The downregulation of genes encoding muscle proteins have a potential role in the development of scrotal hernia in pigs.

BACKGROUND: Testicular descent is a physiological process regulated by many factors. Eventually, disturbances in the embryological/fetal development path facilitate the occurrence of scrotal hernia, a congenital malformation characterized by the presence of intestinal portions within the scrotal sac due to the abnormal expansion of the inguinal ring. In pigs, some genes have been related to this anomaly, but the genetic mechanisms involved remain unclear. This study aimed to investigate the expression profile of a set of genes potentially involved with the manifestation of scrotal hernia in the inguinal ring tissue. METHODS AND RESULTS: Tissue samples from the inguinal ring/canal of normal and scrotal hernia-affected male pigs with approximately 30 days of age were used. Relative expression analysis was performed using qPCR to confirm the expression profile of 17 candidate genes previously identified in an RNA-Seq study. Among them, the Myosin heavy chain 1 (MYH1), Desmin (DES), and Troponin 1 (TNNI1) genes were differentially expressed between groups and had reduced levels of expression in the affected animals. These genes encode proteins involved in the formation of muscle tissue, which seems to be important for increasing the resistance of the inguinal ring to the abdominal pressure, which is essential to avoid the occurrence of scrotal hernia. CONCLUSIONS: The downregulation of muscular candidate genes in the inguinal tissue clarifies the genetic mechanisms involved with this anomaly in its primary site, providing useful information for developing strategies to control this malformation in pigs and other mammals.

The GUDplay technique: A shift of paradigm in glans reconstruction for midshaft and penoscrotal hypospadias with moderate chordee. A proposal of a new approach.

INTRODUCTION: After 5 years experience with the GUD (glandular urethral disassembly) technique for distal hypospadias, we present the GUDplay technique, incorporating Thiersch-Duplay tubularization of the plate till the coronal area, disassembling the glans aggressively and refurbishing the glans. METHODS: We defined the urethral plate and designed an inverted Y incision to open the glans in two wings. The glans was entirely detached from the corpora to gain a great mobility that allowed minor cranial mobilization of the urethra and caudal rotation of the wings. In sequence, there are well-known steps: Duplay urethroplasty, spongioblasts and a Dartos flap to cover the neourethra. The glans was connected to the urethra by 6.0 PDS sutures except in the ventral meatus and the glans wings are joined in the midline. RESULTS: The 5-year-old patient had midshaft hypospadias without previous surgery. The catheter was removed after a week and the healing appears to be good. DISCUSSION: We combined principles of total glans deconstruction in association to Duplay tubularization and then lifted it up to the tip of the glans divided in two wide and mobile wings. We have treated a small series of 6 cases without complications and mean follow-up of 6.2 months.

Use of thermography in the long-term evaluation of scrotal surface temperature and its impact on seminal quality in stallions.

Scrotal surface thermography is a non-invasive method for assessing testicular thermoregulation in stallions; however, few studies have explored the application of this technique concerning the thermal physiology of equine reproductive systems. This study aimed to evaluate the consistency of testicular thermoregulation in stallions over a year using thermography to measure the scrotal surface temperature (SST). Moreover, we assessed the best region for measuring the surface body temperature compared with the SST. Ten light-breed stallions were used in the experiment. Thermographic images of the scrotal and body surfaces (neck and abdomen) were captured. Fresh, cooled and frozen-thawed semen samples were evaluated to verify the impact of thermoregulation on semen quality. Testicular thermoregulation was maintained throughout the year in stallions amidst changes in the external temperature, as evidenced by the weak correlation between the SST and ambient temperature. A lower correlation was observed between the environmental temperature and body surface temperature (BTS) obtained from the abdomen (BTS-A; R = .4772; p < .0001) than with that obtained from the neck (BTS-N; R = .7259; p < .0001). Moreover, both BTS-A and SST were simultaneously captured in a single image. The consistent quality of the fresh, cooled and frozen semen suggests efficient thermoregulation in stallions throughout the year.

