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Archivio Italiano Di Urologia,... Sep 2021The widespread use of ultrasonography for the investigation of common urological conditions, such as infertility or pain, has resulted in an increased incidence of... (Review)
Review
OBJECTIVES
The widespread use of ultrasonography for the investigation of common urological conditions, such as infertility or pain, has resulted in an increased incidence of incidental non-palpable testicular masses. The majority of these are expected to be benign therefore a conservative approach, either active monitoring or organsparing approach, is recommended. However, there are no clinical or radiological parameters which define the exact nature of such lesions and optimal patient selection criteria are lacking. In this comprehensive review we discuss the significance of incidental, small testicular masses (STMs) and the role of organ-sparing approach in the management of these lesions.
MATERIALS AND METHODS
A non-systematic search was performed using PubMed to identify articles that covered the following topics; clinical implications at diagnosis, role of imaging in identifying the malignant capabilities of a lesion, role of surgery and the final pathology.
RESULTS
Incidental STMs are routinely identified following ultrasound examination of infertile men. STMs usually measure a few millimeters in size and the majority of these are benign. Therefore, strict follow up or an organ-sparing approach, with utilisation of frozen section analysis (FSA), is favored for STMs. FSA has a high correlation with final pathology and prevents unnecessary orchidectomies. Advances in imaging, namely ultrasound and magnetic resonance imaging may provide enhanced assessment of STMs and guidance intraoperatively.
CONCLUSIONS
The optimal approach is not well defined and there is no specific clinical parameter that can predict the nature of STMs. The increasing incidence of small, benign testicular masses has resulted in the development of organ-sparing surgery to investigate and manage these lesions. Organ-sparing surgery has been shown to be practical and carries excellent oncological outcomes.
Topics: Frozen Sections; Humans; Male; Orchiectomy; Patient Selection; Testicular Neoplasms; Ultrasonography
PubMed: 34839628
DOI: 10.4081/aiua.2021.3.296 -
BMC Cancer Jan 2022Paratesticular leiomyosarcoma (LMS) is a rare tumor. Conventionally, tumor resection by high inguinal orchiectomy is performed as the preferred treatment approach for...
BACKGROUND
Paratesticular leiomyosarcoma (LMS) is a rare tumor. Conventionally, tumor resection by high inguinal orchiectomy is performed as the preferred treatment approach for paratesticular sarcoma. On the other hand, testis-sparing surgery has recently attracted attention as a less-invasive treatment option for paratesticular sarcoma. However, the prognostic predictors and optimal treatment strategy for paratesticular LMS remain unclear because of its rarity. In this study, we systematically reviewed previously reported cases of paratesticular LMS to evaluate the prognostic factors and establish the optimal treatment strategy.
METHODS
A systematic search of Medline, Web of Science, Embase, and Google was performed to find articles describing localized paratesticular LMS published between 1971 and 2020 in English. The final cohort included 217 patients in 167 articles. The starting point of this study was the time of definitive surgical treatment, and the end point was the time of local recurrence (LR), distant metastasis (DM), and disease-specific mortality.
RESULTS
Patients with cutaneous LMS had a slightly better LR-free survival, DM-free survival, and disease-specific survival than those with subcutaneous LMS (p = 0.745, p = 0.033, and p = 0.126, respectively). Patients with higher grade tumors had a significantly higher risk of DM and disease-specific mortality (Grade 3 vs Grade 1 p < 0.001, and Grade 3 vs Grade 1 p < 0.001, respectively). In addition, those with a microscopic positive margin had a significantly higher risk of LR and DM than those with a negative margin (p < 0.001, and p = 0.018, respectively). Patients who underwent simple tumorectomy had a slightly higher risk of LR than those who underwent high inguinal orchiectomy (p = 0.067). Subgroup analysis of cutaneous LMS demonstrated that the difference in LR between simple tumorectomy and high inguinal orchiectomy was limited (p = 0.212). On the other hand, subgroup analysis of subcutaneous LMS revealed a significant difference in LR (p = 0.039).
