genes. A neural network based on the hub genes showed a 100% success rate of the model. Finally, single-cell sequencing analysis validated the hub genes. CONCLUSION: We developed a novel diagnostic model for cryptorchidism using artificial neural networks and validated its utility as an effective diagnostic tool.
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Criptorquidismo , Recién Nacido , Lactante , Masculino , Humanos , Criptorquidismo/diagnóstico , Criptorquidismo/genética , Aprendizaje Automático , Bases de Datos Factuales , Ontología de GenesRESUMEN
We report a case of testicular torsion in an 8-year-old who was referred to our hospital for right groin pain. He was diagnosed with right retractile testis during a 12-month check-up. However, instead of performing orchiopexy, he was placed under observation until the age of 5, after which he did not seek medical attention. Physical examination revealed swelling and tenderness in the right inguinal region and no palpable testis in the right scrotum. Ultrasound and computed tomography revealed right testicular torsion, and emergency surgery was performed. Intraoperative findings revealed a dark and ischemic testis that was twisted at 180°in the right inguinal region. There was no improvement in blood flow even after the testicular torsion was released; therefore, right orchidectomy with left orchiopexy was performed. Although the incidence of testicular torsion is higher in patients with an undescended testis than in those with a normally positioned scrotal position testis, reports of testicular torsion associated with a retractile testis are rare.
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Criptorquidismo , Torsión del Cordón Espermático , Enfermedades Testiculares , Masculino , Humanos , Niño , Torsión del Cordón Espermático/cirugía , Testículo , Orquiectomía , Enfermedades Testiculares/cirugía , Criptorquidismo/complicaciones , Criptorquidismo/diagnóstico , Criptorquidismo/cirugíaAsunto(s)
Angiolipoma , Criptorquidismo , Neoplasias Testiculares , Testículo , Humanos , Masculino , Criptorquidismo/diagnóstico , Criptorquidismo/patología , Criptorquidismo/cirugía , Neoplasias Testiculares/patología , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/cirugía , Neoplasias Testiculares/diagnóstico por imagen , Testículo/patología , Testículo/diagnóstico por imagen , Angiolipoma/patología , Angiolipoma/diagnóstico , Angiolipoma/cirugíaRESUMEN
BACKGROUND: There are few studies on cryptorchidism in adults, and its treatment is still controversial. METHODS: To summarize the surgical strategy and clinical efficacy of laparoscopic orchidopexy for the treatment of cryptorchidism in adults, 37 adult cryptorchidism patients were retrospectively analyzed between September 2017 and February 2022. All 37 patients underwent laparoscopic orchidopexy, of whom 33 underwent inguinal hernia repair without tension. The intraoperative procedures and surgical techniques were recorded in detail. Preoperative examination and regular postoperative review of color Doppler ultrasound, and reproductive hormone, alpha-fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase levels were performed. RESULTS: All testes descended successfully into the scrotum, including 25 through the inguinal route and 12 through Hesselbach's triangle route. No intraoperative or postoperative complications were observed. The follow-up time was 38.6 (± 19.4) months, and no evidence of testicular malignancy was found during the follow-up period. After analyzing the reproductive hormone levels at 1 year postoperatively in 28 patients with more than 1 year of follow-up, it was found that the patients had a significant increase in testosterone levels and a decrease in follicle-stimulating hormone levels after surgery. None of the patients showed any significant improvement in semen quality after surgery. CONCLUSION: Our study suggests that laparoscopic orchidopexy is a safe and feasible surgical procedure for the treatment of cryptorchidism in adults, especially high cryptorchidism, which is difficult to treat. After comprehensive consideration, preserving the testis should be preferred for treating cryptorchidism in adults to maximize the protection of the patient's reproductive hormone secretion function.
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Criptorquidismo , Laparoscopía , Masculino , Humanos , Lactante , Criptorquidismo/cirugía , Criptorquidismo/diagnóstico , Orquidopexia/métodos , Estudios Retrospectivos , Análisis de Semen , Laparoscopía/métodos , Testículo , Resultado del Tratamiento , HormonasRESUMEN
Abnormalities of the bovine scrotum and testes are an important cause of infertility. Proper evaluation of the male reproductive system is a critical first step in screening for such abnormalities. Excessive periscrotal fat, cutaneous scrotal defects, and unilateral scrotal swelling are common deformities that warrant further investigation. Early diagnosis and surgical intervention are often needed to restore reproductive soundness. This article reviews these conditions and provides therapeutic modalities.
