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1.
Urologiia ; (6): 124-126, 2021 Dec.
Artigo em Russo | MEDLINE | ID: mdl-34967173

RESUMO

Gangrene of the penis is a rare condition manifesting with purulent necrotization of penile tissues and systemic inflammatory response. In more than 90% of cases, the cause of the development of the penile and scrotal gangrene is rapidly progressive necrotizing fasciitis of polymicrobial etiology, which predominantly affected the external genital organs. Isolated cases of penile gangrene development when using the restraining rings of the penis are described in literature (condom urine collection bag, rings for erection, etc.). Cases of penile and scrotum gangrene, when treatment with bilateral orchiectomy and penectomy is required are quite rare. We present the case of penlie and scrotum gangrene in an 86-year-old patient with mental disorders. The cause of gangrene was long-term forced position of the patient with infringement of the penis and scrotum by the thighs. Active intensive therapy, surgical removal of the penis, scrotum and testicles and urine diversion by the imposition of a trocar cystostomy saved the patients life and he was discharged from the hospital in a satisfactory condition.


Assuntos
Doenças dos Genitais Masculinos , Doenças do Pênis , Idoso de 80 Anos ou mais , Gangrena/cirurgia , Humanos , Masculino , Doenças do Pênis/cirurgia , Pênis/cirurgia , Escroto/cirurgia
2.
Khirurgiia (Mosk) ; (12): 118-121, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34941219

RESUMO

The authors report a rare disease at the junction of urology and cardiovascular surgery (arteriovenous malformation (AVM) of the scrotum). The options for correction of this disease are discussed. The authors describe the complications of natural course of disease and their treatment. Treatment strategy with AVM embolization is substantiated. Postoperative regression of symptoms is emphasized. The authors concluded safety and effectiveness of interventional correction of this disease.


Assuntos
Malformações Arteriovenosas , Embolização Terapêutica , Escroto/patologia , Malformações Arteriovenosas/diagnóstico , Malformações Arteriovenosas/terapia , Humanos , Masculino , Escroto/cirurgia
3.
Acta Chir Plast ; 63(3): 96-101, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34814690

RESUMO

BACKGROUND: Fournier's gangrene is necrotizing fasciitis of the genitalia, perineal and perianal region associated with a significant mortality rate. The potentially fatal disease is caused both by aerobic and anaerobic bacteria and primarily occurs in men. The majority of Fournier's gangrene cases is idiopathic or derived from perineal and genital skin infections. Early surgical debridement of necrotic tissues and antibiotics are fundamental. CASE: We report a rare case of Fourniers gangrene of a 57-year-old man secondary to circumcision. The patient presented due to painful swelling of the scrotum and perineum associated with high-grade fever. The patient received broad-spectrum antibiotics and underwent immediate surgical debridement; a total of five other debridements were performed during the recovery until the wounds healed. On a second recovery phase, we performed a penile reconstruction with full thickness skin graft with satisfactory cosmetic and functional results. CONCLUSION: FG remains an urgent condition associated with a high mortality rate, requiring immediate treatment. More statistical reports and standard guidelines are necessary to improve the rate of its survival.


Assuntos
Circuncisão Masculina , Gangrena de Fournier , Gangrena de Fournier/etiologia , Gangrena de Fournier/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Períneo , Escroto/cirurgia , Transplante de Pele
4.
J Med Case Rep ; 15(1): 512, 2021 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-34656174

RESUMO

INTRODUCTION: Basal cell carcinoma is the most common nonmelanotic skin cancer. It has variable clinical and histological subtypes that vary in their aggressiveness and liability to recurrence and metastasis. Chronic ultraviolet radiation exposure is considered to be the main risk factor for developing basal cell carcinoma; therefore, it typically arises on sun-exposed skin, mainly the head and neck. CASE PRESENTATION: We present the case of a 55-year-old Caucasian male who presented with a lesion on the scrotum for 2 years. The lesion was clinically presumed benign and initially treated with curettage. Microscopic examination revealed an incompletely resected micronodular basal cell carcinoma with sebaceous differentiation. Therefore, a second excisional biopsy was performed to completely excise the incidentally discovered malignant tumor. CONCLUSION: We report the first case of micronodular basal cell carcinoma arising on the scrotum. The goal of our article is to draw clinicians' attention to the possible involvement of unexposed skin with basal cell carcinoma, and we highlight the importance of accurate diagnosis and prompt treatment due to the aggressive nature of micronodular basal cell carcinoma.