CONCLUSIONS
Our study demonstrated that subcutaneous LMS and high-grade tumors are prognostic factors for paratesticular LMS. For subcutaneous LMS, tumorectomy with high inguinal orchiectomy should be the optimal treatment strategy to achieve a negative surgical margin.
Topics: Adult; Aged; Aged, 80 and over; Humans; Leiomyosarcoma; Male; Margins of Excision; Middle Aged; Orchiectomy; Organ Sparing Treatments; Prognosis; Retrospective Studies; Testicular Neoplasms; Testis; Treatment Outcome
PubMed: 34980039
DOI: 10.1186/s12885-021-09122-7 -
The Veterinary Record Nov 2023While population control remains a key priority for the UK's leading dog welfare charities, it must increasingly be balanced with concerns about the possible health...
While population control remains a key priority for the UK's leading dog welfare charities, it must increasingly be balanced with concerns about the possible health impact of castration.
Topics: Animals; Dogs; Male; Charities; Orchiectomy; Population Control; United Kingdom; Humans
PubMed: 37921348
DOI: 10.1002/vetr.3611 -
Journal of Ayub Medical College,... 2021Persistent Mullerian Duct Syndrome is extremely rare. Our patient, a 32 years old male, with history of orchidectomy presented with mass abdomen. He was initially...
Persistent Mullerian Duct Syndrome is extremely rare. Our patient, a 32 years old male, with history of orchidectomy presented with mass abdomen. He was initially diagnosed with seminoma and subsequently treated with chemotherapy. Biopsy of the mass showed germ cell tumour and MRI abdomen revealed female rudimentary organs confirmed on per operative and later on histopathology. Karyotype was 46 XY.
Topics: Adult; Disorder of Sex Development, 46,XY; Female; Humans; Male; Mullerian Ducts; Orchiectomy; Seminoma; Testicular Neoplasms
PubMed: 35077632
DOI: No ID Found -
Comprehensive Physiology Sep 2019The major brain areas that control males' sexual motivation and performance include the amygdala, the bed nucleus of the stria terminalis (BNST), the medial preoptic...
The major brain areas that control males' sexual motivation and performance include the amygdala, the bed nucleus of the stria terminalis (BNST), the medial preoptic area (MPOA), and paraventricular nucleus (PVN) of the hypothalamus, as well as the mesolimbic dopamine (DA) system. The MPOA, PVN, and brain stem and spinal nuclei control the genital reflexes. Sensory and motor aspects are integrated and elicited by the amygdala, BNST, MPOA, PVN, and the mesolimbic and nigrostriatal DA tracts, which are integral for other social behaviors, as well. Developmental hormonal effects organize the network to elicit specific behaviors, which are activated by those hormones in adolescence and adulthood. Steroid hormones primarily work through slow genomic mechanisms that increase enzymes, receptors, or structural proteins, although they may also activate membrane receptors for rapid effects. © 2019 American Physiological Society. Compr Physiol 9:1383-1410, 2019.
Topics: Animals; Brain; Genitalia, Male; Humans; Male; Mammals; Neurosecretory Systems; Orchiectomy; Sexual Behavior
PubMed: 31688968
DOI: 10.1002/cphy.c180018 -
Journal of Pediatric Urology Dec 2020During the COVID-19 crisis, there has been widespread reporting that non-COVID-19-related medical care has been delayed, even for emergent conditions. Testicular torsion...
BACKGROUND
During the COVID-19 crisis, there has been widespread reporting that non-COVID-19-related medical care has been delayed, even for emergent conditions. Testicular torsion is an emergent condition with higher risk of testicular loss with longer ischemic times. We sought to investigate whether patients with testicular torsion had longer time from symptom onset to initial presentation, longer total ischemic time, and higher rate of orchiectomy during the pandemic.