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Enfermedades de los Bovinos , Criptorquidismo , Infertilidad , Masculino , Animales , Bovinos , Escroto/anomalías , Escroto/cirugía , Criptorquidismo/diagnóstico , Criptorquidismo/cirugía , Criptorquidismo/veterinaria , Infertilidad/veterinaria , Reproducción , Enfermedades de los Bovinos/diagnósticoRESUMEN
No disponible
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Humanos , Masculino , Preescolar , ADN Mitocondrial/genética , Genoma Mitocondrial/genética , Criptorquidismo/diagnóstico , Hiperamonemia/diagnóstico , Hiperamonemia/genética , Discapacidades del Desarrollo/complicaciones , Ubiquinona/uso terapéutico , Carnitina/uso terapéuticoRESUMEN
La patología testicular supone una parte principal del día a día del cirujano pediátrico. tanto por su frecuencia como por su morbilidad es muy importante prestar la debida atención a la patología, tanto malformativa como adquirida (aguda y crónica), del testículo en el niño. la criptorquidia o ausencia de teste en el escroto es la malformación genitourinaria más frecuente. Se trata de una malformación asintomática de cuyo adecuado manejo y corrección precoz va a depender el pronóstico del teste, así como el riesgo de malignización en la edad adulta. la torsión testicular es un evento agudo que consiste en el giro sobre sí mismo del órgano, comprimiendo el pedículo y comprometiendo el aporte sanguíneo al teste, que si se mantiene en el tiempo conduce a una necrosis testicular. el pronto reconocimiento de este cuadro dentro del síndrome de escroto agudo será vital para conseguir corregir la torsión e impedir la pérdida de la gónada. El varicocele se define como una dilatación varicosa de las venas del plexo pampiniforme a nivel del cordón espermático. puede ser asintomático o generar molestias. Su efecto sobre la fertilidad no está completamente esclarecido y las indicaciones quirúrgicas, al igual que la técnica idónea son asuntos sujetos a controversia. en el presente texto se repasan los conceptos referentes a estos temas, actualizando las recomendaciones de diagnóstico y manejo
Testicular pathology occupies the main part of the day to day work of the pediatric surgeon. Both because of its frequency as well as its morbidity, it is very important to pay attention to the malformative and acquired (acute and chronic) pathology of the testis in the boy. Cryptorchidism or absence of the testis in the scrotum is the most frequent genitourinary malformation. this is an asymptomatic malformation whose adequate management and early correction will depend on the prognosis of the testis and the risk of malignization in the adult age. testicular torsion is an acute event that consists in the twisting of the organ on itself, with compression of the testicular pedicle, affecting the blood supply to the testis. if this is maintained over time, it leads to a testicular necrosis. early recognition of this picture within the acute scrotum syndrome will be vital to be able to correct the torsion and prevent loss of the gonad. Varicocele is defined as a varicose dilation of the pampiniform plexus on the level of the spermatic cord. it can be asymptomatic or generate discomfort. Its effect on fertility has not been completely clarified and the surgical indications and the best treatment are matters subject to controversy. in the present text, the concepts regarding these subjects are reviewed, updating the recommendations for diagnosis and management
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Humanos , Masculino , Recién Nacido , Lactante , Preescolar , Niño , Criptorquidismo , Escroto/patología , Varicocele , Criptorquidismo/diagnóstico , Criptorquidismo/epidemiología , Criptorquidismo/terapia , Enfermedad Aguda , Varicocele/diagnóstico , Varicocele/epidemiología , Varicocele/terapia , PronósticoRESUMEN
El síndrome de Prader-Willi debe formar parte del diagnóstico diferencial en los casos de hipotonía de presentación neonatal de origen central, especialmente cuando se acompaña de otras características clínicas típicas de la enfermedad. La importancia de su diagnóstico precoz, ya sea en el ámbito hospitalario o desde las consultas de Atención Primaria, reside tanto en la necesidad de instaurar una adecuada estimulación y fisioterapia por parte de los Servicios de Atención Temprana como de un correcto soporte nutricional en los que debutan con trastorno importante de succión. Así mismo es importante ofrecer un correcto consejo genético para planificar futuras gestaciones. Presentamos el caso clínico de un recién nacido con hipotonía de presentación neonatal junto con criptorquidia bilateral y fenotipo peculiar, en el que se confirmó, mediante estudio genético, el diagnóstico de sospecha de síndrome de Prader-Willi (AU)
