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Archivio Italiano Di Urologia,... Sep 2012Aim of this paper is to report a systematic review of the literature about the incidence and putative mechanisms of genital tract injuries following open and... (Review)
Review
Aim of this paper is to report a systematic review of the literature about the incidence and putative mechanisms of genital tract injuries following open and laparoscopic herniorraphy and their effects on sexual function and fertility and to point out the measures of prevention and of treatment. The most frequently described events have been intraoperative complications as bladder or spermatic cord structure damage, immediate postoperative complications as ischaemic orchitis, urinary retention, urinary tract infection, hydrocele or scrotal haematoma and bacterial orchitis, or long-term complications as chronic orchialgia, testis atrophy, sexual dysfunction and infertility. The evidence of literature shows that urological complication after hernioplasty are under-reported. Only a small number of studies to date have essentially dealt with sexual quality of life after inguinal hernia surgical repair. The sexual needs of patients with groin hernias are rarely discussed. Extensive laparoscopic procedures, due to the need of learning curve, have increased the risk of vas damage and infertility in young patients candidate to hernioplasty. Early diagnosis prevents urological complication as well as possible legal claims after hernia repair: it should be include careful history, objective and subjective symptoms and signs of uro-genital pathologies, lab data when necessary, immediate eco-color-Doppler imaging and urgent urological consultation. Despite the lack of prospective randomized trials, there is a growing evidence in literature about positive impact of hernioplasty on sexual function, encouraging future studies on this issue.
Topics: Hernia, Inguinal; Herniorrhaphy; Humans; Male; Urologic Diseases
PubMed: 23210400
DOI: No ID Found -
Annals of Medicine and Surgery (2012) Jul 2020Acute scrotal pain is a urological emergency. While for testicular torsion and acute epididymitis clinical recommendations are well established, few is known about low... (Review)
Review
BACKGROUND
Acute scrotal pain is a urological emergency. While for testicular torsion and acute epididymitis clinical recommendations are well established, few is known about low incidence causes of acute scrotal pain. Our aim is to identify and characterise rare differential diagnoses of acute scrotal pain in order to give diagnostic and therapeutic recommendations.
MATERIALS AND METHODS
A systematic literature search was performed in PubMed, Web of Science and the Cochrane Library databases up to February 2019 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The systematic review protocol was registered on PROSPERO (CRD42018099472).
RESULTS
Eighty-four publications were selected for analysis. The databases provided mostly case reports, series and small studies, overall reporting on a cohort of 245 cases. Tumors, segmental testicular infarction, testicular vasculitis, pancreatitis, brucellosis, spermatic vein thrombosis, acute aortic syndrome and appendicitis were identified as rare underlying causes of acute scrotal pain and were characterised. As a result of our data analysis we were able to draw an overview of the rare differential diagnoses and diagnostic management of acute scrotal pain.
CONCLUSION
Rare differential diagnoses of acute scrotal pain are susceptible to misinterpretation as testicular torsion or acute epididymo-orchitis. Surgical management is indicated in case of suspicion for torsion or tumor. We herein present knowledge of the rare differential diagnoses and raise awareness for associated systemic disease in order to facilitate disease management and increase the potential for testicle-sparing treatment.
PubMed: 32547738
DOI: 10.1016/j.amsu.2020.05.031 -
BMJ Clinical Evidence Feb 2007Measles virus causes an estimated 30 million infections and 770,000 deaths a year worldwide, with increased risks of neurological, respiratory, and bleeding... (Review)
Review
INTRODUCTION
Measles virus causes an estimated 30 million infections and 770,000 deaths a year worldwide, with increased risks of neurological, respiratory, and bleeding complications in survivors. Mumps can cause neurological problems and hearing loss, orchitis with infertility, and pancreatitis. Rubella infection is usually mild, but can lead to fetal death or severe congenital abnormalities if contracted in early pregnancy. The incidence of all three infections has decreased significantly in countries with routine vaccination programmes targeted at these diseases, but decreased vaccination rates are associated with increased risks of infection.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of measles, mumps, and rubella vaccination? We searched: Medline, Embase, The Cochrane Library and other important databases up to July 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 94 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: MMR vaccine, monovalent measles vaccine, monovalent mumps vaccine, and monovalent rubella vaccine.
