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Archivio Italiano Di Urologia,... Oct 2023This study aims to build a 3D reconstruction computed simulation model and to establish a regression equation for detecting the testis's temperature by its location...
Reference value of testicular temperature measured by finite element analysis after first staged inguinal orchidopexy in children with abdominal testis and short spermatic cord.
PURPOSE
This study aims to build a 3D reconstruction computed simulation model and to establish a regression equation for detecting the testis's temperature by its location after first staged open orchidopexy in children with abdominal undescended testis (UDT) and short spermatic cords.
METHODS
In this cross-sectional study, we enrolled 31 children with abdominal UDT and short spermatic cords who underwent first staged orchiopexy between 2017 and 2020. Using ultrasonography to obtain the testis's location distance from the skin surface (X1), external iliac vessel (X2), and internal inguinal ring (X3), we input the data into a 3D reconstruction computed simulation along with COMSOL to calculate the testicular temperature. We also used multivariate regression to establish the testicular temperature regression equation from the gathered data.
RESULT
The mean age of the participants was 4.47 ± 1.21 years. The mean size of the operated testis was 0.39 ± 0.13 cc. The mean distance of the testis from X1, X2, and X3 was 3.27 ± 1.25 mm, 21.06 ± 6.42 mm, and 27.19 ± 10.09 mm, respectively. The testicular temperature regression equation derived from testis location was calculated by the formula: 34.57 + 0.0236 X12 - 0.0105 X2 - 0.0018 X3. The concordance for testis temperature calculated via the computational method and regression equation was 83%.
CONCLUSIONS
The current study provided a reference value for the testicular temperature of children with abdominal UDT and short spermatic cords after the first stage of orchiopexy. A testicular temperature regression equation can be established based on the testis location, which will provide relevant information for the testicular development assessment, disease diagnosis, and follow-up, and possibly determination of the time of the second stage of orchiopexy.
Topics: Male; Child; Humans; Infant; Child, Preschool; Testis; Orchiopexy; Spermatic Cord; Finite Element Analysis; Reference Values; Cross-Sectional Studies; Temperature; Cryptorchidism; Retrospective Studies
PubMed: 37791558
DOI: 10.4081/aiua.2023.11528 -
Annales de Pathologie May 2024Paratesticular mesothelioma is a very rare tumour, accounting for 0.3 to 1.4% of all mesotheliomas. Mesothelioma arising from the spermatic cord is extremely rare with...
Paratesticular mesothelioma is a very rare tumour, accounting for 0.3 to 1.4% of all mesotheliomas. Mesothelioma arising from the spermatic cord is extremely rare with only a few cases reported in the literature. We report a case of spermatic cord mesothelioma in a 70-year-old man who presented with a right inguinal mass and pain.
PubMed: 38719754
DOI: 10.1016/j.annpat.2024.04.016 -
Translational Andrology and Urology Feb 2024Inflammatory myofibroblastic tumor (IMT) is a rare entity that is described in several organ systems. This comprehensive review aims to identify IMTs occurring at... (Review)
Review
BACKGROUND AND OBJECTIVE
Inflammatory myofibroblastic tumor (IMT) is a rare entity that is described in several organ systems. This comprehensive review aims to identify IMTs occurring at various genitourinary (GU) organ sites and describe patterns of clinical management in adult and pediatric patients.
METHODS
A comprehensive search of PubMed and Web of Science was conducted according to the Preferred Reporting Items for Systematic Review and meta-analyses statement. Two reviewers performed independent initial screening of abstracts. Eligible articles underwent full review and data extraction. The clinical features, diagnostic tests, treatment, and outcomes at each GU organ site were analyzed individually and summarized into a comprehensive review.
KEY CONTENT AND FINDINGS
Of the 270 articles identified, 112 met inclusion criteria. Articles primarily consisted of case reports or small series describing a total of 167 cases, of which 30 (18%) occurred in children. Most patients (96%) were symptomatic at presentation. The most frequently involved sites included bladder (106 cases) and kidney (n=33) followed by epididymis (n=6), urachus (n=6), ureter (n=5), prostate (n=4), testis (n=4), and spermatic cord (n=3). Complete surgical excision of the mass including partial or total removal of involved organs provided excellent outcomes. Incomplete excision was associated with early local recurrence and progression. Late recurrence or metastatic transformation was rarely noted (<2%).