Assuntos
Carcinoma Basocelular , Neoplasias Cutâneas , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma Basocelular/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Escroto/diagnóstico por imagem , Escroto/cirurgia , Neoplasias Cutâneas/cirurgia , Raios Ultravioleta
5.
Ethiop J Health Sci ; 31(4): 771-778, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34703176

RESUMO

Background: The conventional groin incision herniotomy is still being adhered to despite high success rate of high scrotal approach. Hence, the aim of this study was to compare the outcomes of high scrotal and conventional approaches for the treatment of inguinal hernia in boys. Methods: A prospective study of 100 boys with 108 inguinal hernias whose ages were less than 15 years. They were randomized into 2 groups; high scrotal and conventional approaches. Ninety-four patients with 101 hernias were analyzed. The operative time, conversion rate (high scrotal approach), and postoperative complications were reported. Results: A total of 100 boys with 108 hernias were enrolled but 94 patients with 101 hernias were analyzed. They comprised of 48 patients with 51 hernias in the high scrotal group and 46 patients with 50 hernias in the conventional group. Their age range was between 2 months and 168 months with a mean of 47.9 ± 46.7 months. The conversion rate of high scrotal approach was 1.9%. The mean duration of operation in the high scrotal group was 37.1 ± 13.3 minutes compared with 37.2 ± 15.1 minutes in the conventional group, p = 0.982. Early postoperative scrotal edema was more in the high scrotal group compared to the conventional group, p = 0.018. The Hollander wound evaluation score was better in the high scrotal incision compared to the conventional approach, p = 0.003. Conclusion: The high scrotal approach may be an alternative to conventional herniotomy in boys.


Assuntos
Hérnia Inguinal , Adolescente , Virilha , Hérnia Inguinal/cirurgia , Herniorrafia , Humanos , Lactente , Masculino , Estudos Prospectivos , Escroto/cirurgia
6.
BMJ Case Rep ; 14(10)2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34706911

RESUMO

Scrotal elephantiasis (SE) is a condition considered rare in western industrialised countries but common in filaria prone regions. If no apparent causes are found for SE, it is called idiopathic SE. Medical and conservative therapies are ineffective against idiopathic SE, and surgical intervention is mandatory to treat this disabling condition. Nevertheless, it remains unclear whether surgical intervention improves quality of life among patients with idiopathic SE. Herein, we report a case of a 41-year-old man who underwent acute scrotal resection and reconstruction, secondary to haemorrhage from his idiopathic SE. The aim of this study was to describe the operative approach and assess patient satisfaction after surgical treatment. The patient had no recurrence of SE after surgical treatment at 6 months follow-up and had considerable improvements assessed by general and disease-specific quality of life questionnaires.


Assuntos
Elefantíase , Procedimentos Cirúrgicos Reconstrutivos , Adulto , Elefantíase/cirurgia , Humanos , Masculino , Recidiva Local de Neoplasia , Qualidade de Vida , Escroto/cirurgia
7.
Arch Esp Urol ; 74(7): 709-712, 2021 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-34472440

RESUMO

OBJECTIVE: Report a case of a scrotum-perinea lGranular Cell Tumor (GCT) in pediatric age. METHODS: To report a case. RESULTS: A 12 years old men with a multiple GCT history, located in both extremities, abdomen and scrotum perineal region. Surgical excision of all lesions and a genetic studyare performed to rule out Noonan syndrome. CONCLUSION: GCT or Abrikossoff tumor is a tumor witha very low incidence, especially in pediatric age. The most frequent form of presentation a solitary nodule and the most common behavior is in the form of a benign tumor. Immunohistochemistryis crucial for its diagnosis, the main characteristicis positivity for the S100 protein. Although scrotal location is very rare, it must be considered in the differential diagnosis of scrotal mass. Surgical excision is the treatment of choice.