Topics: Deafness; Hearing; Hearing Loss; Humans; Measles; Mumps; Recovery of Function; Risk Factors; Rubella; Treatment Outcome; Virus Diseases
PubMed: 19454052
DOI: No ID Found -
Deutsches Arzteblatt International May 2017Infections of the genital tract are considered common causes of male fertility disorders, with a prevalence of 6-10%. Most of the affected men are asymptomatic. The... (Review)
Review
BACKGROUND
Infections of the genital tract are considered common causes of male fertility disorders, with a prevalence of 6-10%. Most of the affected men are asymptomatic. The diagnostic evaluation is based mainly on laboratory testing. Inconsistent diagnostic criteria have been applied to date, and this may explain the controversial debate about the role of infection and inflammation in the genital tract as a cause of infertility. The risk of an irreversible fertility disorder should not be underestimated.
METHODS
This review is based on pertinent publications retrieved by a selective literature search in PubMed, including guidelines from Germany and abroad and systematic review articles.
RESULTS
The main causes of inflammatory disease of the male genital tract are ascending sexually transmitted infections (STIs) and uropathogens. Chronic prostatitis has no more than a limited influence on ejaculate variables. By contrast, approximately 10% of men who have had acute epididymitis develop persistent azoospermia thereafter, and 30% have oligozoospermia. Obstruction of the excurrent ducts can ensue, as can post-infectious disturbances of spermatogenesis. The differential diagnostic evaluation includes the determination of testicular volumes, hormone concentrations, and ejaculate variables. Epidemiological data are lacking with regard to infertility after primary orchitis of infectious origin; however, up to 25% of testicular biopsies obtained from infertile men reveal focal inflammatory reactions. Multiple studies have suggested a deleterious effect of leukocytes and inflammatory mediators on sperm para - meters. On the other hand, the clinical significance of bacteriospermia remains unclear.
CONCLUSION
Any suspicion of an infectious or inflammatory disease in the male genital tract should prompt a systematic diagnostic evaluation and appropriate treatment. For patients with obstructive azoospermia, the etiology and site of the obstruction determine the surgical approach to be taken. In the near future, the elucidation of underlying pathophysiological mechanisms and the identification of suitable biomarkers may enable new strategies for conservative treatment.
Topics: Germany; Humans; Infertility, Male; Inflammation; Male; Risk Factors; Urinary Tract Infections
PubMed: 28597829
DOI: 10.3238/arztebl.2017.0339 -
Preventive Veterinary Medicine Jan 2022In the Qinghai-Tibet Plateau of China, the yak is an animal of particular economic interest, which provides protein and income for herders in daily life. Brucellosis is... (Meta-Analysis)
Meta-Analysis
In the Qinghai-Tibet Plateau of China, the yak is an animal of particular economic interest, which provides protein and income for herders in daily life. Brucellosis is a bacterial disease that can infect humans and animals, including yaks. It can damage the yak reproductive system, causing miscarriage and orchitis. At the same time, brucellosis threatens the health of herders. We performed this meta-analysis using R software to explore the combined prevalence and risk factors of brucellosis in yak in China. Variability was assessed by the I statistic and Cochran Q statistic. We identified 52 publications of related research from four databases (Wanfang Data, VIP Chinese Journal Database, China National Knowledge Infrastructure, and of PubMed). The pooled prevalence of yak brucellosis was 8.39 %. Prevalence was highest in Southwestern China (11.1 %). The point estimate of brucellosis in yak from 2012 to 2016 was the highest (11.47 %). The point estimate of age ≤ 12 months (1.44 %) was lower than that of age > 12 months (15.6 %). This study shows that yak brucellosis is serious, and its incidence is higher than before 2012. We recommend carrying out large-scale yak brucellosis investigations in Western China and conducting comprehensive testing planning. The detection of brucellosis in adult animals should be strengthened to reduce the economic loss caused by brucellosis to herders and to improve public health.
Topics: Animals; Brucellosis; Cattle; Cattle Diseases; China; Incidence; Male; Prevalence; Tibet
PubMed: 34844124
DOI: 10.1016/j.prevetmed.2021.105532 -
Journal of Medical Virology May 2021PubMed, Scopus, and ISI Web of Knowledge databases were searched to identify studies published up to December 2020 on the involvement of urinary and male genital systems...