CONCLUSIONS
IMTs exhibit locally invasive, symptomatic and progressive phenotypes that affect all urologic organs in adults and children. Clinical features and imaging results are similar to those noted with urologic cancers. These tumors require complete surgical excision since incomplete resection increases the risk of symptomatic recurrence.
PubMed: 38481869
DOI: 10.21037/tau-23-471 -
Urology Annals 2023Varicocele, the dilation of the pampiniform plexus of the spermatic cord. It is discovered incidentally in most patients. Symptoms vary, but its impact is especially...
OBJECTIVE
Varicocele, the dilation of the pampiniform plexus of the spermatic cord. It is discovered incidentally in most patients. Symptoms vary, but its impact is especially experienced in the field of fertility and reflected in semen parameters. Varicocelectomy is a surgical approach to correct the varicocele, however, reports are conflicting regarding its success. Our aim was to evaluate the efficacy of varicocelectomy on semen parameters and conception rates in patients who underwent surgery and its association with comorbidities such as diabetes, hypertension, and obesity.
MATERIALS AND METHODS
This cross-sectional study included the complete medical records of 86 patients. Data collection form included the patient's age, body mass index (BMI), chronic diseases, smoking, surgical history, medication usage, and the reason for performing surgery. Presurgical and postsurgical semen parameters were evaluated 3 months before surgery and an average of 6 months postoperatively. Data were analyzed with SPSS, Chi-square test, and independent and paired -test.
RESULTS
No significant difference was found between primary and secondary infertility regarding semen analysis, postoperative semen analysis indicated an improvement in semen motility at 180 min with no effect on other parameters. Using spontaneous intercourse or fertilization (IVF) after varicocelectomy was significantly associated with increasing conception rates irrespective of the type of infertility. Diabetes, hypertension, BMI, and smoking did not appear to affect semen parameters.
CONCLUSION
Patients who underwent varicocelectomy had improved sperm motility at 180 min and subsequently had a higher chance of successful conception either through spontaneous intercourse or IVF. Further studies are needed to understand the relationship between conception and sperm motility. Semen parameters were not affected if the patient had comorbidities such as diabetes and hypertension. Furthermore, smoking and BMI did not appear to affect the conception rate.
PubMed: 37664101
DOI: 10.4103/ua.ua_49_22 -
Journal of Medical Ultrasonics (2001) Jan 2024Testicular torsion is a urological emergency caused by the loss of testicular tissue due to ischemic damage. Rapid diagnosis and urgent treatment play a crucial role in... (Review)
Review
Testicular torsion is a urological emergency caused by the loss of testicular tissue due to ischemic damage. Rapid diagnosis and urgent treatment play a crucial role in the management of testicular torsion. Manual detorsion can be performed at the bedside, thereby reducing the duration of ischemia. Recent studies have reported the use of point-of-care ultrasonography for diagnosing testicular torsion; however, no review article has focused on the ultrasonographic findings pertaining to manual detorsion. This review describes the diagnosis of testicular torsion and the ultrasonographic indications for manual detorsion. Spermatic cord twisting or the whirlpool sign, absence of or decreased blood flow within the affected testis, abnormal testicular axis, abnormal echogenicity, and enlargement of the affected testis and epididymis due to ischemia are the sonographic findings associated with testicular torsion. The following findings are considered indications for manual detorsion: direction of testicular torsion, i.e., inner or outer direction (ultrasonographic accuracy of 70%), and the degree of spermatic cord twist. The following sonographic findings are used to determine whether the treatment was successful: presence of the whirlpool sign and the degree and extent of perfusion of the affected testis. Misdiagnosis of the direction of manual detorsion, a high degree of spermatic cord twisting and insufficient detorsion, testicular compartment syndrome, and testicular necrosis were found to result in treatment failure. The success of manual detorsion is determined based on the symptoms and sonographic findings. Subsequent surgical exploration is recommended in all cases, regardless of the success of manual detorsion.