Prader-Willi syndrome should be part of the differential diagnosis in cases of central neonatal hypotonia, especially when accompanied by other typical clinical features of the disease. The importance of an early diagnosis, either in hospital or in primary care center lies both in the need to establish an early care and nutritional support, which will improve the quality of life of patients suffering from this syndrome, and genetic counselling that should be made to parents of affected children to plan future pregnancies. We present the case of a new-born with neonatal hypotonia, bilateral cryptorchidism and peculiar phenotype, in which the suspected diagnosis of Prader-Willi syndrome was confirmed by genetic study. We also present a review of the etiology, phenotypic findings and clinical course over the stages of life, management and prognosis of the entity (AU)
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Humanos , Masculino , Recién Nacido , Síndrome de Prader-Willi/diagnóstico , Síndrome de Prader-Willi/genética , Hipotonía Muscular/diagnóstico , Criptorquidismo/complicaciones , Criptorquidismo/diagnóstico , Diagnóstico Precoz , Atención Primaria de Salud , Servicios de Salud del Niño , Diagnóstico Diferencial , Criptorquidismo/genéticaRESUMEN
OBJETIVO: Establecer las características clínico epidemiológicas de criptorquidia en pacientes internados en los meses de septiembre a diciembre de 2016 DISEÑO: estudio descriptivo y prospectivo donde se realizó la recolección de datos de una serie de casos de pacientes internados con criptorquidia LUGAR: Hospital del Niño "Dr. Ovidio Aliaga Uría" (La Paz- Bolivia) MÉTODOS: Se incluyeron 64 pacientes de edades entre 1 y 10 años. Se realizó una entrevista estructurada a los padres aplicando un instrumento precodificado, previo consentimiento verbal. Luego se realizó una revisión del expediente clínico para completar datos. Se ingresó los datos a una base Excel, se procedió al análisis de los mismos a través del uso de la estadística descriptiva. RESULTADOS: El rango de edad de tratamiento fue 1 año a 10 años y 2meses, con promedio de 3 años y 8 meses; la edad al momento del diagnóstico en promedio fue 2 años y 9 meses. El tiempo transcurrido entre diagnóstico y tratamiento fue 11 meses. La criptorquidia derecha fue más frecuente con 53%. El hallazgo diagnóstico se realizó en primera instancia por un familiar en 28% y en 72% por un personal de salud. El 68% fue diagnosticado en el primer nivel, 9% en segundo y 23% en el tercero. CONCLUSIONES: La edad en la que se opera y diagnostica la criptorquidia en nuestro medio no está dentro de las recomendaciones americanas y europeas.
OBJECTIVE: To establish the clinical epidemiological characteristics of cryptorchidism in hospitalized patients from September to December 2016 DESIGN: descriptive and prospective study where the data collection of a series of inpatient cases with cryptorchidism PLACE: Hospital del Niño "Dr. Ovidio Aliaga Uría "(La Paz- Bolivia) METHODS: We included 64 patients aged 1 to 10 years. A structured interview was conducted with parents using a pre-coded instrument, with prior verbal consent. A review of the clinical file was completed to complete data. The data were entered into an Excel database, and the analysis was performed through the use of descriptive statistics. RESULTS: The age range of treatment was 1 year to 10 years and 2 months, with an average of 3 years and 8 months; The average age at diagnosis was 2 years and 9 months. The time elapsed between diagnosis and treatment was 11 months. The most common type of cryptorchidism was the right one with 53%. The diagnostic finding was made in the first instance by a relative in 28% and in 72% by a health personnel. 68% were diagnosed in the first level, 9% in the second and 23% in the third. CONCLUSIONS: The age at which cryptorchidism is operated and diagnosed in our country is not within the American and European recommendations.
