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1.
Ultraschall Med ; 42(1): 10-38, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33530122

RESUMO

Acute testicular pain in childhood can be caused by testicular torsion, torsion of the appendix testis, or epididymo-orchitis. Quick and reliable diagnosis is essential for determining the further course of action (surgery or conservative approach). The diagnostic tool of choice is high-resolution sonography with a linear transducer (> 10 MHz) combined with color and spectral Doppler sonography. The Doppler device settings should include a low pulse repetition frequency (< 4 cm/s), a low wall filter (< 100 Hz), and adequate gain. Comparison with the unaffected healthy testis is essential. The most important of the three diseases is torsion of the spermatic cord because it requires immediate surgical intervention and detorsion. The affected testis is enlarged and has an inhomogeneous echotexture with hypoechoic and hyperechoic areas as well as an associated hydrocele. In testicular torsion, color Doppler shows reduced or absent intratesticular vessels in comparison with the healthy contralateral testis. Spectral Doppler shows decreased flow velocities especially during diastole in intratesticular arteries and an increased resistance index. The investigation should always include imaging of the spermatic cord from the outer inguinal ring to the upper pole of the testis. In contrast to a normal finding, the vessels and the ductus deferens are not displayed as linear tubular structures but in form of a spiral twist. Ultrasound shows a target-like structure with multiple concentric rings. Color Doppler sonography shows the typical whirlpool sign. In torsion of the appendix testis, the appendix testis is enlarged in the groove between the testis and epididymis. The longitudinal diameter of the appendix testis can be greater than 5 mm. The echogenicity of the torsed appendage can vary between hypoechoic (acute torsion) and hyperechoic (prior torsion). An associated hydrocele of varying size is usually seen. Color Doppler sonography reveals a lack of perfusion of the enlarged appendix testis and increased vascularity of the testis and primarily the epididymis. Epididymo-orchitis is characterized by an enlarged epididymis and/or testis with inhomogeneous echogenicity (hypoechoic - hyperechoic). Color Doppler sonography shows increased vascularity in comparison with the unaffected testis. Spectral Doppler reveals increased diastolic flow velocities and a decreased resistance index. Idiopathic scrotal edema and an incarcerated inguinal hernia must be ruled out in the differential diagnosis.


Assuntos
Escroto , Torção do Cordão Espermático , Doenças Testiculares , Doença Aguda , Adolescente , Criança , Diagnóstico Diferencial , Epididimo , Humanos , Masculino , Escroto/diagnóstico por imagem , Torção do Cordão Espermático/diagnóstico por imagem , Testículo/diagnóstico por imagem
2.
Clin Imaging ; 67: 198-206, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32866821

RESUMO

Nuclear protein of the testis (NUT) carcinoma (NC) (formerly known as NUT midline carcinoma) is an aggressive pleomorphic squamous cell carcinoma with a dismal prognosis. Primary NC tumors are commonly located in the chest or head and neck regions. Imaging plays an indispensable role in the staging, management, treatment response assessment, and surveillance of NC. Primary pulmonary NC usually presents as a large mass with lymphadenopathy and pleural involvement. Primary head and neck NC presents as a large expansile necrotic mass in the sinonasal region with locoregional destruction and occasional cervical lymph node involvement. These imaging features are relatively non-specific but are consistent among patients. Currently, there are no standardized guidelines for the treatment of NC. Because of its rarity, paucity of reports in the medical literature, and the lack of awareness among radiologists, NUT carcinoma (NC) has been largely underdiagnosed and misdiagnosed. Clinical aggressive features and pleomorphic/undifferentiated squamous cell carcinoma should prompt genetic evaluation for NUT translocation to diagnose NC. In this article, we discuss NC's clinicopathologic and imaging features and treatment options, including emerging new treatments.


Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Neoplasias Testiculares/diagnóstico por imagem , Testículo/diagnóstico por imagem , Adulto , Carcinoma de Células Escamosas/patologia , Feminino , Neoplasias de Cabeça e Pescoço , Humanos , Neoplasias Pulmonares/genética , Masculino , Pescoço/patologia , Proteínas Nucleares/genética , Proteínas Nucleares/metabolismo
3.
Chirurgia (Bucur) ; 115(4): 505-510, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32876024

RESUMO

Introduction: Spermatic vein thrombosis is a rare entity with poor clinical distinctive signs for the differential diagnosis, which raises numerous controversies about the appropriate management. Case report: A 55 years old man presents at the emergency room for left scrotal pain and swelling evolving for two weeks. The patient denied any recent local traumatic event. Physical examination revealed an approximately 15 to 20 cm length mass from the posterior scrotum to the external inguinal orifice. The other genitals had a healthy appearance at the moment of the examination. An incarcerated hernia couldn't be excluded. The Doppler ultrasound evaluation of the scrotum con firmed the suspicion of left testicular vein thrombosis with complete cessation of blood flow. Both testicles appeared to have regular blood flow. CT scan established that the thrombus extended up to the left external inguinal orifice. Surgical treatment was preferred to address an eventually incarcerated hernia. The left testicular vein was excised from the external orifice. Postoperative management consisted of apixaban for 30 days, and the cardiology department thus conducted the treatment. Conclusions: Doppler ultrasound evaluation of the scrotum represents the gold standard diagnostic test for spermatic vein thrombosis. There are still controversies about the management approach of this pathology, conservative or surgical.


Assuntos
Doenças Testiculares/diagnóstico por imagem , Testículo/irrigação sanguínea , Trombose Venosa/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Escroto/irrigação sanguínea , Escroto/diagnóstico por imagem , Doenças Testiculares/diagnóstico , Doenças Testiculares/cirurgia , Testículo/diagnóstico por imagem , Resultado do Tratamento , Ultrassonografia Doppler , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/cirurgia
4.
Arq. bras. med. vet. zootec. (Online) ; 72(4): 1137-1144, July-Aug. 2020. tab, ilus
Artigo em Português | LILACS, VETINDEX | ID: biblio-1131517

RESUMO

Utilizaram-se quatro garanhões nos meses de janeiro, abril, julho e outubro de 2016, em dois protocolos, em que: GI (n=4; 5mL de solução salina, i.v.) e GII (n=4; 5000UI de hCG, i.v.) e subdividiram-se esses protocolos em ciclos (C1 e C2), seguindo o esquema crossover, sendo: CI=animais 1 (GI) e 2 (GII), avaliados nos dias D1, D3 e D5, e animais 3 (GI) e 4 (GII), em D2, D4 e D6; CII= animais 1 (GII) e 2 (GI), em D1, D3, D5, e animais 3 (GII) e 4 (GI), em D2, D4 e D6. Realizou-se o tratamento em D1 e D2 de cada ciclo e a ultrassonografia testicular no modo color Doppler e Doppler espectral, uma hora antes de cada coleta de sêmen e imediatamente após. Avaliou-se: número de reflexo de Flehmen, de montas sem ereção, início da monta, tempo de reação à ereção e total da monta e análises de qualidade seminal. Estatisticamente foram utilizados os testes de qui-quadrado e ANOVA. Não houve diferenças estatísticas (P>0,05) entre os parâmetros analisados. Concluiu-se que uma única dose de 5000UI de hCG em garanhões não causou alterações significativas nos parâmetros avaliados em diferentes estações do ano.(AU)