MATERIALS AND METHODS
Using billing data, we identified all patients age >1yo seen in our hospital from 1/1/2018 through 5/31/2020 who underwent emergent scrotal exploration for confirmed testicular torsion, comparing the COVID-19 crisis (3/1/2020-5/31/20) to the pre-COVID-19 period (1/1/2018-2/29/20). The primary outcome was time from symptom onset to initial presentation and secondary outcomes were ischemic time (time from symptom onset to entry of the OR) and orchiectomy rate. Parameters were compared with Mann-Whitney U and Fisher's exact tests; Poisson regression compared rates of torsion.
RESULTS
Of 94 total cases, 77 occurred during the pre-COVID-19 period and 17 during the COVID-19 crisis. Median time from symptom onset to initial presentation was not significantly different (2.4 h [IQR 1.1 h-38.9] during COVID-19 vs. 5.6 h [IQR 1.6-16.9] during pre-COVID-19 period, p = 0.476). Time to presentation was >12 h in 5/17 patients (29%) during COVID-19 and 24/77 patients (31%) during pre-COVID-19 period (p = 1.00). Median ischemic time during COVID-19 was 7.5 h (IQR 4.7 h-45.5 h) compared to 9.4 h (IQR 5.4 h-22.5 h) during pre-COVID-19 period (p = 0.694). Incidence of orchiectomy in our center was 29% (5/17) during COVID-19 and 17% (13/77) during pre-COVID-19 period (p = 0.397). About half of patients were seen initially at outside facilities prior to arrival (47% [8/17] during COVID-19 vs. 49% [38/77] during pre-COVID-19 period, p = 1.00). The number of torsion case presentations per week to our facility increased from 0.7 cases/week in the pre-COVID-19 period to 1.3 cases/week during COVID-19 (p = 0.015); when comparing only the March 1 to May 31 calendar period, there were 0.6 cases/week during the pre-COVID-19 period and 1.3 cases/week during COVID-19 (p = 0.021).
CONCLUSION
Time to presentation, ischemic times, and orchiectomy rates for testicular torsion at our center were not significantly different during the COVID-19 period compared to the preceding 2 year period. The number of torsion case per week presenting to our facility increased significantly.
Topics: Adolescent; COVID-19; Child; Child, Preschool; Comorbidity; Humans; Infant; Male; Orchiectomy; Pandemics; Retrospective Studies; SARS-CoV-2; Spermatic Cord Torsion; Time Factors; United States; Young Adult
PubMed: 33223456
DOI: 10.1016/j.jpurol.2020.10.021 -
Tropical Animal Health and Production Nov 2022Castration is frequently used to reduce aggressive behavior and improve the meat quality of animals. Traditionally, surgical and mechanical castration are used to... (Review)
Review
Castration is frequently used to reduce aggressive behavior and improve the meat quality of animals. Traditionally, surgical and mechanical castration are used to sterilize the animals, but these approaches are associated with a high level of pain, stress, long recovery periods, and post-operative infections. Immunocastration is a new animal-friendly, painless alternative castration technique that is used to prevent undesired sexual behavior, reduce aggressive behavior, prevent unwanted pregnancy, control wildlife populations and wandering species, enhance growth performance, improve meat quality, and treat various sex hormone-dependent disorders. The mechanism of immunocastration includes the immunological block of the hypothalamic-pituitary-gonadal axis (HPG axis) which inhibits gonadotropin secretions, causes atrophy of gonadal tissues, and inhibits gametogenesis, resulting in infertility in both female and male mammals. By the mid-1990s, various immunocastration vaccines have been tested in different animal models to achieve successful castration effects. Recently, genetic immunocastration especially DNA vaccine has gained increasing attention due to its safety, being animal-friendly, and being easy to use. This review aims to evaluate the potential of traditional castration methods, as well as the current status of immunocastration vaccines, their effects, and future prospective.
Topics: Male; Female; Animals; Animal Welfare; Orchiectomy; Vaccines; Meat; Gonadotropin-Releasing Hormone; Mammals
PubMed: 36323906
DOI: 10.1007/s11250-022-03348-8 -
Puerto Rico Health Sciences Journal Dec 2022Primary testicular rhabdomyosarcoma is a rare pediatric genitourinary tumor with few cases reported in the literature. The clinical presentation is identical to that of...