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Criptorquidismo/diagnóstico , Pediatría/estadística & datos numéricos , Cómputos Matemáticos , Criptorquidismo/cirugíaRESUMEN
Background: Nonpalpable undescended testes (NPT) constitute 20%30% of undescended testes, and its management has been a challenge both in diagnosis and treatment. Worldwide, laparoscopy is the current gold standard of management. In Nigeria, the management of NPT has largely been by open surgery with consequent high morbidity. In Nigeria, the trend is changing from a largely open management with its attendant high morbidity, to laparoscopic management which is the current worldwide gold standard of care. Aim: This study aims to classify the laparoscopic features of NPT and determine the outcome of managed cases in our center. Methodology: Prospective data were collected from consecutive patients who had laparoscopy for NPT at the Paediatric Surgical Unit of Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria from June 2014 to July 2016. Results: A total of 15 patients with 23 testes were treated. There were eight patients with bilateral NPT; four had left and the remaining three right NPT. The age ranged from 1.2 to 29 years with a median of 5 years. Eleven out of the 22 internal inguinal rings were open. The position of the testes was canalicular (2), peeping (2), low abdominal (6), high abdominal (6), blind-ended vas (1), absent vas and vessels (5). No further intervention was needed for the six agenetic/atrophic testes. Standard open orchiopexy was done for the two canalicular testes. Eight testes were brought down by one stage laparoscopic orchiopexy while four were brought down by staged laparoscopic Fowler-Stephens procedure. Laparoscopic orchiectomy was done in two patients (a grossly dysmorphic testes [nubbin] and a high abdominal testis in a 29-year-old). Orchiopexy was successful in 11 out of 15 fixed testes. Of the unsuccessful ones, three testes were atrophic (volume less than what it was initially) while two were high scrotal (one testes has both complications). There was no conversion to open abdominal surgery. All patients were discharged within 24 h of surgery.Conclusion: Laparoscopy provides for a better management of NPT by combining diagnosis and intervention in the same sitting with a good success rate and minimal postoperative morbidity
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Criptorquidismo/diagnóstico , Criptorquidismo/cirugía , Laparoscopía , Nigeria , PalpaciónRESUMEN
OBJETIVO: Es presentar un estudio retrospectivo, descriptivo y observacional realizado sobre un grupo de pacientes diagnosticados de testículo no descendido palpable (TNDP) y tratados quirúrgicamente mediante la incisión para-escrotal, técnica 'Bianchi'. MÉTODOS: La muestra está formada por un grupo de pacientes de entre 6 y 168 meses de edad, diagnosticados de testículo no descendido palpable y tratados mediante orquidopexia a través de incisión para-escrotal tipo Bianchi (4), desde enero de 2008 a junio de 2015 por el Equipo de Urología Pediátrica de Málaga, al que los autores pertenecen. Para formar parte de la muestra los pacientes debían de cumplir los siguientes criterios: sexo masculino, diagnóstico de TNDP, edad mayor de 6 meses y tiempo mínimo de seguimiento postoperatorio de 6 meses. RESULTADOS: La muestra la componen 200 testículos y 157 pacientes diagnosticados de TNDP, con edades comprendidas entre los 6 y 168 meses y tratados por los mismos cirujanos principales. En un 72,62% de los pacientes la anomalía fue unilateral. De los 200 testículos intervenidos, un 51,5% presentaba el TNDP en el lado derecho. Localizándose el teste no descendido en un 64,5% de los casos en el conducto inguinal, un 22,5% en el conducto inguinal superficial y un 13% en el profundo. No hubo complicaciones significativas si bien se registraron un 4,5% de complicaciones leves que no requirieron tratamiento (hematoma cutáneo escrotal, 2,5%; edema cutáneo escrotal, 1,5% y dehiscencia cutánea parcial, 0,5%). Con respecto al estado de la cicatriz, en un 15,5% no se visualizaba, 16% excelente, muy bien 12,5% y sólo en 1% presentaron un aspecto algo hipertrófico. CONCLUSIONES: Es una técnica de sencilla ejecución y fácilmente reproducible, que presenta buenos resultados, mínimas complicaciones quirúrgicas. Sus resultados a medio y largo plazo son excelentes y con magnífico aspecto estético
