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European Journal of Pediatrics Sep 2021The terms "epididymal cyst" and "spermatocele" are commonly used to describe the same entity, but, conversely, they are slightly different. Epididymal cyst is a benign... (Review)
Review
The terms "epididymal cyst" and "spermatocele" are commonly used to describe the same entity, but, conversely, they are slightly different. Epididymal cyst is a benign mass, and it is more common than previously thought in prepubertal age. Pathogenic mechanisms for epididymal cyst have not been fully clarified yet, even if epididymal cysts have been reported in association with other malformations of the urinary tract or complex syndromes. Epididymal cyst is easily characterized and differentiated from spermatocele using ultrasound imaging. Conservative management constitutes the treatment of choice in the majority of cases, and surgery is recommended only in selected cases. Conclusion: To date, a review on epididymal cyst in childhood is lacking in the literature. Herein, an overview of knowledge about epididymal cyst in children has been carried out with particular attention to differential diagnosis, proper management, and practice guidelines for caregivers of children who may present with an epididymal cyst. What is Known: • Epididymal cyst is a benign sac in the testicles which is usually asymptomatic. • Epididymal cyst is easily diagnosed by ultrasound scans, and it is considered a self-limiting disease in the majority of cases. What is New: • Insight on differential diagnosis between epididymal cyst and spermatocele. • Valuable knowledge on the best management strategy for epididymal cyst and on practice guidelines for parents of children presenting with epididymal cyst.
Topics: Child; Diagnosis, Differential; Epididymis; Humans; Male; Spermatocele; Syndrome; Ultrasonography
PubMed: 33851241
DOI: 10.1007/s00431-021-04080-5 -
Urologie (Heidelberg, Germany) Jun 2024The hydrocele is overall a rare condition in urology. A differentiation between primary and secondary hydrocele is essential for further treatment. A primary hydrocele... (Review)
Review
The hydrocele is overall a rare condition in urology. A differentiation between primary and secondary hydrocele is essential for further treatment. A primary hydrocele with a patent vaginal process tends to spontaneously regress in the first 2 years of life in newborns. If treatment is necessary, open as well as laparoscopic methods are available with good results. The treatment of scrotal pathologies, especially secondary hydrocele, often poses a challenge in the clinical practice. Despite the benign nature, supposedly simple surgical techniques and good chances of healing, postoperative complications are frequent. In comparison to open surgery, sclerotherapy provides a good alternative for the treatment of secondary hydrocele.
Topics: Humans; Testicular Hydrocele; Male; Infant, Newborn; Sclerotherapy; Infant; Laparoscopy
PubMed: 38780784
DOI: 10.1007/s00120-024-02367-7 -
Urology Jun 2022To describe our contemporary experience with aspiration and sclerotherapy (AS) as a non-surgical alternative for patients with symptomatic hydrocele and spermatocele who...
OBJECTIVE
To describe our contemporary experience with aspiration and sclerotherapy (AS) as a non-surgical alternative for patients with symptomatic hydrocele and spermatocele who prefer non-surgical treatment.
MATERIALS AND METHODS
Patients were identified by billing diagnosis code for hydrocele or spermatocele from 2015 to 2019. Patients underwent AS with doxycycline (200-400 mg). Physical examination, ultrasound and aspirate microscopy were used to differentiate hydrocele from spermatocele. Baseline and follow-up data were recorded.
RESULTS
In total, 65 patients underwent AS, 54/65 (83%) for hydrocele and 11/65 (17%) for spermatocele with mean aspirate volumes 307 mL (SD 238 mL) and 138 mL (SD 112 mL), respectively. Follow-up data was available for 38/54 (70%) hydroceles and 8/11 (73%) spermatoceles with median follow-up 28 (IQR 23-41) and 22 (IQR 18.5-30.5) months respectively. Relief of patient reported bother associated with scrotal size occurred in 29/38 (77%) hydroceles and 8/9 (89%) spermatoceles. 2/54 (4%) hydrocele patients developed hematoma managed with in-office aspiration. Immediate post-procedural pain occurred in 2/56 (4%) hydroceles and 2/10 (20%) spermatocele. Post-procedural pain requiring more than 5 tablets of hydrocodone/acetaminophen 5mg/325mg occurred in 2/57 (3%) hydroceles and 2/10 (20%) spermatoceles. Surgical repair was ultimately pursued in 3/38 (8%) and 1/9 (11%) patients with persistent hydrocele and spermatocele respectively.