PubMed, Scopus, and ISI Web of Knowledge databases were searched to identify studies published up to December 2020 on the involvement of urinary and male genital systems in COVID-19. Sixteen studies involving a total of 575 patients (538 males and 37 females) were included in this systematic review. The COVID-19 phase was available for 479 patients: 426 in the acute and 53 in the recovery phase. De novo lower urinary tract symptoms (LUTS) were observed in 43 patients and deterioration of pre-existing LUTS in 7. Bladder hemorrhage was observed in three patients and acute urinary retention in one. Regarding the male genital system, scrotal discomfort was observed in 8 patients, swelling in 14, pain in 16, and erythema in 1; low flow priapism was observed in 2 patients. Ultrasound examination identified acute orchitis in 10 patients, acute epididymitis in 7, and acute epididymo-orchitis in 16. A case-control study reported that patients with moderate COVID-19 show a significant reduction in sperm concertation, the total number of sperms per ejaculate, progressive motility, and complete motility. In contrast to what is known from the first studies on the subject, this review also includes subsequent studies that give evidence of the involvement of the lower urinary tract and male genital system in COVID-19.
Topics: COVID-19; Genitalia, Male; Humans; Male; SARS-CoV-2; Urinary Tract
PubMed: 33595134
DOI: 10.1002/jmv.26883 -
Andrologia Mar 2020To compare the difference of mean platelet volume (MPV), platelet lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), platelet (PLT) and leucocyte between... (Meta-Analysis)
Meta-Analysis
To compare the difference of mean platelet volume (MPV), platelet lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), platelet (PLT) and leucocyte between testicular torsion (TT), epididymo-orchitis and healthy controls and further evaluate predictive values of these haematologic parameters in diagnosis and the differential diagnosis of TT. Databases were systematically retrieved, and reference search was also conducted manually. We applied Stata software 12.0 to perform a systematic review and meta-analysis. Ultimately, five case-control studies with 672 participants were recruited for analyses. Pooled analyses indicated that TT patients had lower NLR (WMD = -1.66, 95% CI = -3.25 to -0.06) and PLT (WMD = -27.39, 95% CI = -48.03 to -6.75) compared to epididymo-orchitis patients. In the meantime, TT patients had higher NLR and leucocyte than healthy controls (p < .05). That is to say, when a man develops TT, his NLR and leucocyte will rise up but his NLR will not reach the level of epididymo-orchitis. To sum up, NLR, PLT and leucocyte were vital factors for TT diagnosis. Leucocyte is an useful parameter for diagnosing both TT and epididymo-orchitis, but it cannot be used in differentiating the two diseases. NLR is beneficial parameter for differential diagnosis between TT and epididymo-orchitis. PLT can also be utilised in differential diagnosis among young patients.
Topics: Epididymitis; Humans; Lymphocyte Count; Male; Mean Platelet Volume; Orchitis; Spermatic Cord Torsion
PubMed: 31782182
DOI: 10.1111/and.13490 -
Andrologia Oct 2019The present study was conducted to assess the semen parameters, complications and clinical effect of microsurgical varicocelectomy with testicular delivery (TD) for... (Comparative Study)
Comparative Study Meta-Analysis
The present study was conducted to assess the semen parameters, complications and clinical effect of microsurgical varicocelectomy with testicular delivery (TD) for treatment of varicocele. Relevant studies were collected and reviewed systemically from PubMed, Medline, Embase, Web of Science, China National Knowledge Infrastructure databases and the Cochrane Library and a meta-analysis was performed. Relative ratio (RR), standardised mean difference (SMD) and their 95% confidence intervals (CIs) were adopted to estimate the outcome measures. Eight articles and a total of 1,139 subjects including 487 patients with TD in microsurgical varicocelectomy and 652 patients without TD were enrolled in this meta-analysis. The pooled RR indicated that microsurgical varicocelectomy with TD increased the incidence of orchiepididymitis (RR = 4.36, 95% CI = 1.12-16.99, p = 0.034) and scrotal oedema (RR = 4.25, 95% CI = 2.40-7.54, p = 0.000) than microsurgical varicocelectomy without TD postoperatively. In conclusion, compared to microsurgical varicocelectomy without TD, TD to further ligate the gubernacular veins in microsurgical varicocelectomy results in a higher incidence of orchiepididymitis and scrotal oedema and take longer operation time. However, TD may not have any beneficial influences on semen parameters, serum testosterone, varicocele occurrence, wound infection and natural conception.