Four stallions were used in January, April, July and October 2016 in two protocols: GI (n=4; 5ml saline, iv) and GII (n=4; 5000 hCG, iv), and these protocols were subdivided into cycles (C1 and C2) following the cross over scheme, as follows: CI=animal 1 (GI) and 2 (GII) evaluated on days D1, D3 and D5 and animal 3 (GI) and 4 (GII) at D 2, D 4 and D 6; CII=animal 1 (GII) and 2 (GI) at D1, D3, D5 and animal 3 (GII) and 4 (GI) at D2, D4 and D6. Treatment was performed on D1 and D2 of each cycle and testicular ultrasound in color Doppler and spectral Doppler mode, one hour before each semen collection and immediately after. We evaluated: Flehmen's reflex number, mounts without erection, start of the mount, reaction time to erection and total mount and seminal quality analyzes. Statistically, the Chi-square and ANOVA tests were used. There were no statistical differences (P>0.05) between the analyzed parameters. It was concluded that a single dose of 5000IU hCG in stallions did not cause significant changes in the parameters evaluated in different seasons of the year.(AU)


Assuntos
Animais , Masculino , Testículo/diagnóstico por imagem , Gonadotropina Coriônica/administração & dosagem , Cavalos/fisiologia , Estações do Ano , Ultrassonografia Doppler em Cores/veterinária
5.
Niger J Clin Pract ; 23(7): 1004-1007, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620732

RESUMO

Background: Scrotal ultrasonography has high sensitivity in the detection of intra-scrotal abnormalities. Various ultrasonographic parameters such as the spermatic cord diameter, venous diameter, and venous retrograde flow in either supine or upright positions with or without Valsalva maneuver have been investigated to assess patients suspected of having varicocele. Aims: This study aimed at comparing testicular vein diameter in supine and upright positions using ultrasonography. Methodology: This is a prospective multicenter study conducted between September 2018 and June 2019. Eighty-two consenting suspected cases of varicocele, 20 years and above, referred for scrotal ultrasonography were included in this study. Results: The study population had a mean age of 42.9 + 14.89 (SD) with a range of 20-96 years. The highest number of participants fell within the age range of 30-39 years 23 (28%). Varicocele was demonstrated in 96.3% of the patients. More patients showed sonographic evidence of varicocele in the upright position, on the right 50 (61%) as well as left 50 (61%). Bilateral varicocele had a higher frequency in the upright position 45 (54.9%), while supine was 23 (28%). Upright position had the widest diameter in 72% of participants on the right and 82% on the left. The upright position also showed higher average vein diameter of 2.6 mm and 2.9 mm on the right and left, respectively, while it was 2.2 mm and 2.3 mm for right and left in the supine position. Conclusion: The upright position is more predictive of varicocele in scrotal ultrasound examination for suspected cases of varicocele. We recommend an upright position where one position is to be used.


Assuntos
Cordão Espermático/diagnóstico por imagem , Posição Ortostática , Decúbito Dorsal , Testículo/diagnóstico por imagem , Ultrassonografia/métodos , Varicocele/diagnóstico por imagem , Veias/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade , Cordão Espermático/irrigação sanguínea , Testículo/irrigação sanguínea , Manobra de Valsalva
7.
Pediatr Infect Dis J ; 39(8): e200-e202, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32467452

RESUMO

Coronavirus disease 2019 (COVID-19) symptoms in children are incompletely described. We present the first case of orchiepididymitis associated with COVID-19 in a boy and discuss pathways of testicular involvement by SARS-CoV2 virus. This case underlines the need for further study of the clinical presentation of pediatric COVID-19 and the potential association with nonrespiratory symptoms.


Assuntos
Infecções por Coronavirus/fisiopatologia , Epididimite/etiologia , Epididimite/fisiopatologia , Pneumonia Viral/fisiopatologia , Betacoronavirus , Criança , Infecções por Coronavirus/complicações , Epididimite/diagnóstico por imagem , Humanos , Itália , Masculino , Pandemias , Pneumonia Viral/complicações , Testículo/diagnóstico por imagem
8.
Br J Radiol ; 93(1110): 20200063, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32271626