Assuntos
Neoplasias dos Genitais Masculinos , Tumor de Células Granulares , Neoplasias Cutâneas , Criança , Neoplasias dos Genitais Masculinos/diagnóstico , Neoplasias dos Genitais Masculinos/cirurgia , Tumor de Células Granulares/diagnóstico , Tumor de Células Granulares/cirurgia , Humanos , Masculino , Períneo , Escroto/cirurgia
8.
ANZ J Surg ; 91(11): 2514-2517, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34585831

RESUMO

BACKGROUND: Acute scrotal pain is a common emergency presentation in paediatric surgery. Torsion of the testicular appendage (TTA) is the most common cause for pain, with testicular torsion (TT) being the sinister pathology to exclude. Outcomes are time dependent, and a delayed scrotal exploration could result in testicular loss. METHODS: We performed a review on a large retrospective cohort of 449 surgical scrotal explorations at a large referral paediatric surgical centre over three years. RESULTS: Only about a quarter of children with testicular pain presented within 4 h. TT is commonly associated with nausea and an abnormal lie. Two children with a classical 'blue dot' sign were later found to have a testicular torsion. 19% of all children with a TTA were also seen to have Bell clapper anomaly (BCA). Recurrent testicular pain was associated with 84.7% (p < 0.001) of BCA. Intra-operative diagnosis of TTA correlated with histopathology in 84.6% (p=0.021). The sensitivity of intraoperative diagnosis was 90.9% with a specificity of 75.3%. CONCLUSION: Routine histopathology for a classic TTA may not be required especially in resource poor situations. All children presenting with recurrent episodes of testicular pain must be considered for surgical scrotal exploration. And in view of the incidence of BCA in this cohort, all scrotal explorations for acute scrotal pain should include an assessment for BCA.


Assuntos
Dor Aguda , Torção do Cordão Espermático , Criança , Humanos , Masculino , Estudos Retrospectivos , Escroto/cirurgia , Torção do Cordão Espermático/diagnóstico , Torção do Cordão Espermático/cirurgia , Testículo
9.
J Med Case Rep ; 15(1): 465, 2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34544483

RESUMO

BACKGROUND: Up to 30% of all scrotal masses are sarcomas. Leiomyosarcoma of the scrotal wall is rare, and its clinical significance and prognosis have not been well defined, since the most reported cases have little or no follow-up. CASE PRESENTATION: We report a 45-year-old Caucasian man who was admitted with a firm, nontender, mobile scrotal wall mass from 15 months ago. Laboratory data including testicular tumor markers were within normal range, and transscrotal ultrasonography revealed an oval-shaped, hypoechogenic, solid mass with blood flow and well-defined border. Histopathologic examination and immunohistochemistry staining, following surgical excision, were in favor of malignant leiomyosarcoma. CONCLUSION: Here we describe the morphological features and immunohistochemical presentations of the tumor and the patient's relatively long-term follow-up.


Assuntos
Neoplasias dos Genitais Masculinos , Leiomiossarcoma , Neoplasias dos Genitais Masculinos/diagnóstico por imagem , Neoplasias dos Genitais Masculinos/cirurgia , Humanos , Imuno-Histoquímica , Leiomiossarcoma/diagnóstico por imagem , Leiomiossarcoma/cirurgia , Masculino , Pessoa de Meia-Idade , Escroto/diagnóstico por imagem , Escroto/cirurgia , Ultrassonografia
10.
Med J Malaysia ; 76(5): 774-776, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34508395

RESUMO

Penile self-injections are performed with the purpose of increasing the size of the penis. Commonly, mineral oils or mineral oil-like substances are used for this purpose. However, there are very few publications describing on the complications from vegetable oil injections especially olive oil. Following the injection, the resulting deformity of the male genitalia is described as penile paraffinomas lipogranuloma of the penis. We would like to report a case of penis augmentation by a 50-year-old gentleman using olive oil injections that caused a massive, severely deformed of the penis and scrotum. Surgical excision and reconstruction was done. The patient was discharged after five days postoperatively, with full graft take. Injecting any oily substances into the human body is hazardous. The differential diagnosis of nodules following injections should be kept in mind and in doubtful cases, biopsy should be done. Regular follow-up is essential to prevent the further inflammatory event. Safe and legal procedures should be implemented for penile enlargement so as to avoid self-injections and in the prevention of such debilitating problems.


