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Veterinaria Italiana Dec 2020Orchitis and epididymo-orchitis are inflammatory lesions of the testicle. We herein describe a case of monolateral chronic orchitis which occurred in a Tiro Pesante...
Orchitis and epididymo-orchitis are inflammatory lesions of the testicle. We herein describe a case of monolateral chronic orchitis which occurred in a Tiro Pesante Rapido (TPR) stallion, born in 2002, with a history of good fertility. The stallion was healthy and asymptomatic although the left testis was found to be smaller as compared with the right one and was hard in consistency. Histopathology examination revealed tubular atrophy and parenchymal sclerosis. Scattered foci of calcification and chronic inflammation, the latter dominated by macrophages and lymphocytes, were also observed. Although lesions were clearly present, the semen was demonstraed to be of good quality. This study highlights the need for periodic clinical and ultrasound evaluation of stallions, in order to preserve their reproductive performance.
Topics: Animals; Chronic Disease; Horse Diseases; Horses; Male; Orchitis; Testis
PubMed: 32602673
DOI: 10.12834/VetIt.2330.13219.1 -
European Review For Medical and... Jan 2021The objective of this review is to provide currently available information on the potential effects of coronavirus disease 2019 (COVID-19) on male fertility. (Review)
Review
OBJECTIVE
The objective of this review is to provide currently available information on the potential effects of coronavirus disease 2019 (COVID-19) on male fertility.
MATERIALS AND METHODS
This is a mini-review. Due to the similarity between the COVID-19 and severe acute respiratory syndrome (SARS) virus, we searched for the following keywords: "SARS-CoV, male reproductive system, infertility, COVID-19, SARS-CoV-2, and orchitis". By reviewing and analyzing the literature, we analyzed the influence of temperature on sperm, the expression of angiotensin-converting enzyme 2 (ACE2) in the testes, and the impact of SARS-CoV-2 on the male reproductive system.
RESULTS
SARS-CoV-2 enters the body through the ACE2 receptor. The high expression of ACE2 on the surface of spermatogonia and supporting cells in the testes, as well as the immune response caused by COVID-19, can lead to testicular spermatogenesis dysfunction and reduced sperm count.
CONCLUSIONS
COVID-19 infection can affect male reproductive function, and standard treatment strategies should be established in time to help male patients infected with COVID-19.
Topics: Angiotensin-Converting Enzyme 2; COVID-19; Genitalia, Male; Humans; Male; Orchitis; Spermatozoa
PubMed: 33577068
DOI: 10.26355/eurrev_202101_24682 -
Journal of Family Medicine and Primary... Sep 2022Blood-testis barrier is body's innate mechanism to defend germ cells by creating a physical and immunological barrier. But some viral infections are known to evade it.... (Review)
Review
Blood-testis barrier is body's innate mechanism to defend germ cells by creating a physical and immunological barrier. But some viral infections are known to evade it. As ACE2 and TMPRSS2 are present all over the body including male reproductive tract, it is worth exploring how coronavirus disease (COVID-19) could possibly affect male fertility. A review of literature was done using search engines like PubMed, Medline, Google Scholar, etc., and all the latest articles up to May 2021 were considered. Some studies have substantiated the presence of orchitis in COVID patients using semen and tissue samples. Though most studies report the absence of virus in testis, involvement of seminiferous tubules has been seen in pathological analysis suggesting defective spermatogenesis. This can be primarily attributed to inflammation and increased vascular permeability. Other factors that could affect male fertility are fever, autoimmune response, drugs, and erectile dysfunction. Male fertility is an important aspect of health care and must be looked into. Further studies can be done to understand host immunity towards SARS-CoV-2 in the testis. It will be worthwhile to know whether viral orchitis and its sequelae are acute or chronic in nature, and if they are reversible. Effect of the virus on female reproductive tract can also be assessed further. Counselling can be given to affected/recovering patients along with correct selection of drugs to prevent these long-term complications.