RESUMO

Multiparametric ultrasound (MPUS), combining conventional techniques (greyscale and colour Doppler ultrasound), ultrasound strain elastography, and contrast-enhanced ultrasound (CEUS), has been successfully used in the assessment of adult scrotal pathology. Contrast-enhanced ultrasound can confidently establish testicular tissue vascularity even in the small-volume paediatric testis. Elastography provides further assessment of tissue stiffness, potentially adding useful diagnostic information. In children, ultrasonography is particularly advantageous, being safe, radiation-free and negating the need for sedation or general anaesthesia during the imaging evaluation. In this review article, we aim to familiarise readers with the MPUS scanning protocol used for paediatric scrotal examination and provide an overview of scrotal MPUS features, with particular focus to clinical indications where MPUS may be advantageous over conventional ultrasonography.


Assuntos
Doenças dos Genitais Masculinos/diagnóstico por imagem , Escroto/diagnóstico por imagem , Ultrassonografia/métodos , Abscesso/diagnóstico por imagem , Adolescente , Fatores Etários , Criança , Contraindicações de Medicamentos , Meios de Contraste/administração & dosagem , Meios de Contraste/efeitos adversos , Cistos/diagnóstico por imagem , Ecocardiografia Doppler em Cores , Técnicas de Imagem por Elasticidade/métodos , Epididimite/diagnóstico por imagem , Humanos , Recém-Nascido , Infarto/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Masculino , Fosfolipídeos/administração & dosagem , Fosfolipídeos/efeitos adversos , Escroto/lesões , Torção do Cordão Espermático/diagnóstico por imagem , Hexafluoreto de Enxofre/administração & dosagem , Hexafluoreto de Enxofre/efeitos adversos , Neoplasias Testiculares/diagnóstico por imagem , Testículo/irrigação sanguínea , Testículo/diagnóstico por imagem , Testículo/lesões
9.
Top Companion Anim Med ; 38: 100371, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32115074

RESUMO

A 5-year-old male Beagle dog produced ejaculates with a high percentage of spermatozoa with abnormal morphology, especially sperm tail defects. Although libido and semen volume were normal, ejaculates showed asthenospermia, oligozoospermia, and teratozoospermia. The spermatozoa exhibited morphologic defects affecting the flagellum, mainly coiled tails with or without macrocephalia (33.5 ± 2.1%), bent tails (18.3 ± 3.4%), and proximal cytoplasmic droplets (6.7 ± 2.8%). The peripheral plasma testosterone level was 2.76 ± 0.21 ng/mL. The resistive index and the pulsatility index from marginal and intratesticular vessels measured by Doppler ultrasound showed higher values in the right testicle than in the left testicle. Histologic evaluation revealed focal reduction in the number of germ cells and sperm in the seminiferous tubules in the right testicle. This is the first report that describes simultaneously the presence of sperm tail defects in the ejaculate and changes in the blood flow of testicular vessels in the dog.


Assuntos
Doenças do Cão/patologia , Cauda do Espermatozoide/patologia , Testículo/irrigação sanguínea , Animais , Cães , Masculino , Análise do Sêmen , Espermatozoides/anormalidades , Testículo/diagnóstico por imagem , Testosterona/sangue , Ultrassonografia Doppler/veterinária
10.
Medicine (Baltimore) ; 99(12): e19463, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32195944