Confidence degree and skill development in undergraduate medical students using male urogenital training simulators.

INTRODUCTION: medical training should provide the future professional, in addition to theoretical knowledge, general and specific skills. In urology, urogenital training simulators have been presented as an ally in improving the degree of confidence and development of competencies for undergraduate medical students. METHODS: exploratory descriptive research with a quantitative approach, of an experimental nature, of the randomized controlled type with cross-sectional cut. Conducted with the students of the 4th year of medicine of a Higher Education Institution in the West of Paraná. RESULTS: 91 students attended a theoretical class with a complete explanation of the activities to be performed and answered the initial questionnaire about the degree of confidence to perform tasks in three stations with male urogenital training simulators (prostatic touch, bladder catheterization and scrotal evaluation). Of these, 45 received guidance and training with the simulators prior to the stations, while 46 should demonstrate skills directly in the three stations, mimicking patient care, only with information from the theoretical classes. The students who received previous guidance with the simulators had their scores in the development of competence higher. And, when they repeated the questionnaire about the degree of confidence to demonstrate skills with the mannequins, there was a higher degree of confidence in performing the tasks, except for the execution of a task considered more difficult. CONCLUSION: there was an improvement in the degree of confidence and in the development of competencies of undergraduate medical students with the orientations in the male urogenital training simulators.

Anatomical and physiological adaptation of the scrotal artery with muscular reinforcement in the middle layer and connective reinforcement of the adventitia.

The histology of blood vessels shows they are structured in three layers or tunics: tunica intima, which includes the internal limiting lamina with high elastin content; tunica media of smooth muscles fibers of circular disposition, which includes the external limiting lamina; and tunica adventitia of connective tissue. The vascular system is essential in regulating body temperature, especially in the scrotum and testis. This study aimed to analyze the histology of the scrotal arteries and their possible relationship to testicular temperature homeostasis. This study used scrotal samples from human adults, anonymized and obtained from the University of Chile's teaching bank. The control group corresponds to an arteriole of muscle tissue. The results show that the middle layer of the scrotal artery is made up of smooth muscle fibers distributed in two layers: a longitudinal inner sublayer and a circular outer sublayer, different from the findings in muscle tissue arteries, with a single, circularly arranged muscle layer. This arrangement could be related to testicular temperature homeostasis by reducing the temperature of the testis and seminiferous tubules. The results described in this work suggest that these anatomical adaptations may be very significant in the face of the constant increase in global temperature. Further and better research is required to understand the mechanisms of thermoregulation in human reproduction and the histological particularities of the tissues that form the scrotum. RESEARCH HIGHLIGHTS: The human scrotal artery has a histological composition adapted for regulation of testicular temperature. The muscular double middle layer of the scrotal artery retains intravascular temperature.

Calcinosis escrotal: ¿una entidad idiopática? / Scrotal Calcinosis: an Idiopathic Entity?

La calcinosis escrotal es una enfermedad benigna e infrecuente que se presenta en adultos de mediana edad, con múltiples nódulos asintomáticos a nivel de la piel del escroto. Algunos autores vinculan la aparición de estas lesiones a la calcificación secundaria de quistes epidérmicos o ecrinos. Cuando no se encuentra relacionada con dichas entidades ni con alteraciones del metabolismo fosfocálcico, el cuadro se considera idiopático. El tratamiento de elección es quirúrgico, en caso de impacto en la calidad de vida o relevancia estética para el paciente. (AU)

Scrotal calcinosis is a rare, benign disease that presents in middle-aged adults with multiple asymptomatic nodules on the skin of the scrotum. Some authors link the appearance of these lesions to the secondary calcification of epidermal or eccrine cysts. When it is not related to these entities or to alterations in phosphocalcic metabolism, the condition is considered idiopathic. The treatment of choice is surgical, in case of impact on the quality of life or aesthetic relevance for the patient. (AU)

Reconstrucción escrotal con colgajo pediculado del músculo gracilis bilateral e injerto de piel parcial / Scrotal reconstruction with bilateral gracilis muscle pedicled flap and split-thickness skin graft