CONCLUSION
AS is a safe and effective treatment alternative for hydrocele and spermatocele for patients wishing to avoid surgery.
Topics: Humans; Male; Pain, Procedural; Sclerotherapy; Spermatocele; Testicular Hydrocele; Treatment Outcome
PubMed: 34968574
DOI: 10.1016/j.urology.2021.12.009 -
Abdominal Radiology (New York) Feb 2020
Review
Topics: Diagnosis, Differential; Humans; Male; Spermatocele; Ultrasonography, Doppler
PubMed: 31822968
DOI: 10.1007/s00261-019-02360-1 -
FP Essentials Apr 2021Scrotal and testicular conditions include benign masses, infections, testicular torsion, and testicular cancer. Common palpable benign scrotal masses include...
Scrotal and testicular conditions include benign masses, infections, testicular torsion, and testicular cancer. Common palpable benign scrotal masses include spermatocele, varicocele, and hydrocele. Most patients with these masses require no treatment. Some varicoceles are associated with impaired fertility, probably due to an increase in scrotal temperature that leads to testicular hyperthermia, oxidative stress, and reduced spermatogenesis. Patients with documented infertility or scrotal pain should be referred to a urology subspecialist for consideration of surgical management. Epididymitis and epididymo-orchitis are caused by infection with , , or enteric bacteria. Antibiotics and supportive measures (eg, scrotal elevation, bed rest) are recommended for management of acute epididymitis. Testicular torsion is a urologic emergency that requires rapid surgical exploration and orchidopexy to reduce the risk of testicular loss due to ischemia. Salvage rates exceed 90% when surgical exploration is performed within 6 hours of symptom onset. Testicular cancer commonly manifests as a painless, incidentally discovered mass in a single testis. Ultrasonography is recommended to confirm the diagnosis. The recommended primary intervention for a suspected malignant testicular tumor is radical inguinal orchiectomy.
Topics: Humans; Male; Men's Health; Scrotum; Spermatic Cord Torsion; Testicular Neoplasms
PubMed: 33856180
DOI: No ID Found -
Abdominal Radiology (New York) Nov 2020'-Celes' is an ancient Greek language suffix that means 'tumor,' 'hernia,' 'swelling,' or 'cavity.' There are many '-celes' in the abdomen and pelvis that may be... (Review)
Review
'-Celes' is an ancient Greek language suffix that means 'tumor,' 'hernia,' 'swelling,' or 'cavity.' There are many '-celes' in the abdomen and pelvis that may be encountered during routine imaging interpretation, including santorinicele, choledochocele, ureterocele, lymphocele, mucocele, rectocele, cystocele, peritoneocele, varicocele, spermatocele, hydrocele, hematocele, pyocele and syringocele. Most '-celes' are detected incidentally at imaging for other clinical indications, but some deserve more attention due to a range of clinical symptoms or functional disorder that can adversely affect patient quality of life. The objective of this article was to address all of the '-celes' that a general radiologist and abdominal radiologist should know and be able to recognize. Imaging characteristics, diagnostic clues, and pitfalls have been provided to improve diagnostic accuracy and patient outcomes.
Topics: Abdomen; Hernia; Humans; Male; Pelvis; Quality of Life; Rectocele
PubMed: 32356005
DOI: 10.1007/s00261-020-02546-y -
Scandinavian Journal of Urology Oct 2021Gold standard treatment of symptomatic hydrocele or spermatocele is surgery. Despite a minor procedure, complications such as bleeding and infections leading to...
OBJECTIVE
Gold standard treatment of symptomatic hydrocele or spermatocele is surgery. Despite a minor procedure, complications such as bleeding and infections leading to reoperations may be devastating for the patients. In autumn 2018, an accumulation of complications was seen in our department. The aim of this study was to investigate the rate and grade of complications and to identify potential means to reduce these.
MATERIALS AND METHODS
Patient records of all patients undergoing surgical repair of hydrocele or spermatocele from December 2017 to November 2018 were examined. Results were audited to identify potential causes of complications. The focus was on the perioperative hemostasis and postoperative activity restrictions. The outcome was compared to a consecutive patient series operated the following year.
RESULTS
Sixty-five men were operated on during the first period. Twenty-two patients contacted the department postoperatively due to swelling or pain, 19 patients were examined at the hospital and six patients were re-operated 1-9 times. The following year, 69 patients were operated on. Of these, 16 patients contacted the department postoperatively ( = 0.17), 13 patients were examined at the hospital, and five patients were re-operated ( = 0.68). There was the same complication rate in patients operated by specialist urologists or supervised younger doctors. However, patients preoperatively examined and informed by a specialized urologist had significantly fewer complications compared to those informed by urological residents and interns ( = 0.012).