RESUMO

RATIONALE: Primary testicular lymphoma (PTL) is a rare type of extranodal non-Hodgkin's lymphoma (NHL). Although data of PTL in patients with diffuse large B-cell lymphoma (DLBCL) are accumulating, there are still patients respond poorly to prognosis. PATIENT CONCERNS: All patients had disease of the DLBCL subtype and those patients had primary involvement of the testis. In our studies, eleven patients had stage I/II disease, and 3 patients had advanced disease with B symptoms. Four patients exhibited a MYC+, BCL2+, and BCL6- expression pattern, 4 patients had a MYC+, BCL6+, and BCL2- expression pattern, and 3 patients had a MYC+, BCL2+, and BCL6+ expression pattern. Additionally, 43% (7/16) of PT-DLBCL patients had a germinal center B-cell-like (GCB) phenotype, while the others had a non-GCB phonotype. DIAGNOSES: In our case, most patients presented with unilateral painless scrotal swelling and the enlargement of the testicles in the first examination. After hospitalization, all patients underwent preoperative imageological examination of the testis and epididymis and postoperative revealed that all patients were the diffuse infiltration of a large number of anomalous lymphocytes. In addition, no invasion of other sites was observed within 3 months after diagnosis. INTERVENTIONS AND OUTCOMES: Underwent orchiectomy on the affected side was performed by urologists after all patients were diagnosed with PTL. Meanwhile, some patients received at least one course of chemotherapy, or received postoperative combined RT and chemotherapy. Because of it particularity, nineteen instances of lymph node region involvement were discovered in 12 patients since the operation. LESSONS: PT-DLBCL has unique biological characteristics, and its treatment modalities are becoming increasingly standardized. In the future, systematic interventions need to be actively considered in the early stages of PTL.


Assuntos
Linfoma Difuso de Grandes Células B/metabolismo , Linfoma Difuso de Grandes Células B/patologia , Neoplasias Testiculares/metabolismo , Neoplasias Testiculares/patologia , Testículo/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimiorradioterapia/métodos , Centro Germinativo/patologia , Humanos , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/terapia , Linfoma não Hodgkin/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Orquiectomia/métodos , Fenótipo , Prognóstico , Estudos Retrospectivos , Neoplasias Testiculares/terapia , Testículo/diagnóstico por imagem , Ultrassonografia/métodos
11.
Eur J Radiol ; 126: 108939, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32171915

RESUMO

PURPOSE: This study aimed to evaluate the role of volumetric apparent diffusion coefficient (ADC) histogram analysis in discriminating between benign and malignant testicular masses. METHODS: In this retrospective study, fifty-nine patients with 61 pathologically confirmed testicular masses were consecutively enrolled, including 18 benign lesions and 43 malignant lesions. All patients conducted preoperative magnetic resonance imaging (MRI) with diffusion-weighted imaging. Eighteen volumetric histogram parameters were extracted from the ADC map of each lesion. Comparisons were conducted by an independent t-test or Mann-Whitney U test, where appropriate. The classification performance of the parameters that showed significant differences between benign and malignant testicular disease were evaluated via receiver operating characteristic (ROC) curve analysis. RESULTS: Among the 18 histogram parameters we extracted, the energy, total energy, and range of ADC of testicular malignancies were all significantly increased compared with those of benignities. The minimum ADC and 10th percentile ADC of testicular malignancies were both significantly reduced compared with those of benignities. The minimum ADC value achieved the highest diagnostic performance in distinguishing between testicular benignities and malignancies, with an area under the ROC curve (AUC) of 0.822, sensitivity of 81.40 %, and specificity of 77.78 %. CONCLUSIONS: Volumetric ADC histogram analysis might be a useful tool to preoperatively discriminate between benign and malignant testicular masses.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Interpretação de Imagem Assistida por Computador/métodos , Neoplasias Testiculares/diagnóstico por imagem , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Estatísticas não Paramétricas , Testículo/diagnóstico por imagem , Adulto Jovem
13.
JAMA Netw Open ; 3(2): e1921610, 2020 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-32083688