Los defectos en la región escrotal son producidos en la mayoría de los casos por la gangrena de Fournier, y en ocasiones por traumatismo o patologías oncológicas. Estas heridas generan mucha dificultad para el desarrollo de una vida normal a los pacientes que lo padecen; por lo general producen dolor, los testículos quedan desprotegidos y la espermatogénesis puede verse alterada. Actualmente no existe un método estándar de reconstrucción escrotal, y las técnicas tradicionalmente utilizadas no ofrecen una cobertura funcional ni estética. Generalmente producen mucho abultamiento en la región genital, que puede dificultar el movimiento de las piernas y el uso de pantalones. En este trabajo se expone una opción quirúrgica para reconstruir el escroto, por medio del colgajo pediculado de músculo gracilis bilateral e injerto de piel parcial. Para tal efecto, se presenta un caso clínico de un paciente de 64 años con secuelas en la región perineal, posterior a una gangrena de Fournier. El paciente presentaba una pérdida total del escroto y exposición de ambos testículos. El método arriba mencionado es una opción válida para reconstruir el escroto y en este trabajo se describe la técnica empleada de forma detallada, donde se puede apreciar que presenta escasas complicaciones y es fácil de reproducir por un cirujano plástico entrenado.

Defects in the scrotal region are caused in most cases by Fournier's gangrene, and sometimes by trauma or oncological pathologies. These wounds generate difficulties for the development of a normal life; They usually produce pain; the testicles are unprotected and spermatogenesis can be altered. Currently there is no standard method of scrotal reconstruction, and the techniques traditionally used do not offer functional or aesthetic coverage. They generally produce a big bulge in the genital region, which can make it hard to move the legs and wear pants. A surgical option is exposed to reconstruct the scrotum, by means of the bilateral gracilis muscle pedicled flap and split-thickness skin graft. For this purpose, a clinical case of a 64-year-old patient with sequelae in the perineal region, after Fournier's gangrene, is presented. The patient presented a total loss of the scrotum and exposure of both testicles. The method mentioned above is a valid option to reconstruct the scrotum and the technique used is described in detail, where it can be seen that it is easy to reproduce by a trained plastic surgeon.

Genetic association between feed efficiency, growth, scrotal circumference, and carcass traits in Guzerat cattle.

The objective of this study was to estimate the genetic parameters for feed efficiency-related traits and their genetic correlations with growth, male fertility, and carcass traits using multi-trait analysis in Guzerat cattle. Further, it aimed to predict the direct and correlated responses for feed efficiency traits when selection was applied for growth, male fertility, and carcass traits. The evaluated traits were adjusted weight at 120 (W120), 210 (W210), 365 (W365), and 450 days of age (W450), adjusted scrotal circumference at 365 days of age (SC365) and at 450 days of age (SC450), scrotal circumference, ribeye area (REA), backfat thickness (BFT), rump fat thickness (RFT), residual feed intake (RFI), and dry matter intake (DMI). The genetic parameters were obtained by the restricted maximum likelihood method (REML), using an animal model in multi-trait analyses. The heritability estimates for W120, W210, W365, W450, SC365, and SC450 varied from low to high (0.17 to 0.39). The carcass traits, REA, BFT, and RFT, displayed low to moderate heritability estimates, 0.27, 0.10, and 0.31, respectively. The heritability estimates for RFI (0.15) and DMI (0.23) were low and moderate, respectively. The RFI showed low genetic correlations with growth traits, ranging from - 0.07 to 0.22, from 0.03 to 0.05 for scrotal circumference, and from - 0.35 to 0.16 for carcass, except for DMI, which ranged from 0.42 to 0.46. The RFI and DMI presented enough additive genetic variability to be used as selection criteria in Guzerat breed genetic improvement program. Additionally, the response to selection for RFI would be higher when selection is performed directly for this trait. The selection for residual feed intake would not promote unfavorable correlated responses for scrotal circumference, carcass (yield and finish), and growth traits. Therefore, the selection for more efficient animals would not compromise the productive, reproductive, and carcass performance, contributing to reduce the production costs, increasing the profitability and sustainability of beef cattle production in tropical areas.