OBJECTIVE: To present a retrospective, descriptive and observational study performed on a group of patients diagnosed with palpable undescended testicle (PUT) and surgically treated by pre-scrotal access, the 'Bianchi technique'. METHODS: The sample consists of a group of patients from 6 to 168 months old, diagnosed with palpable undescended testicle and treated by orchidopexy through pre-scrotal access Bianchi type (4), from January 2008 to June 2015 by the Pediatric Urology Equipment of Malaga, where the authors belong. To be part of the sample, the patients must meet the following requirements: male, diagnosis PUT, older than 6 months old and a minimum of 6 months of postoperative follow. RESULTS: The sample is comprised of 200 testicles and 157 patients diagnosed with PUT, aged between 6 and 168 months old and treated by the same main surgeons. In a 72.62% of the patients the anomaly was unilateral. From the 200 testicles intervened, a 51.5% had PUT on the right side. Localization of the undescended testis was in the inguinal canal in a 64.5% of cases, 22.5% in the superficial inguinal canal and a 13% in the deep one. There weren't significant complications but in 4.5% of the cases there were minor complications that did not require treatment (cutaneous scrotal hematoma, 2.5%; scrotal skin edema, 1.5%, and partial dehiscence, 0.5%). Regarding the state of the scar, in 15.5% it's not visible, in 16% excellent, very good in 12.5% and only 1% had a bit of an hypertrophic aspect. CONCLUSIONS: This is a easy technique, which presents good surgical results, with minimum surgical complications, its short, medium and long term results are excellent and with a great aesthetic appearance
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Humanos , Masculino , Lactante , Preescolar , Criptorquidismo/diagnóstico , Criptorquidismo/cirugía , Procedimientos Quirúrgicos Urológicos/instrumentación , Procedimientos Quirúrgicos Urológicos/métodos , Orquidopexia/instrumentación , Orquidopexia/métodos , Orquidopexia , Escroto/patología , Escroto/cirugía , Estudios Retrospectivos , Estudios de Seguimiento , Cuidados Posoperatorios/métodosRESUMEN
PURPOSE: Testicular microlithiasis (TM) is a relatively rare clinical entity of controversial significance characterized by the existence of hydroxyapatite microliths located in the seminiferous tubules. The aim of this study was to observe the natural course of changes in the calcific density of pediatric TM. MATERIALS AND METHODS: We included a total of 23 TM patients undergoing scrotal ultrasound (US) on at least two occasions from July 1997 to August 2014. We retrospectively analyzed the patient characteristics, clinical manifestations, specific pathological features, and clinical outcomes. We measured the calcified area and compared the calcific density between the initial and final USs. RESULTS: The mean age at diagnosis was 11.3+/-4.6 years, and the follow-up period was 79.1+/-38.8 months (range, 25.4-152.9 months). During the follow-up period, no patients developed testicular cancer. Calcific density on US was increased in the last versus the initial US, but not to a statistically significant degree (3.74%+/-6.0% vs. 3.06%+/-4.38%, respectively, p=0.147). When we defined groups with increased and decreased calcification, we found that diffuse TM was categorized into the increased group to a greater degree than focal TM (10/20 vs. 4/23, respectively, p=0.049). In addition, five of eight cases of cryptorchidism (including two cases of bilateral cryptorchidism) were categorized in the increased calcification group. CONCLUSIONS: Diffuse TM and cryptorchidism tend to increase calcific density. Close observation is therefore recommended for cases of TM combined with cryptorchidism and cases of diffuse TM.