RESUMO

Importance: Diet may play a role in testicular function, but data on how adherence to different diet patterns influences human testicular function are scarce. Objective: To determine whether adherence to specific dietary patterns is associated with testicular function in young men. Design, Setting, and Participants: This cross-sectional study included 2935 young Danish men unselected regarding fertility status who were enrolled from April 1, 2008, through May 31, 2017. Data were analyzed from July 1, 2017, to January 30, 2019. Exposures: Dietary patterns identified with principal component analysis based on responses to a validated food frequency questionnaire. Main Outcomes and Measures: Standard semen quality assessment; serum concentrations of testosterone, free testosterone, estradiol, inhibin B, follicle-stimulating hormone, luteinizing hormone, and sex hormone-binding globulin; and testicular volume measured with ultrasonography. Results: Among the 2935 participants included in the analysis, median age was 19 (interquartile range, 19-20) years and 2290 (78.0%) had normal body mass index. The 4 dietary patterns identified included Western, prudent, open-sandwich (a traditional Danish eating pattern), and vegetarianlike. The greatest adherence to the prudent pattern was associated with the highest total sperm count (median, 167 [95% CI, 146-183] million), followed by adherence to vegetarianlike (median, 151 [95% CI, 134-168] million) and open-sandwich (median, 146 [95% CI, 131-163] million) patterns. Adherence to the Western pattern was associated with the lowest total sperm count (median, 122 [95% CI, 109-138] million), which was significantly lower than sperm count in the other 3 diet patterns. After adjusting for confounders, the median total sperm count for men in the highest quintile of adherence to the Western pattern was 26 million lower (95% CI, -42 to -9 million) than for men in the lowest quintile of adherence to this pattern. Conversely, the median total sperm count of men in the highest quintile of adherence to the prudent pattern was 43 million (95% CI, 23-63 million) higher than that of men in the lowest quintile. Men with the highest adherence to the Western pattern had a lower median ratio of inhibin B to follicle-stimulating hormone (-12 [95% CI, -20 to -3]) and higher median ratio of free testosterone to luteinizing hormone (10 [95% CI, 2-19]) compared with men with lowest adherence to this pattern. Conclusions and Relevance: In this cross-sectional study, adherence to generally healthy diet patterns was associated with better semen quality, with potentially more favorable fertility potential among adult men.


Assuntos
Dieta/estatística & dados numéricos , Hormônios Gonadais/sangue , Espermatozoides/fisiologia , Testículo , Adulto , Estudos Transversais , Dinamarca/epidemiologia , Inquéritos sobre Dietas , Hormônio Foliculoestimulante/sangue , Humanos , Masculino , Análise do Sêmen , Globulina de Ligação a Hormônio Sexual/análise , Testículo/diagnóstico por imagem , Testículo/fisiologia , Adulto Jovem
14.
Andrologia ; 52(3): e13517, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31965584

RESUMO

Primary rhabdomyosarcoma of tunica vaginalis is very rare. We report a case of a 15-year-old man presenting as hydrocele. Pre-operatively, no masses were detected by ultrasonography. Hydrocelectomy was performed. At surgery, a 0.8 cm polypoid nodule and diffusely thickened tunica were found. Pathologic examination finally revealed rhabdomyosarcoma. A PET-CT was then performed and indicated scrotal implantation metastasis. The patient underwent radical inguinal orchiectomy and was treated with chemotherapy and radiotherapy after surgery. At 12 months of follow-up, he remained disease-free.


Assuntos
Rabdomiossarcoma/diagnóstico , Escroto/patologia , Hidrocele Testicular/diagnóstico , Neoplasias Testiculares/diagnóstico , Testículo/patologia , Adolescente , Quimiorradioterapia Adjuvante , Erros de Diagnóstico , Humanos , Masculino , Orquiectomia , Rabdomiossarcoma/secundário , Rabdomiossarcoma/terapia , Escroto/diagnóstico por imagem , Escroto/cirurgia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia , Testículo/diagnóstico por imagem , Testículo/cirurgia , Resultado do Tratamento
15.
J Ultrasound Med ; 39(1): 119-126, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31268182