Relationship between body weight and scrotal circumference in growing Pelibuey sheep raised under tropical conditions / Relação entre o peso corporal e a circunferência escrotal em ovinos Pelibuey em crescimento criados em condições tropicais

The body weight (BW) of an animal is a vital economic trait that might help in decision-making in the handling of animals. The objective of the present study was to develop equations for the prediction of BW in Pelibuey sheep using scrotal circumference (SC). The BW (23.40 ± 6.96 kg) and SC (20.25 ± 6.19 cm) have been recorded in 405 male Pelibuey at the Southeastern Center for Ovine Integration, Mexico. Linear, logarithmic, quadratic, exponential, cubic, and power regression models were used for data analysis. Pearson correlation (R), Coefficient of determination (R2), Adjusted coefficient of determination (Adj.R2) Root mean square error (RMSE), Akaike information criterion (AIC), and Bayesian information criterion (BIC) were used to select the best model. Power regression model showed the highest R (0.93), R2 (0.86), Adj.R2 (0.86) and lowest RMSE (0.02), AIC (-989.44) and BIC (-981.44). The current study suggests that SC might be used as the only predictor for BW of growing Pelibuey sheep raised under tropical conditions.

O peso corporal (PC) do animal é uma característica econômica importante, que pode auxiliar na tomada de decisões no manejo dos animais. O objetivo do presente estudo foi desenvolver equações para a predição do PC em ovinos Pelibuey por meio da circunferência escrotal (CE). O PC (23,40±6,96kg) e a CE (20,25±6,19cm) foram registrados em 405 ovinos machos da raça Pelibuey no Centro de Integração Ovina da Região Sudeste do México. Os modelos lineares, logarítmicos, quadráticos, exponenciais, cúbicos e de regressão de potência foram utilizados para a análise dos dados. A correlação de Pearson (R), o coeficiente de determinação (R2), o coeficiente de determinação ajustado (Adj.R2), o erro do quadrado médio (EQM), o critério de informação de Akaike (AIC) e o critério de informação bayesiano (BIC) foram usados para selecionar o melhor modelo. O modelo de regressão de potência apresentou maiores R (0,93), R2 (0,86), Adj.R2 (0,86) e menores EQM (0,02), AIC (-989,44) e BIC (-981,44). O estudo atual sugere que a CE pode ser usada como um único preditor para o PC de ovinos Pelibuey em crescimento criadas em condições tropicais.

Weak genotype x environment interaction suggests that measuring scrotal circumference at 12 and 18 mo of age is helpful to select precocious Brahman cattle.

The aim of this study was to evaluate the genotype x environment interaction (GxE) for scrotal circumference (SC) measured at different ages using pedigree-based (A-1) and pedigree and genomic-based (H-1) relationship matrices. Data from 1,515 Brahman bulls, from the Cooperative Research Centre for Beef Genetic Technologies (Beef CRC) experimental dataset, were used in this study. SC was adjusted to age and body weight measured at 6 mo (SC6), 12 mo (SC12), 18 mo (SC18), and 24 mo of age (SC24). Body weight (BW) measured at 6 mo (BW6), 12 mo (BW12), 18 mo (BW18), and 24 mo of age (BW24) was used as criteria to describe the environment for SC in each age. All the animals measured were genotyped using medium-density SNP chips ("50k" or "70k" SNP) and their genotype were imputed using a reference panel with 729,068 SNP. The environment gradient (EG) was obtained by standardizing the solutions of the contemporary groups obtained by Animal Model with BW as the dependent variable. Then, the reaction norms (RN) were determined through a Random Regression Model. The breeding values (EBV) were estimated using either A-1 or H-1. The rank correlation was obtained using Spearman's correlation among the EBV estimated for the traits in analysis. For SC6 and SC24, higher estimates of heritability (h²) were obtained using A-1, when compared with those observed with H-1. In those ages, the improvement of the environment decreases the h² coefficient. On the other hand, the h² for SC12 and SC18 increased as the environment became more favorable, regardless of the matrix used. The RN for SC6 and SC24 estimated using A-1 and H-1 showed a decrease of variance from the worst to the best environment, an indication of existence of GxE. On the other hand, for SC12 and SC18, there were no significant differences between the EBV estimated in the lower and in the higher environments, regardless of the kinship matrix used, suggesting absence of GxE on those ages. Spearman's correlation among EBV estimated using A-1 and H-1 in different EG was practically equal to unity for all traits evaluated. In our study, there was weak evidence of GxE effect on SC in ages suitable for selection for sexual precocity. So, the absence of GxE at 12 and 18 mo means that these ages are advantageous for measuring SC to selection for sexual precocity. The advantage is that no changes in classification were observed when the sires were evaluated in different environments.