PubMed: 36505593
DOI: 10.4103/jfmpc.jfmpc_199_22 -
International Journal of Molecular... Dec 2020The immune privilege of the testes is necessary to prevent immune attacks to gamete-specific antigens and paternal major histocompatibility complex (MHC) antigens,... (Review)
Review
The immune privilege of the testes is necessary to prevent immune attacks to gamete-specific antigens and paternal major histocompatibility complex (MHC) antigens, allowing for normal spermatogenesis. However, infection and inflammation of the male genital tract can break the immune tolerance and represent a significant cause of male infertility. Different T cell subsets have been identified in mammalian testes, which may be involved in the maintenance of immune tolerance and pathogenic immune responses in testicular infection and inflammation. We reviewed the evidence in the published literature on different T subtypes (regulatory T cells, helper T cells, cytotoxic T cells, γδ T cells, and natural killer T cells) in human and animal testes that support their regulatory roles in infertility and the orchitis pathology. While many in vitro studies have indicated the regulation potential of functional T cell subsets and their possible interaction with Sertoli cells, Leydig cells, and spermatogenesis, both under physiological and pathological processes, there have been no in situ studies to date. Nevertheless, the normal distribution and function of T cell subsets are essential for the immune privilege of the testes and intact spermatogenesis, and T cell-mediated immune response drives testicular inflammation. The distinct function of different T cell subsets in testicular homeostasis and the orchitis pathology suggests a considerable potential of targeting specific T cell subsets for therapies targeting chronic orchitis and immune infertility.
Topics: Animals; Autoimmunity; Biomarkers; Disease Management; Disease Susceptibility; Homeostasis; Humans; Immunity; Immunomodulation; Leydig Cells; Male; Sertoli Cells; Spermatogenesis; T-Lymphocyte Subsets; T-Lymphocytes; Testis
PubMed: 33374605
DOI: 10.3390/ijms22010057 -
Aktuelle Urologie May 2016Acute epididymitis is an inflammation of the epididymis. It mostly occurs unilaterally and may spread to the testis ('epididymo-orchitis') if untreated. Increasing... (Review)
Review
BACKGROUND
Acute epididymitis is an inflammation of the epididymis. It mostly occurs unilaterally and may spread to the testis ('epididymo-orchitis') if untreated. Increasing technological advances allow for an even more detailed examination of concurrent symptoms such as ejaculate changes and the whole spectrum of pathogenic agents, which ranges from sexually transmitted pathogens such as Chlamydia and gonococci to enterobacteria and, rarely, viruses. This review summarises major aspects of the disease including the latest scientific findings.
METHODS
A selective literature search including the last 40 years was performed via Medline.
RESULTS
With about 400 cases a year in 100 000 men, acute epididymitis is the most common urogenital infection in men. It occurs across all age groups including children. Despite the fact that bacterial ascension is aetiologically of utmost relevance, only one out of three men reports signs of dysuria or urethritis. In young, sexually active men, sexually transmitted pathogens are regularly found in addition to the characteristic enterobacteriae, even if these men have an unremarkable sexual history. 88% of epididymal abscess formations can be successfully treated without surgery. Patients with indwelling urethral catheters are at a high risk of multiple drug resistance and should be treated empirically with both a fluoroquinolone and a third-generation cephalosporin until antimicrobial susceptibility testing has been completed. About 40 out of 100 patients develop post-inflammatory sub-fertility. Here, virulence factors like haemolysin A produced by uropathogenic E. coli have a negative impact on semen parameters compared to those patients suffering from epididymitis induced by haemolysin A negative strains. With adequate antibiotic treatment there is no evidence for testicular atrophy. Only one out of 10 men relapses. These cases should be examined thoroughly for subvesical obstruction. Some of them may benefit from prophylactic vasectomy.
CONCLUSIONS
This review presents key aspects of acute epididymitis, which are increasingly adopted in updated guidelines.
Topics: Abscess; Adolescent; Adult; Aged; Anti-Bacterial Agents; Bacterial Infections; Drug Resistance, Bacterial; Epididymitis; Guideline Adherence; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Orchitis; Risk Factors; Sexually Transmitted Diseases; Young Adult
PubMed: 27123660
DOI: 10.1055/s-0042-104803 -
Ultrasonography (Seoul, Korea) Jul 2021The purpose of this pictorial essay is to describe the ultrasonographic and clinical findings of patients with small testes due to a wide range of causes. We...