RESUMO

OBJECTIVES: To evaluate the diagnostic accuracy of ultrasound (US) to diagnose the directionality of testicular rotation and the degree of spermatic cord twist in pediatric patients with testicular torsion. METHODS: A retrospective review of 14 pediatric patients with testicular torsion was conducted. The directionality of testicular rotation was classified as an inner or outer direction (inner, counterclockwise in the left testis [viewed from below] and clockwise in the right testis; and outer, counterclockwise in the right testis and clockwise in the left testis). The Clopper-Pearson method and the Fisher exact, Mann-Whitney U, and Wilcoxon signed rank sum tests were used for the statistical analyses. RESULTS: The diagnostic accuracy of US in the directionality of testicular rotation and the degree of spermatic cord twist were 78.6% (11 of 14; 95% confidence interval, 49.2%-95.3%) and 36.4% (4 of 11; 95% confidence interval, 10.9%-69.2%), respectively. Outer rotation was seen in 50.0% of the cases. The directionality of testicular rotation and the degree of spermatic cord twist as determined by US were not significantly different between the patients with salvaged testis and those with testicular loss (inner/outer direction, 4/2 versus 4/4; P = .627; mean twist ± SD, 330.0° ± 73.5° versus 337.5° ± 115.4°; P > .999). There was no significant difference in the degree of spermatic cord twist determined by US and surgical results (343.0° ± 97.1° versus 458.2° ± 168.2°; P = .063). CONCLUSIONS: The accuracy of US in determining the directionality of testicular rotation was relatively high in our small cohort. This information may be useful for pediatric surgeons and urologists when performing early manual reduction for testicular torsion.


Assuntos
Torção do Cordão Espermático/diagnóstico por imagem , Testículo/diagnóstico por imagem , Ultrassonografia/métodos , Adolescente , Criança , Pré-Escolar , Humanos , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos , Cordão Espermático/diagnóstico por imagem
16.
Urology ; 135: 136-138, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31568794

RESUMO

Neonatal testicular torsion is an uncommon event that rarely results in testicular salvage. We present 2 cases in the neonatal intensive care unit of extremely premature males (<28 weeks gestation) with witnessed testicular torsion, prompt diagnosis, surgical detorsion, and good short-term outcomes. Although an uncommon scenario, we present the feasibility of surgery in the extremely premature infant and potential for testicular salvage.


Assuntos
Lactente Extremamente Prematuro , Doenças do Prematuro/cirurgia , Terapia de Salvação/métodos , Torção do Cordão Espermático/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Estudos de Viabilidade , Humanos , Recém-Nascido , Doenças do Prematuro/diagnóstico , Unidades de Terapia Intensiva Neonatal , Masculino , Torção do Cordão Espermático/diagnóstico , Testículo/diagnóstico por imagem , Testículo/cirurgia , Resultado do Tratamento , Ultrassonografia Doppler
17.
Int J Infect Dis ; 90: 60-64, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31634613

RESUMO

OBJECTIVE: Testicular involvement or atrophy in leprosy is silent, unreported, and under-estimated. The aim of this study was to assess the frequency of testicular atrophy and its consequences through the examination of clinical manifestations, hormonal profile, and semen analysis in leprosy patients. METHODS: A descriptive observational study using a cross-sectional design and consecutive sampling method was conducted from May to July 2018. The study was conducted in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia and included 32 men affected by leprosy and five healthy men as a control group. All patients were subjected to history-taking, dermatological and genital examinations, assessment of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone, and testicular ultrasonography examination. Semen analysis was performed for the 10 patients who consented. RESULTS: Testicular atrophy was observed in 93.75% of patients. Clinical manifestations of testicular atrophy were loss of libido (21.87%), female pubic hair pattern (9.38%), gynecomastia (6.25%), and secondary infertility (6.25%). Hormonal imbalance was seen in 16 patients, and all 10 patients who underwent semen analysis showed an abnormality. CONCLUSIONS: This study showed a high frequency of testicular atrophy, but the symptoms were only present in a few of patients. The assessment of testicular function should be recommended as a routine work-up for leprosy patients.