CONCLUSION
Despite the change in patient information and increased awareness of possible complications, a high proportion of patients still were in need of unplanned contact to the department and reoperation.
Topics: Edema; Humans; Male; Postoperative Complications; Postoperative Period; Reoperation; Retrospective Studies; Spermatocele; Testicular Hydrocele
PubMed: 33569989
DOI: 10.1080/21681805.2021.1884131 -
Fertility and Sterility Mar 2023To assess the risk of new persistent opioid use in opioid-naïve men who underwent male fertility procedures.
OBJECTIVE
To assess the risk of new persistent opioid use in opioid-naïve men who underwent male fertility procedures.
DESIGN
Retrospective cohort study using a claims database.
SETTING
A database linking electronic medical record data and claims-assessing men who underwent fertility procedures between 2010 and 2021.
PATIENT(S)
Opioid-naïve men who underwent fertility procedures (open or laparoscopic varicocelectomy, spermatocele excision, and testicular excisional or incisional biopsy) without further surgical intervention requiring anesthesia in the 2 years after the index procedure. Those with and without perioperative opioid prescriptions were propensity score matched on age, race/ethnicity, smoking status, mental health diagnoses, and preoperative pain diagnoses.
INTERVENTION(S)
Perioperative opioid prescription.
MAIN OUTCOME MEASURE(S)
The primary outcome was the incidence of new persistent opioid use (opioid prescription 3-9 months after the index fertility procedure). The secondary outcome was prolonged opioid use (opioid prescription 9-24 months after the index fertility procedure).
RESULT(S)
A total of 387,565 men who underwent fertility procedures were identified, of whom 25.1% received an opioid prescription. After propensity score matching, 97,215 men were included; 4.7% of men who received a perioperative opioid prescription developed new persistent opioid use compared with 2.2% of those without a perioperative opioid prescription (risk ratio, 2.16; 95% confidence interval, 2.05-2.27; number needed to harm, 39). When assessing each unique fertility procedure independently, men who received perioperative opioids had statistically higher odds of developing new persistent opioid use for all procedure types. Men with new persistent opioid use were much more likely to go on and develop prolonged opioid use than men without new persistent opioid use.
CONCLUSION(S)
Opioid prescription after male fertility procedures is associated with a significant risk of new persistent opioid use, emphasizing the importance of judicious opioid prescribing for male fertility procedures.
Topics: Humans; Male; Analgesics, Opioid; Retrospective Studies; Pain, Postoperative; Practice Patterns, Physicians'; Opioid-Related Disorders; Drug Prescriptions
PubMed: 36529185
DOI: 10.1016/j.fertnstert.2022.12.015 -
Clinical Medicine Insights. Case Reports 2022We report a case of a post-aspiration giant unilocular spermatocele in a young man. A 27-year-old man sought medical advice for a huge right scrotal swelling. The...
We report a case of a post-aspiration giant unilocular spermatocele in a young man. A 27-year-old man sought medical advice for a huge right scrotal swelling. The swelling first appeared following scrotal trauma and was aspirated. Shortly after, it reappeared and persisted for several years with a sense of heaviness, infrequent periods of right scrotal pain, and cosmetic concerns. Ultrasonography of the scrotum revealed a huge fluid cyst pushing the testis antero-inferiorly in the right hemi-scrotum. Scrotal exploration suggested the spermatocele nature of the cyst that emerged from the head of the epididymis. The cyst was excised, and its fluid content and wall underwent pathological examination for confirmation.
PubMed: 35591974
DOI: 10.1177/11795476221097218 -
Urology Case Reports Nov 2022Spermatocele is a common cause of benign scrotal swelling that mostly arises from the head of the epididymis. It is a fluid-filled swelling containing spermatozoa....
Spermatocele is a common cause of benign scrotal swelling that mostly arises from the head of the epididymis. It is a fluid-filled swelling containing spermatozoa. Torsion of a spermatocele is a very rare encounter for a urologist. It is poorly described in the English literature and there are only seven cases reported so far. There is no specific clinical feature suggesting spermatocele torsion and the diagnosis is often made during an emergency scrotal exploration. We report the eighth case of torsed spermatocele in a young adult diagnosed during emergency scrotal exploration for a suspected testicular torsion.
PubMed: 35959225
DOI: 10.1016/j.eucr.2022.102172