Beef production systems rely on efficient cow-calf operations, that is, farms where the cow herd has a high level of fertility and pregnancies are common. Bull fertility also plays an important role in terms of pregnancy rates. To increase herd fertility, cattle breeders and genetic selection programs use some indicator traits that are related to fertility. A common indicator trait used is scrotal circumference (SC), which like most reproduction traits are influenced by the animal's genetics and its environment. For some traits, when the environment has a large effect and it interacts with the genetics of the animals, selection might be less successful. Therefore, it is important to investigate genotype by environment interactions and their effect on reproduction traits used for selection. In this study, SC was measured at four different ages in Brahman cattle. We found weak evidence of genotype by environment effect on SC measured at 12 and 18 mo. In short, SC measured at these ages can be a good indicator of sexual precocity. No changes in sire rankings were observed when SC was measured at those ages, meaning that selecting the best sire is more straightforward than if the environment was playing a bigger role.

A novel orchiectomy surgical procedure in donkeys ( Equus asinus africanus) with parascrotal access.

Donkeys are a public health concern in the Northeast region of Brazil, with thousands of stray animals. Orchiectomy is an important population control measure; however, the long postoperative period with daily treatment of open wounds in the scrotum makes it difficult to perform a large number of castrations in sheltering centers. We evaluate a novel surgical procedure for orchiectomy in donkeys using parascrotal access. Twelve donkeys were used, divided into two groups: I - submitted to orchiectomy through parascrotal surgical access (novel procedure), and II - submitted to orchiectomy through scrotal access (conventional). Postoperative evaluations consisted of a macroscopic evaluation of the surgical wound (bleeding and intensity of edema), hematological parameters, and peritoneal fluid, which occurred in both groups at the moments (M): M0 - before the surgical procedure. The others moments occurred after surgery: M12 (twelve hours); M24 (twenty-four hours); M48 (forty-eight hours); M72 (seventy-two hours); M8D (eight days); and M16D (sixteen days). The surgical techniques did not generate an important systemic inflammatory response to the point detected by the leukogram, fibrinogen dosage, and peritoneal fluid. The parascrotal technique required long surgery but promoted less bleeding, less edema, and faster healing. The techniques used did not promote sufficient systemic inflammation to alter the number of leukocytes and the fibrinogen concentration; however, evaluation of the peritoneal fluid proved to be important for evaluating inflammatory processes involving the scrotum and inguinal canal. We describe a novel surgical procedure for orchiectomy in Donkeys using a parascrotal access that promoted less risk of bleeding, shorter period of edema, and healing time, but required longer surgery time.