Primary testicular rhabdomyosarcoma is a rare pediatric genitourinary tumor with few cases reported in the literature. The clinical presentation is identical to that of other common testicular neoplasms. Diagnosis entails careful microscopic examination and immunohistochemical analysis to rule out other primary testicular malignancies. Treatment consists of radical orchiectomy and adjuvant chemotherapy with possible retroperitoneal lymph node dissection. This multimodal approach is required to improve survival outcomes and reduce disease recurrence. We present the case of a primary testicular embryonal rhabdomyosarcoma in a 19-year-old male who presented with a rapidly, enlarging, painless testicular mass. He was treated with radical orchiectomy and adjuvant chemotherapy. Once found with metastatic disease, he then received salvage chemotherapy and radiotherapy without success.
Topics: Male; Child; Humans; Young Adult; Adult; Rhabdomyosarcoma, Embryonal; Neoplasm Recurrence, Local; Testicular Neoplasms; Neoplasms, Germ Cell and Embryonal; Orchiectomy
PubMed: 36516214
DOI: No ID Found -
Journal of Animal Science Dec 2022To determine the effects of castration on growth performance, serum hormone levels, cecal microbiota composition, and metabolites in cattle. A total of 18 Holstein bulls...
To determine the effects of castration on growth performance, serum hormone levels, cecal microbiota composition, and metabolites in cattle. A total of 18 Holstein bulls and steers were divided into bull and steer groups and randomly assigned to 3 pens (3 cattle per pen, and each cattle were separated by a fence) to determine the average daily gain (ADG), daily dry matter intake (DMI), and feed efficiency (G/F). After the finishing trial, six cattle per group were randomly slaughtered. Serum was collected to measure the hormone concentration, and the cecal content was collected to measure the pH, short-chain fatty acids, and digestive enzyme activities. Metagenome sequencing and untargeted metabolomics were used to investigate the microbiota composition, functional profiles, and differential metabolites of the cecal contents. We found that castration significantly decreased ADG, DMI, and G/F in cattle (P < 0.05). The serum testosterone, thyroxine, growth hormone (P < 0.05), and triiodothyronine (P < 0.01) concentrations significantly decreased in the steer group when compared to those of the bull group. The activities of cellulase, xylanase, pectinase, and β-glucosidase (P < 0.05) significantly decreased in the steer group, whereas the activities of lipase and α-amylase significantly increased. Moreover, castration significantly decreased the relative abundance of Ruminococcaceae_bacterium, Treponema_porcinum, Oscillibacter_sp. (P < 0.05), and Alistipes_senegalensis (P < 0.01), whereas the relative abundance of Phocaeicola_plebeius (P < 0.05) was significantly increased. Also, the relative abundance of Phocaeicola_plebeius was negatively correlated with testosterone levels, and the function of the cecal microbiota was enriched in the GH29 and GH97 families in the steer group. Metabolomic analysis indicated that castration increased the levels of L-valine, L-phenylalanine, L-aspartic acid, L-isoleucine, L-lysine, methionine, L-glutamic acid, and L-leucine, while decreasing the levels of α-ketoglutaric acid through the 2-oxocarboxylic acid metabolism pathway. In addition, α-ketoglutaric acid was negatively correlated with Oscillibacter_sp. (P < 0.01). Overall, castration can inhibit cattle growth by altering the composition of the cecal microbiota. Therefore, this study provides a theoretical and practical basis for improving the growth performance of steers.
Topics: Cattle; Animals; Male; Animal Feed; Ketoglutaric Acids; Orchiectomy; Methionine; Testosterone; Body Composition; Diet
PubMed: 36326798
DOI: 10.1093/jas/skac367 -
Asian Journal of Andrology 2022
Topics: Male; Adult; Humans; Spermatic Cord Torsion; Orchiectomy
PubMed: 35532556
DOI: 10.4103/aja202222