The purpose of this pictorial essay is to describe the ultrasonographic and clinical findings of patients with small testes due to a wide range of causes. We retrospectively reviewed the ultrasonographic and clinical findings of various causes of small testes. We present various causes of small testes on ultrasonography including Klinefelter syndrome, testicular torsion, mumps orchitis, inguinal hernia, cryptorchidism, varicocele, and trauma. On ultrasonography, small testes in patients with testicular torsion, mumps orchitis, and trauma usually showed heterogeneous echogenicity. Atrophic testes were homogeneously hypoechoic in patients with cryptorchidism and inguinal hernia and were isoechoic to the normal testis in patients with varicocele. Klinefelter syndrome patients had small hyperechoic or hypoechoic nodules, but the echogenicity of the remnant portion of the testes was homogeneous. Ultrasonography is helpful for detecting small testes and for the differential diagnosis of the various possible causes of small testes.
PubMed: 33455146
DOI: 10.14366/usg.20133 -
Abdominal Radiology (New York) Dec 2017
Review
Topics: Diagnosis, Differential; Epididymitis; Humans; Male; Orchitis; Scrotum; Testis; Ultrasonography, Doppler, Color
PubMed: 28647767
DOI: 10.1007/s00261-017-1222-4 -
Human Reproduction Update Nov 2017Zika virus (ZIKV) is an arthropod-borne virus of the family Flaviviridae, genus Flavivirus. ZIKV is currently the focus of an ongoing pandemic and worldwide public... (Review)
Review
BACKGROUND
Zika virus (ZIKV) is an arthropod-borne virus of the family Flaviviridae, genus Flavivirus. ZIKV is currently the focus of an ongoing pandemic and worldwide public health emergency. Although originally isolated in 1947, its pathogenesis was poorly known and very few documented infections were published until recently. Its route of transmission and its impact on reproduction and pregnancy have only recently begun to be disclosed.
OBJECTIVE AND RATIONALE
This review summarizes the most recent knowledge about ZIKV infection and pathogenesis and focuses on its impacts on male and female genital tracts, including the risks of sexual transmission and to pregnancy. The consequences of ZIKV infection for pregnancy planning and ART are also discussed.
SEARCH METHODS
The PubMed and EMBASE databases were inter-rogated using specific terms, such as 'ZIKV', 'transmission', 'male', 'female', fertility', 'pregnancy, 'semen', 'testis', 'ovary' and 'genital tract', up to 17 March 2017.
OUTCOMES
ZIKV has long been considered a harmless virus, but increasing evidence suggests that it has adverse effects on the neurological system and on pregnancy outcomes. In mice, ZIKV slows foetal growth and damages the foetal brain. In humans, the virus is able to cross the placental barrier and to induce foetal death and major anomalies, such as microcephaly, brain defects and long-term neurologic sequelae, i.e. the 'congenital Zika syndrome'. In addition to its transmission by mosquitoes, ZIKV may be transmitted sexually. Currently available data indicate that ZIKV RNA can remain detectable in semen for several months, whereas shedding in the female genital tract appears to be rare and of short duration. Current guidance on preventing the sexual transmission of ZIKV is based on the assumption that transmission occurs from a male partner to a receptive partner. Furthermore, in mouse models, the virus can actively replicate in male genital organs and induce severe orchitis, which raises concerns about its possible impact on human male fertility.
WIDER IMPLICATIONS
These new and relevant findings have led many countries and institutions to release updated and regular guidance for preconception counselling and ART to prevent the sexual transmission of ZIKV. Progress in understanding the sexual transmission of ZIKV and its dissemination to genital systems would also help to better anticipate and control outbreaks of potentially sexually transmissible infectious agents.