Scrotal circumference in Karagouniko and Chios sheep in relation to the aerial environment

Local breeds are a valuable asset in sheep farming systems in Greece and other Mediterranean countries. Among these, Karagouniko and Chios sheep hold a special position, participating in numerous genetic improvement programs, but a research gap exists on their scrotal circumference (SC) in relation to the environmental parameters photoperiod (PHOTO), air temperature, sunshine and rainfall. Therefore, four seasons were examined: April-June and July-September (Long days, increasing and decreasing photoperiod length, respectively), and October-December and January-March (Short days, decreasing and increasing photoperiod length, respectively). Repeated measures analysis of variance and linear correlation analysis were used to investigate the effect of the period on SC and the relationships of SC and each of the environmental parameters above, respectively, in both breeds. Also, independent t-tests were used to investigate SC differences between Karagouniko and Chios. A progressive increase of SC in both breeds coincided with the lowering of PHOTO from April-June to October-December. A significant correlation was confirmed between the SC of each breed and PHOTO, shedding light on the importance of this parameter on SC. Chios sheep had significantly larger (P < 0.05) SC (35.23 cm) than the Karagouniko one (34.59 cm). Better exploitation of these sheep breeds could be derived from the current study's findings.

Sexual behavior and seminal characteristics of Brahman bulls in the Colombian tropical flooded savanna: effects of reproductive management systems and climatic periods.

The objective of this study was to evaluate the seminal traits and sexual behaviors of mature Brahman bulls in a multi-sire system during mating or resting seasons and different climatic periods of the year at the Colombian flooded savannas. Thirty-two Brahman bulls, suitable for reproduction, were used, which were subjected to breeding soundness evaluation, as well as the libido and service capacity tests. Such evaluations were compared among different seasons of the year in relation to the rainfall. Libido and service capacity tests were carried out in paddock for 12 continuous hours. Scrotal circumference and all seminal traits were not influenced by the mating or rest seasons, neither by the different climatic periods. However, libido and service capacity were significantly affected by the climatic periods, decreasing their expression during the intense rainfall season, and increasing during the transition period from summer to the onset of rains, which could be considered the appropriate time to establish mating seasons in this region. Furthermore, a high positive correlation was observed between libido and service capacity confirmed by a logistic model that animals with low libido have low probability of having high service capacity. In conclusion, although Brahman bulls are physiologically adapted to tropical regions, their expression of sexual behavior is markedly influenced by the weather. Hence, the use of libido test may serve as a good predictor of the service capacity, and a useful tool to improve the selection of sires.

Scrotal hemangiosarcoma in a Large White boar / Hemangiossarcoma na bolsa escrotal de um reprodutor Large White

Tumors are rarely diagnosed in swine specie because of the short lifespan of production animals. Normally, these tumors do not present any clinical signs and are often detected at the time of slaughter. A 2-year-old Large White boar, used in the reproductive management of a farm and without a history of pre-existing problems, was examined for skin lesions on the scrotum. Samples were collected from skin segments containing lesions for histopathological and immunohistochemical diagnosis. Microscopically, the nodes in the scrotum pouch consisted of poorly demarcated, highly cellular, expansile, and multifocally invasive neoplasms, composed of immature endotheliocytes organized into neovascular formations. The tumor cells were pleomorphic, slightly oval to spindle-shaped, with eosinophilic cytoplasm and hyperchromatic nuclei with one to three nucleoli. All the nodules analyzed were compatible with hemangiosarcoma. After immunohistochemical evaluation, for the quantification of tissue angiogenesis the neoplastic cells immunoexpressed the CD31 monoclonal antibodies and factor VIII, through the identification of proteins expressed on the surface of endothelial cells. The Ki67 cell proliferation marker was positive in approximately 10% of the neoplastic cells, demonstrating a high degree of malignancy. Hemangiosarcoma in swine species has already been identified in several organs and tissues; however, to date, no study has demonstrated the diagnosis of this condition on the skin of the scrotum, as reported in this study. Therefore, it is expected that this report will contribute to the knowledge of the frequency of neoplasms in swine species.