Topics: Epididymitis; Humans; Incidence; Infertility, Male; Ligation; Male; Microsurgery; Orchitis; Postoperative Complications; Testis; Treatment Outcome; Varicocele; Vascular Surgical Procedures
PubMed: 31264242
DOI: 10.1111/and.13363 -
Current Urology Mar 2020It is estimated that between 50 and 89% of non-gonococcal urethritis is not caused by . Associations between non-chlamydial non-gonococcal urethritis (NCNGU) with... (Review)
Review
BACKGROUND
It is estimated that between 50 and 89% of non-gonococcal urethritis is not caused by . Associations between non-chlamydial non-gonococcal urethritis (NCNGU) with balanoposthitis, epididymo-orchitis and reactive arthritis have been suggested, but evidence to support these often-theoretical relationships is sparse and further investigation is called for. Concerns over increasing antimicrobial resistance has rendered the need for clarity over this question ever more pressing in recent years. A review of the current evidence on the complications of NCNGU in men is therefore urgently warranted.
OBJECTIVE
This systematic review summarizes and evaluates the available evidence that NCNGU, whether symptomatic or asymptomatic, causes the significant complications that are already well-recognized to be associated with non-gonococcal urethritis. These significant complications are epididymo-orchitis, balanoposthitis, and sexually-acquired reactive arthritis (Reiter's syndrome) including arthritis or conjunctivitis.
SUMMARY
We conducted a systematic review and qualitative synthesis using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Five databases (PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and British Nursing Index) were searched. We included studies that measured clinical outcome after diagnosis of NCNGU in men. Bias was assessed using variations of the Newcastle-Ottawa scale. Data were extracted and entered into a pre-written data abstraction proforma. Seven peer-review studies were included. This included 2 retrospective cohort studies, 1 case series, 2 case reports and 2 cross-sectional studies. The studies described and analyzed 3 types of complication: balanitis, posthitis and/or meatitis; reactive arthritis and/or conjunctivitis; and epididymitis. All studies reported one or more complications.
KEY MESSAGES
This review identifies an important avenue for future research: while the available evidence suggests that NCNGU has the potential to cause significant complications in men, with the strongest evidence existing for balanitis, posthitis and/or meatitis, the nature and significance of these relationships is far from clear. The findings of this review suggest that prospective, adequately powered research into whether there is a causal link between NCNGU and significant clinical complications in men would be highly worthwhile. The findings of this review raise important questions about the utility of the term NCNGU in research and clinical practice.
PubMed: 32398991
DOI: 10.1159/000499266 -
Impact of Sexual Activity on the Risk of Male Genital Tumors: A Systematic Review of the Literature.International Journal of Environmental... Aug 2021Most cancers are related to lifestyle and environmental risk factors, including smoking, alcohol consumption, dietary habits, and environment (occupational exposures). A... (Review)
Review
Most cancers are related to lifestyle and environmental risk factors, including smoking, alcohol consumption, dietary habits, and environment (occupational exposures). A growing interest in the association between sexual activity (SA) and the development of different types of tumors in both men and women has been recorded in recent years. The aim of the present systematic review is to describe and critically discuss the current evidence regarding the association between SA and male genital cancers (prostatic, penile, and testicular), and to analyze the different theories and biological mechanisms reported in the literature. A comprehensive bibliographic search in the MEDLINE, Scopus, and Web of Science databases was performed in July 2021. Papers in the English language without chronological restrictions were selected. Retrospective and prospective primary clinical studies, in addition to previous systematic reviews and meta-analyses, were included. A total of 19 studies, including 953,704 patients were selected. Case reports, conference abstracts, and editorial comments were excluded. Men with more than 20 sexual partners in their lifetime, and those reporting more than 21 ejaculations per month, reported a decreased risk of overall and less aggressive prostate cancer (PCa). About 40% of penile cancers (PCs) were HPV-associated, with HPV 16 being the dominant genotype. Data regarding the risk of HPV in circumcised patients are conflicting, although circumcision appears to have a protective role against PC. Viral infections and epididymo-orchitis are among the main sex-related risk factors studied for testicular cancer (TC); however, data in the literature are limited. Testicular trauma can allow the identification of pre-existing TC. SA is closely associated with the development of PC through high-risk HPV transmission; in this context, phimosis appears to be a favoring factor. Sexual behaviors appear to play a significant role in PCa pathogenesis, probably through inflammatory mechanisms; however, protective sexual habits have also been described. A direct correlation between SA and TC has not yet been proven, although infections remain the most studied sex-related factor.
Topics: Female; Humans; Male; Prospective Studies; Retrospective Studies; Risk Factors; Sexual Behavior; Sexual Partners; Testicular Neoplasms
PubMed: 34444249
DOI: 10.3390/ijerph18168500