Assuntos
Doenças do Pênis , Pênis , Granuloma , Humanos , Masculino , Pessoa de Meia-Idade , Azeite de Oliva , Doenças do Pênis/induzido quimicamente , Doenças do Pênis/cirurgia , Pênis/cirurgia , Escroto/cirurgia
11.
Urologiia ; (4): 114-120, 2021 09.
Artigo em Russo | MEDLINE | ID: mdl-34486284

RESUMO

The aim of the work is to present a modern view on the clinical application of urogenital flaps, such as autologous scrotal flap and foreskin. This plastic material has such characteristics as acceptable extensibility, good blood supply, accessibility and the absence of significant defects in the donor area. The use of urogenital flaps is an actual and promising direction in reconstructive urology. Unfortunately, currently there is not much literature data on the efficiency of using this type of flaps. Recent literature, both national and foreign studies, dedicated to using urogenital flaps, including comparative data with flaps of other localizations, are reviewed in the article. The review consists of several parts, corresponding to certain groups of nosologies, for the treatment of which urogenital flaps of different localization were used.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Retalhos Cirúrgicos , Humanos , Masculino , Pênis/cirurgia , Escroto/cirurgia
12.
ANZ J Surg ; 91(10): 2201-2202, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34476883

RESUMO

Giant inguinoscrotal hernias are an uncommon but challenging surgical entity. We report on how to repair a giant inguinoscrotal hernia using a single-stage approach suitable for emergency surgery. This involves a combined laparotomy and inguinal approach, with posterior component separation and transversus abdominis release.


Assuntos
Hérnia Inguinal , Hérnia Ventral , Músculos Abdominais , Hérnia Inguinal/cirurgia , Herniorrafia , Humanos , Laparotomia , Masculino , Escroto/diagnóstico por imagem , Escroto/cirurgia
16.
BMJ Case Rep ; 14(6)2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34083196

RESUMO

A 10-day-old newborn was taken to the paediatric emergency room due to scrotal swelling. Physical examination showed scrotal enlargement and palpable intrascrotal hard formations. Laboratory blood tests revealed no significant alterations. Testicular ultrasonography showed thickened and hypoechoic scrotal walls and bilateral intrascrotal isoechoic nodules with small internal calcifications. An abdominal X-ray confirmed evidence of bilateral scrotal microcalcifications and small calcifications in the left hypochondrium. Urgent laparotomy performed for scrotal exploration verified the presence of nodular formations on the vaginal tunic of both testicles; the nodules were removed. Bilateral orchidopexy was performed in the same surgical session. When dealing with an acute scrotum in a newborn both emergency radiologists and clinicians should consider the possibility of scrotal meconium pseudocyst as a rare but possible cause of periorchitis.


Assuntos
Doenças dos Genitais Masculinos , Orquite , Criança , Feminino , Doenças dos Genitais Masculinos/diagnóstico por imagem , Doenças dos Genitais Masculinos/etiologia , Doenças dos Genitais Masculinos/cirurgia , Humanos , Recém-Nascido , Masculino , Mecônio , Orquite/diagnóstico por imagem , Orquite/etiologia , Escroto/diagnóstico por imagem , Escroto/cirurgia
17.
Oper Neurosurg (Hagerstown) ; 21(3): 87-93, 2021 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-33989403

RESUMO

BACKGROUND: Scrotal migration of intact or disconnected tubing is a rare complication of ventriculoperitoneal shunts. While some illustrative case reports can be found in the literature, a systematic review on treatment options is lacking. OBJECTIVE: To propose the first literature-based treatment algorithm on scrotal shunt migration. METHODS: We conducted a literature search using the keywords: "VP," "ventriculoperitoneal," "shunt," and "scrotum." We identified 36 publications with 48 cases reported including our index case. RESULTS: Median age at presentation was 13.5 mo (3 d to 65 yr) which was 4 mo (3 d to 72 mo) after last shunt-related surgery. All patients had scrotal swelling, 39 (81%) patients presented without other symptoms, 4 (8%) had additionally local pain, and 4 (8%) patients presented with symptoms of shunt dysfunction. Treatment was surgically in all but one case where spontaneous resolution without repeat migration occurred. In 3 of 4 patients who had either subcutaneous shortening or abdominal repositioning of the shunt without hernia repair, scrotal shunt migration recurred within the following month. Whereas the surgical treatment with reposition of the migrated catheter back into the peritoneal cavity via a groin incision plus hernia repair yielded a definite treatment in all 26 performed cases, the revision rate was significantly higher in the shunt revision without hernia repair cohort (P = .0009). CONCLUSION: Scrotal shunt migration is a rare shunt complication with good recovery when treated surgically. We recommend hernia repair in addition to either manual or surgical repositioning of migrated tubing.