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Adolescente , Niño , Humanos , Masculino , Calcificación Fisiológica , Cálculos/complicaciones , Criptorquidismo/diagnóstico , Densitometría/métodos , Estudios de Seguimiento , Gonadoblastoma/diagnóstico , República de Corea , Escroto/diagnóstico por imagen , Túbulos Seminíferos/patología , Enfermedades Testiculares/complicaciones , Neoplasias Testiculares/diagnósticoRESUMEN
INTRODUCTION:L'ectopie testiculaire est frequente. Le diagnostic et la prise en charge precoces sont necessaires a cause des risques d'atrophie; de cancerisation; de subfertilite; et les consequences psychologiques en rapport avec l'absence d'un testicule dans une bourse. Cette prise en charge est tardive dans notre milieu. Le but de ce travail etait d'etudier les facteurs interferant avec cette prise en charge. MeTHODOLOGIE Nous avons revu 172 dossiers des patients operes d'ectopie testiculaire de 1999 a 2012. Nous avons etudie l'age au moment de l'operation; la qualification de la personne ayant assure l'accouchement; les facteurs interferant avec la prise en charge et les resultats de cette prise en charge. ReSULTATS L'age des patients au moment de la chirurgie variait de 1 a 48 ans; avec une moyenne de 8 ans. Seuls 21 patients avaient ete operes dans les delais recommandes. L'information medicale avait ete erronee ou insuffisante dans 93 cas. L'on retrouvait la peur de l'operation dans 42 cas; les problemes financiers dans 14 cas; l'ignorance des parents dans 7 cas. CONCLUSION Le manque d'information des soignants ou des parents; la peur de l'operation et le manque de moyens financiers sont les principales causes de delai dans la prise en charge de l'ectopie testiculaire. Ce travail fait ressortir la responsabilite du personnel de sante dans le la prise en charge precoce de l'ectopie testiculaire
Asunto(s)
Informes de Casos , Criptorquidismo/diagnóstico , Manejo de la Enfermedad , TestículoRESUMEN
O presente trabalho consiste no primeiro relato de criptorquidismo em uma jaguatirica, adulta, de vida livre. Para a captura foram empregadas armadilhas com desarme de guilhotina, usando como isca vísceras de bovino. O animal foi contido quimicamente por meio de dardos anestésicos e mantido sob anestesia, utilizando a associação de cloridrato de quetamina e cloridrato de xilazina. Durante o exame andrológico, observou-se que o testículo esquerdo localizava-se subcutâneo, próximo à região inguinal, caracterizando-se criptorquidismo unilateral. Esse testículo apresentava-se flácido, com volume de 2,57mL, enquanto o testículo contralateral apresentava consistência firme e volume de 11,50mL. A área ocupada pelas espículas penianas mostrou-se compatível com a de animais reprodutores. O criptorquidismo é uma condição hereditária ligada à baixa variabilidade genética, já relatada em felinos silvestres consanguíneos. Nesse sentido, devido ao crescente isolamento populacional em fragmentos florestais, este achado torna-se preocupante, uma vez que pode ser indicativo de endogamia em populações de jaguatiricas de vida livre.
This paper is the first report of unilateral cryptorchidism in an adult wildlife ocelot, captured in Parque Estadual do Rio Doce. Cage traps were used to capture the animal, using bovine offal as bait. The animal was anesthetized with anesthetic darts and kept under anesthesia through a combination of ketamine and xylazine. The andrologycal examination showed that the left testicle was located subcutaneously near the inguinal region. In this case of unilateral cryptorchidism, the testis was soft and had a volume of 2.57mL, while the contralateral testis had a firm consistency and volume of 11.50mL. The length of the region occupied by the penile spikes was similar to other breeding animals. Cryptorchidism is an inherited condition linked to low genetic variability previously reported in consanguineous wild cats. Due to the increasing isolation of wild population in forest fragments, this finding is concerning because it can be indicative of inbreeding in wild ocelot populations.
Asunto(s)
Criptorquidismo/diagnóstico , Criptorquidismo/veterinaria , Felidae/anomalías , Felidae/crecimiento & desarrollo , Anestesia , Anestesia/veterinariaRESUMEN
Background: The use of ultrasonography in the pre-operative localisation of undescended testes has become controversial due to fears about its accuracy. This study was designed to ascertain the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of ultrasonography in the localisation of the undescended testes in children. Patients and Methods: A prospective evaluation of all boys undergoing operation for undescended testes at the Lagos University Teaching Hospital, Idi-Araba, Lagos, over a 12 month period was performed. The pre-operative clinical and ultrasound findings were compared with the findings on surgical exploration. Results: Forty boys with 52 undescended testes were studied. The mean age of the boys at the time of surgery was 4.0 ± 0 years (range 1-11 years). Forty-six (88.5%) testes were localised pre-operatively by ultrasound- 20 of 22 (90.9%) palpable testes and 26 of 30 (86.7%) non-palpable testes. Intra-operatively, 49 (94.2%) of the undescended testes were found while 3 (5.8%) were absent/vanishing testes. Ultrasound evaluation had an accuracy of 86.5%, sensitivity of 89.8%, and specificity of 33.3%, PPV of 95.7% and a NPV of 16.7%. Conclusion: Ultrasound assessment is beneficial in pre-operative evaluation of children with undescended testes