Na espécie suína os tumores são pouco diagnosticados devido a curta vida útil dos animais de produção. Normalmente não causam sinais clínicos, sendo, muitas vezes, encontrados no momento do abate. Um reprodutor com dois anos de idade, da raça Large White, utilizado no manejo reprodutivo de uma granja, sem histórico de problemas pré-existentes, foi examinado em função de lesões na pele da bolsa escrotal. Foram coletadas amostras de segmentos de pele contendo lesões para o diagnóstico histopatológico e imunohistoquímico. Microscopicamente os nodos em bolsa escrotal consistiam em neoplasias mal demarcadas, altamente celulares, expansivas e multifocalmente invasivas composta por endoteliócitos imaturos organizados em formações neovasculares. As células tumorais eram pleomórficas, levemente ovais a fusiformes com citoplasma eosinofílico e núcleos hipercromáticos e com um a três nucléolos. Todos os nódulos analisados foram compatíveis com hemangiossarcoma. Para a quantificação da angiogênese tecidual, após a avaliação imunohistoquímica, as células neoplásicas imunoexpressaram os anticorpos monoclonais CD31 e Fator VIII, através da identificação de proteínas expressas na superfície das células endoteliais. Observou-se o marcador de proliferação celular Ki67 positivo em aproximadamente 10% das células neoplásicas, demonstrando um alto grau de malignidade. O hemangiossarcoma na espécie suína já foi identificado em vários órgãos e tecidos, mas, até o momento, nenhum trabalho demonstrou o diagnóstico na pele da bolsa escrotal, como reportado, ineditamente, neste estudo. Face o exposto, espera-se que este relato contribua para a frequência de neoplasias encontradas na espécie suína.

Quiste del rafe medio perineal / Median raphe cysts of the perineum

Introducción: los quistes de rafe medio (QRM) son lesiones infrecuentes del aparato genital masculino, pueden localizarse desde la parte distal del pene hasta la zona perianal. Se deben a defectos del cierre del rafe medio durante el desarrollo embrionario. Objetivo: presentar un lactante con el diagnóstico de QRM, discutir el diagnóstico, tratamiento y seguimiento. Caso clínico: niño de 1 año y 3 meses de edad con 7 lesiones quísticas de 0.5 cm cada una en el rafe medio escrotal desde el nacimiento, la ecografía de partes blandas reporta imagen sólida hipoecogénica de borde definidos y sin vascularización al doppler. Se realizó exéresis quirúrgica y la patología confirmó el diagnóstico de quiste de rafe medio perineal, con buena evolución en el seguimiento. Discusión: 75% de los casos de los QRM son asintomáticos es por ello que muchas veces su diagnóstico es tardío, además su desconocimiento produce confusión con patologías quísticas o tumorales similares. El diagnóstico es clínico, aunque la ecografía puede ayudar para excluir otras anomalías como las vasculares. El tratamiento de elección debe ser la extirpación quirúrgica para evitar episodios de sobreinfección o molestias locales derivadas de su localización y tamaño. Conclusión: debido a lo infrecuente de esta patología es importante darla a conocer. Se recomienda realizar la valoración integral del paciente pediátrico para lograr un adecuado diagnóstico, ofrecer el mejor tratamiento y brindar información adecuada a los padres.

Introduction: median raphe cysts (MRC) are uncommon lesions of the male genitalia. They can be found anywhere from the distal penis to the perianal area. They are caused by an incomplete closure of the median raphe during embryologic development. Objective: to present a case of MRC in an infant and provide a review on diagnosis, treatment and follow-up. Case report: one year and three months old boy, with seven 0.5 cm sized cystic lesions along the scrotum median raphe, noticed since birth. A soft tissue ultrasound demonstrated a well-circumscribed hypoechogenic solid image without any evidence of vascularity at Doppler ultrasound. Surgical excision was conducted and histopathology confirmed the diagnosis of a median raphe cyst of the perineum, showing good progression in follow-up. Discussion: 75% of cases of MRC are asymptomatic, thus their diagnosis is often delayed. Not knowing this condition leads to confuse MRC with other similar cysts or tumors. The diagnosis is mostly clinical, although ultrasound may help to exclude other anomalies such as vascular anomalies. Surgical excision is the treatment of choice to prevent superinfection or local discomfort due to its location and size. Conclusion: Recognition of this uncommon pathology is imperative. A comprehensive evaluation of the pediatric patient is recommended to achieve an adequate diagnosis and treatment and provide appropriate information to the parents.