Assuntos
Migração de Corpo Estranho , Hérnia Inguinal , Cateteres , Migração de Corpo Estranho/diagnóstico por imagem , Migração de Corpo Estranho/etiologia , Migração de Corpo Estranho/cirurgia , Hérnia Inguinal/cirurgia , Humanos , Masculino , Escroto/cirurgia , Derivação Ventriculoperitoneal/efeitos adversos
19.
J Int Med Res ; 49(5): 3000605211003773, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34041951

RESUMO

We report the disease characteristics, diagnosis, and treatment of granulomatous orchitis. A 38-year-old man presented with a history of intermittent swelling, pain, and discomfort in the right testicle of 3 days' duration. Unenhanced magnetic resonance imaging (MRI) of the testis and scrotum revealed an oval mass in the right testis measuring approximately 17 mm in diameter, with clear borders and a target ring-like appearance from periphery to center. T1-weighted imaging (T1WI) showed uniform low-intensity signals, and T2WI showed mixed high- and low-intensity signals. Diffusion-weighted imaging (DWI) signals were iso-intense, and the outer ring on enhanced scans showed progressive enhancement. We performed radical resection of the right testis under combined spinal-epidural anesthesia. The pathological diagnosis was granulomatous right orchitis. Two months postoperatively, ultrasonography showed no testis and epididymal echo signals in the right scrotum, and no obvious abnormalities; color Doppler blood flow imaging (CDFI) findings were normal. Granulomatous orchitis is rare in clinical practice, and the cause is unknown. The disease involves non-specific inflammation; however, it is currently believed that antibiotics and steroids are ineffective for conservative treatment, and orchiectomy should be actively performed.


Assuntos
Orquite , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Orquiectomia , Orquite/diagnóstico por imagem , Escroto/diagnóstico por imagem , Escroto/cirurgia , Testículo/diagnóstico por imagem , Testículo/cirurgia
20.
J Urol ; 206(4): 1001-1008, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34032502

RESUMO

PURPOSE: We assessed the role of standing vs supine scrotal ultrasound (SUS) for varicocele assessment by evaluating differences in clinical outcomes. MATERIALS AND METHODS: We retrospectively reviewed men from 2008-2020 diagnosed with varicocele who had documented SUS with both supine and standing assessments with and without Valsalva. Clinical outcomes (semen parameters, TUNEL and serum testosterone [T]) after microsurgical varicocelectomy were compared among men who had varicoceles diagnosed by standing SUS (vein size >2.5 mm, vein size >3.0 mm or reversal of flow) to those who would have been missed on supine SUS only. RESULTS: A total of 349 men underwent varicocelectomy (right: 5 [1.4%]; left: 118 [33.8%]; bilateral: 226 [64.8%]). Disagreement between those with abnormal standing vs normal supine for vein size >2.5 mm was: 56 men (16.1%) on the right and 31 men (8.9%) on the left, for vein size >3.0 mm was: 64 men (18.3%) on the right, and 56 men (16.1%) on the left, and for flow reversal was: 36 (14.0%) on the right and 40 (15.4%) on the left. For those >2.5 mm, only T had significant improvements on the left (p=0.05). For those >3.0 mm significant differences were seen for sperm motility on the right (p=0.04), and TUNEL (p=0.04) and T (p <0.01) on the left. For flow reversal, significant differences were seen for sperm concentration (p <0.01), morphology (p=0.03) and volume (p=0.05) on the right and TUNEL on the left (p=0.02). CONCLUSIONS: Standing SUS identifies a greater number of men who would have been missed using supine SUS only.


Assuntos
Escroto/irrigação sanguínea , Posição Ortostática , Varicocele/diagnóstico , Veias/diagnóstico por imagem , Adulto , Humanos , Masculino , Microcirurgia , Diagnóstico Ausente/prevenção & controle , Estudos Retrospectivos , Escroto/diagnóstico por imagem , Escroto/cirurgia , Decúbito Dorsal , Ultrassonografia/métodos , Procedimentos Cirúrgicos Urológicos Masculinos , Manobra de Valsalva , Varicocele/cirurgia , Veias/cirurgia
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