Topics: Animals; Female; Humans; Infectious Disease Transmission, Vertical; Male; Mice; Microcephaly; Orchitis; Pregnancy; Pregnancy Complications, Infectious; Reproduction; Semen; Sexually Transmitted Diseases, Viral; Vagina; Zika Virus; Zika Virus Infection
PubMed: 28961800
DOI: 10.1093/humupd/dmx024 -
Travel Medicine and Infectious Disease 2014To review retrospectively the clinical symptoms, laboratory findings and treatment outcomes of patients with Brucellar epididymo-orchitis. (Review)
Review
OBJECTIVE
To review retrospectively the clinical symptoms, laboratory findings and treatment outcomes of patients with Brucellar epididymo-orchitis.
MATERIAL AND METHOD
Retrospective data of 28 patients with Brucellar epididymo-orchitis who admitted to four medical centers between 2005 and 2013 were retrospectively reviewed. Positive blood culture, positive Rose Bengal test results or high agglutination titres of ≥ 1/160 with the positive clinical and ultrasonographic findings of orchitis were accepted as the main criteria for Brucellar epididymo-orchitis.
RESULTS
The mean patient age was 31 ± 16.9 years. Testicular involvement was on the left side in 16 patients and on the right side in 11 patients, one had bilateral disease. Testicular pain and swelling were the most common symptoms and elevation of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leucocytosis were the most common laboratory findings. Initial treatment was orchidectomy in six patients due to malignancy suspicion. All but three patients were successfully treated with antibiotic combinations of rifampicin, doxycycline and streptomycin. Two of three treatment resistant patients underwent orchidectomy.
CONCLUSION
Brucellosis is a common cause of epididymo-orchitis in endemic regions. Early diagnosis and treatment is crucial in the management and thus it must be kept in mind in endemic and non-endemic regions.
Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Brucella; Brucellosis; Child; Drug Combinations; Epididymitis; Humans; Male; Middle Aged; Orchiectomy; Orchitis; Retrospective Studies; Treatment Outcome; Turkey; Young Adult
PubMed: 25457303
DOI: 10.1016/j.tmaid.2014.10.005 -
Acta Radiologica (Stockholm, Sweden :... Mar 2022Diffusion-weighted imaging (DWI) can quantitatively reflect the diffusion characteristics of tissues, providing a theoretical basis for qualitative diagnosis and...
BACKGROUND
Diffusion-weighted imaging (DWI) can quantitatively reflect the diffusion characteristics of tissues, providing a theoretical basis for qualitative diagnosis and quantitative analysis of a disease.
PURPOSE
To characterize testicular lesions that present as a hypointense signal on magnetic resonance imaging (MRI) T2-weighted images using DWI.
MATERIAL AND METHODS
Study participants were divided into three groups. Group A were healthy controls (n = 35), group B included patients with mumps orchitis (n = 20), and group C included patients with seminoma (n = 15). DWI sequences used b-values of 0, 1000, and 2000 s/mm. Apparent diffusion coefficient (ADC) values between 1000 and 2000 s/mm were calculated by MRI postprocessing software. The Kruskal-Wallis test and receiver operating characteristic analysis were performed to evaluate how well ADC values distinguished between mumps orchitis and seminoma.
RESULTS
Normal testicular tissue showed a hyperintense signal on DWI and hypointensity on the ADC map: mean ADC value was 0.77 (0.69-0.85) ± 0.08 ×10 mm/s. Mumps orchitis and seminoma showed slight hyperintensity on DWI: mean ADC values were 0.85 (0.71-0.99) ± 0.15 ×10 mm/s and 0.43 (0.39-0.47) ± 0.04 × 10 mm/s, respectively. There were statistically significant differences in mean ADC values between normal testicular tissue and seminoma and between mumps orchitis and seminoma. The cutoff ADC value for differentiating seminoma from mumps orchitis was 0.54 × 10 mm/s. The sensitivity, specificity, and Youden Index for diagnosing seminoma were 99%, 31%, and 30%, respectively.
CONCLUSION
High b-value DWI has potential utility for differentiating mumps orchitis from seminoma in the clinical setting.
Topics: Adult; Case-Control Studies; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Humans; Male; Mumps; Orchitis; ROC Curve; Retrospective Studies; Seminoma; Sensitivity and Specificity; Statistics, Nonparametric; Testicular Neoplasms; Testis; Young Adult
PubMed: 33557577
DOI: 10.1177/0284185121991980