Topics: Male; Humans; Spermatic Cord Torsion; Point-of-Care Systems; Testis; Ultrasonography; Ischemia
PubMed: 37863980
DOI: 10.1007/s10396-023-01374-z -
Polski Przeglad Chirurgiczny Oct 2023Testicular and scrotal abnormalities can occur in children, adolescents, and adults. The lesions, often accompanied by pain and swelling/enlargement of the scrotum, can...
Testicular and scrotal abnormalities can occur in children, adolescents, and adults. The lesions, often accompanied by pain and swelling/enlargement of the scrotum, can cause anxiety in patients and their parents. Regardless of age, proper diagnosis is based on adequate anamnesis and physical examination. Color Doppler ultrasound is the first-line test in the differential process of testicular and scrotal diseases. Testicular and scrotal lesions require differentiation for benign and malignant processes as well as therapeutic management, including urgent surgical intervention. The aim of this paper is to present the most common causes of testicular and scrotal abnormalities in pediatric and adult patients and to outline the symptoms and diagnostic and therapeutic management.
Topics: Male; Adolescent; Humans; Child; Genital Diseases, Male; Scrotum; Spermatic Cord Torsion
PubMed: 38348982
DOI: 10.5604/01.3001.0053.9349 -
Veterinary Surgery : VS Apr 2024To describe a modified laparoscopic-assisted cryptorchidectomy technique in dogs using a single-port endoscope and evaluate clinical outcome in abdominal cryptorchid...
OBJECTIVE
To describe a modified laparoscopic-assisted cryptorchidectomy technique in dogs using a single-port endoscope and evaluate clinical outcome in abdominal cryptorchid dogs that underwent the procedure.
STUDY DESIGN
Prospective case series.
ANIMALS
A total of 14 client-owned dogs (19 abdominal cryptorchid testes).
METHODS
Dogs scheduled for laparoscopic cryptorchidectomy between January 2019 and April 2022 were enrolled in the study. The dogs underwent single-port laparoscopic-assisted cryptorchidectomy (SP-LAC) performed by a single surgeon using a 10-mm single-port endoscope placed in the midline immediately cranial to the prepuce. The abdominal testis was endoscopically located and grasped, the cannula was retracted, the capnoperitoneum was reversed to allow exteriorization of the testis, and the spermatic cord was ligated extracorporeally.
RESULTS
Median age was 13 months (range, 7-29 months) and median bodyweight was 23.0 kg (range, 2.2-55.0 kg). Nine of 14 dogs had unilateral abdominal cryptorchidism (7 right-sided and 2 left-sided) and 5/14 dogs had bilateral abdominal cryptorchidism. Median surgical time for unilateral abdominal cryptorchidectomy was 17 min (range, 14-21 min) and for bilateral abdominal cryptorchidectomy 27 min (range, 23-55 min). Ten dogs had additional surgical procedures performed concurrently with SP-LAC. One major intraoperative complication (testicular artery hemorrhage) occurred that required emergency conversion and two minor entry-related complications were observed.
CONCLUSION
The SP-LAC procedure enabled removal of abdominal testes and was associated with a low morbidity.
CLINICAL SIGNIFICANCE
The SP-LAC procedure can be performed by a single surgeon and represents a less invasive alternative to multi-port laparoscopic-assisted or single-port multi-access laparoscopic cryptorchidectomy techniques.