Assuntos
Hanseníase Multibacilar/tratamento farmacológico , Adolescente , Adulto , Estudos Transversais , Hormônio Foliculoestimulante/sangue , Humanos , Indonésia , Hansenostáticos/efeitos adversos , Hansenostáticos/uso terapêutico , Hormônio Luteinizante/sangue , Masculino , Sêmen/metabolismo , Doenças Testiculares/sangue , Doenças Testiculares/etiologia , Doenças Testiculares/fisiopatologia , Testículo/diagnóstico por imagem , Testículo/metabolismo , Testículo/fisiopatologia , Testosterona/sangue , Adulto Jovem
18.
J Urol ; 203(4): 760-766, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31580179

RESUMO

PURPOSE: We evaluated possible factors predicting testicular cancer in patients undergoing testis sparing surgery. MATERIALS AND METHODS: We retrospectively analyzed the records of all patients who underwent testis sparing surgery for a small testicular mass at a total of 5 centers. All patients with 1 solitary lesion 2 cm or less on preoperative ultrasound were enrolled in the study. Testis sparing surgery consisted of tumor enucleation for frozen section examination. Immediate radical orchiectomy was performed in all cases of malignancy at frozen section examination but otherwise the testes were spared. Univariate and multivariate analysis were performed and ROC curves were produced to evaluate preoperative factors predicting testicular cancer. RESULTS: Overall 147 patients were included in the study. No patient had elevated serum tumor markers. Overall 21 of the 147 men (14%) presented with testicular cancer. On multivariate analysis the preoperative ultrasound diameter of the lesion was a predictor of malignancy (OR 6.62, 95% CI 2.26-19.39, p=0.01). On ROC analysis lesion diameter had an AUC of 0.75 (95% CI 0.63-0.86, p=0.01) to predict testicular cancer. At the best cutoff of 0.85 the diameter of the lesion had 81% sensitivity, 58% specificity, 24% positive predictive value and 95% negative predictive value. CONCLUSIONS: Our study confirms that small testicular masses are often benign and do not always require radical orchiectomy. Preoperative ultrasound can assess lesion size and the smaller the nodule, the less likely that it is malignant. Therefore, we suggest a stepwise approach to small testicular masses, including tumorectomy, frozen section examination and radical orchiectomy or testis sparing surgery according to frozen section examination results.


Assuntos
Orquiectomia/métodos , Tratamentos com Preservação do Órgão/métodos , Neoplasias Testiculares/cirurgia , Testículo/patologia , Adulto , Biomarcadores Tumorais/sangue , Secções Congeladas , Humanos , Masculino , Seleção de Pacientes , Período Pré-Operatório , Curva ROC , Estudos Retrospectivos , Medição de Risco/métodos , Neoplasias Testiculares/sangue , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/patologia , Testículo/diagnóstico por imagem , Testículo/cirurgia , Carga Tumoral , Ultrassonografia
19.
Urology ; 135: 4-10, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31585196

RESUMO

Ultrasound is the imaging modality of choice to evaluate scrotal pathology. However, differentiating malignant and benign testicular tumors is not always possible, and there is interest in evaluating magnetic resonance imaging (MRI) as a potential adjunct for diagnosis. We conducted a systematic review and found 9 studies related to MRI diagnosis of testicular masses. A total of 220 testicular masses (217 patients) undergoing MRI were identified. Notable findings include malignant masses having a lower apparent diffusion coefficient compared to benign masses (3 of 4 studies) and that quantitative enhancement patterns could differentiate Leydig cell tumors from germ cell tumors in 2 studies. While there were some distinct qualitative characterizations of testicular masses on MRI, further research is needed to identify appropriate clinical contexts for use.


Assuntos
Imagem por Ressonância Magnética , Neoplasias Testiculares/diagnóstico por imagem , Testículo/patologia , Diagnóstico Diferencial , Humanos , Masculino , Orquiectomia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/cirurgia , Testículo/diagnóstico por imagem , Testículo/cirurgia , Ultrassonografia
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