Topics: Humans; Male; Dogs; Animals; Cryptorchidism; Orchiectomy; Laparoscopy; Abdomen; Dog Diseases
PubMed: 37424154
DOI: 10.1111/vsu.13988 -
International Journal of Surgical... Apr 2024. This study aims to review the morphological and immunohistochemical features of testicular tumors and compare them with prognostic parameters. . Testicular tumors... (Review)
Review
. This study aims to review the morphological and immunohistochemical features of testicular tumors and compare them with prognostic parameters. . Testicular tumors diagnosed between January 2011 and September 2021 were reviewed. Patient age, tumor subtype, size, spread, lateralization, number of foci, and immunohistochemical results were recorded. . A total of 121 tumors were detected, of which 108 (89%) were germ cell tumors (GCTs). Of the germ cell tumors, 70 (65%) were found to be pure type, and 38 (35%) were mixed germ cell tumors. The ratio of pure seminoma among GCTs was 56/108 (52%). Lymphatic/vascular invasion (LVI) was detected in 48/121 (40%), rete testis invasion in 32/121 (26%), hilar soft tissue invasion in 10/121 (8%), epididymal invasion in 5/121 (4%), and spermatic cord invasion in 5/121 (4%) patients. Lymphatic/vascular invasion was observed in 6 (22%) of 27 germ cell tumors smaller than 3 cm in size, and rete testis invasion was observed in 2 (7%), while in 40 (55%) of the 73 germ cell tumors of 3 cm and above, lymphatic/vascular invasion was seen, and 26 (36%) of them had rete testis invasion. Immunohistochemical results contributed significantly to the determination of tumor components and rates, especially in mixed germ cell tumors. . Most of the tumors were germ cell tumors, and the majority were seminomas. Lymphatic/vascular invasion and rete testis invasion rates increase as the tumor diameter increases, which is more evident when the 3 cm cut-off value is taken into account ( < 0.005).
Topics: Humans; Male; Epididymis; Lymphatic Vessels; Neoplasms, Germ Cell and Embryonal; Seminoma; Testicular Neoplasms
PubMed: 37292006
DOI: 10.1177/10668969231180270 -
Heliyon May 2024Testicular torsion is a urological emergency that involves the twisting of the spermatic cord along its course. Compelling pieces of evidence have implicated oxidative... (Review)
Review
Testicular torsion is a urological emergency that involves the twisting of the spermatic cord along its course. Compelling pieces of evidence have implicated oxidative stress-sensitive signaling in pathogenesis of testicular I/R injury. Although, surgical detorsion is the mainstay management; blockade of the pathways involved in the pathogenesis may improve the surgical outcome. Experimental studies using various testicular I/R models have been reported in a bid to explore the mechanisms associated with testicular I/R and evaluate the benefits of potential therapeutic measures; however, most are limited by their shortcomings. Thus, this review was intended to describe the details of the available testicular I/R models as well as their merits and drawbacks, the pathophysiological basis and consequences of testicular I/R, and the pharmacological agents that have being proposed to confer testicular benefits against testicular I/R. This provides an understanding of the pathophysiological events and available models used in studying testicular I/R. In addition, this research provides evidence-based molecules with therapeutic potentials as well as their mechanisms of action in testicular I/R.
PubMed: 38694115
DOI: 10.1016/j.heliyon.2024.e27760 -
Therapeutic Advances in Urology 2023Chronic scrotal content pain, sometimes referred to as chronic orchialgia, is a common urological condition that gives rise to persistent and often severe painful...
BACKGROUND
Chronic scrotal content pain, sometimes referred to as chronic orchialgia, is a common urological condition that gives rise to persistent and often severe painful stimuli to the scrotum and surrounding structures. Despite its relative commonality, accounting for over 2% of urological visits, chronic scrotal content pain is complex to manage and patients may be required to access multiple providers and undergo invasive procedures, including microsurgical spermatic cord denervation (MSCD) surgery.
OBJECTIVE
The objective of this study was to understand the experiences and perspectives of persons with chronic scrotal content pain and accessing MSCD surgery.
DESIGN
An exploratory qualitative design, guided by interpretive description and integrated knowledge translation, was adopted.
METHODS
We conducted in-depth qualitative interviews with six patients with chronic scrotal content pain who underwent MSCD surgery in a surgical center in Western Canada. Data were analyzed thematically.
RESULTS
Analysis of the study data resulted in three core themes: living with chronic scrotal content pain, quality of life, and MSCD procedure and outcomes. We highlight the debilitating nature of pain and the broad impacts upon health, quality of life, and social functioning. Participants described how MSCD surgery offered an effective solution for persistent and debilitating pain. For the participants, MSCD surgery offered hope and the chance to regain their normality.
CONCLUSION
For those with chronic scrotal content pain, access to a pain specialist, along with the adoption of a biopsychosocial approach to pain and early access to MSCD surgery, may improve patient experiences and outcomes. Considering the high prevalence of urological pain, greater interdisciplinary care is needed in order to support more effective and timely management.
PubMed: 37767052
DOI: 10.1177/17562872231196685