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Archivos Espanoles de Urologia Nov 2023To investigate the correlation between temperature and testicular torsion in Jiaodong Peninsula which has temperate continental monsoon climate and is represented by...
BACKGROUND
To investigate the correlation between temperature and testicular torsion in Jiaodong Peninsula which has temperate continental monsoon climate and is represented by Yantai and its surrounding areas.
METHODS
A retrospective analysis was conducted by reviewing clinical data of 292 patients who were admitted and surgically confirmed to have testicular torsion in the Yantai Yuhuangding hospital medical complex between January 1, 2009, and August 31, 2022. Male patients who underwent circumcision (foreskin) were allocated to the control group. Temperature data were obtained from the China Meteorological Data Service Center. Chi-squared test or Fisher's exact test and one-way analysis of variance were employed to compare patient characteristics and climatic variables among the different groups. Pearson's correlation analysis was used to analyze the association between monthly average ambient temperature and monthly cumulative number of cases. Moreover, a logistic regression model was utilized to identify the independent factors of testicular torsion.
RESULTS
The mean age of patients with testicular torsion was 16.8 years. The number of cases was the highest in autumn. The temperature was the highest in summer and the lowest in winter ( < 0.01). Furthermore, the temperature difference (TD) in autumn was the highest in the four seasons groups ( < 0.01). The patients were divided into the high TD and low TD groups according to the mean TD (7.62 C) on the admission day. The high TD group had a higher number of patients than the low TD group, and the temperature was lower in the former group than in the latter group ( < 0.01). A roughly negative correlation was observed between ambient temperature and the number of cases (Pearson's r = -0.228, 95% confidence interval (CI): -0.366 to -0.079, = 0.003). Logistic regression analysis revealed that the independent risk factor for testicular torsion was TD on admission day (odds ratio, 1.82; 95% CI, 1.28-2.59; < 0.001).
CONCLUSIONS
To some extent, external temperature can affect the body surface temperature of patients and then induce testicular torsion. We concluded that testicular torsion easily occurs in the season in which the temperature drops and the TD is high.
Topics: Humans; Male; Adolescent; Spermatic Cord Torsion; Retrospective Studies; Temperature; Cold Temperature; Seasons
PubMed: 38053424
DOI: 10.56434/j.arch.esp.urol.20237609.84 -
Urology Case Reports Nov 2023Testicular cancer is the most common solid tumor affecting men aged 20-39 years old. About 95% of all testicular tumor is testicular germ cell tumor. Bilateral...
BACKGROUND
Testicular cancer is the most common solid tumor affecting men aged 20-39 years old. About 95% of all testicular tumor is testicular germ cell tumor. Bilateral testicular tumor is a rare incident and has similar histopathology only in less than 5% of all testicular cancer patients. Besides oncological issues, bilateral testicular tumors could lead to further consequences, such as psychosocial and hormonal issues. This article shows a case of different histopathology in the metachronous bilateral testicular tumors.
CASE PRESENTATION
A 34-years-old male came with right radical orchiectomy due to testicular pure seminoma pT1N0M0S0 three and half years ago. He underwent bleomycin, etoposide phosphate (BEP) chemotherapy for progressive multiple lymphadenopathies in paracaval and interaortacaval region from positron emission tomography (PET)/computerized tomography (CT) scan a year later. Sperm banking was done before initiated chemotherapy. High metabolic activity was detected in contralateral testis from follow up PET-scan. Left testicle enlargement with hard consistency was found on physical examination and there is an elevation of alpha-feto protein (AFP) and β-hCG. Intraoperatively, the frozen section identified a malignant tumor and the patient was decided to undergo radical left orchiectomy. Postoperative pathological results showed a mixed germ cell tumor of 3.5 × 2.5 × 2 cm consisting of immature teratoma, yolk sac tumor and embryonic carcinoma without lympho-vascular invasion and involvement of the spermatic cord. Post-operative imaging and testicular tumor marker did not identify any metastases. BEP chemotherapy, testosterone replacement therapy was planned for further management in this patient with complete blood count, prostate serum antigen (PSA) and digital rectal examination should be measured three to six weeks after initiation.
CONCLUSION
Metachronous bilateral TGCT with different histopathology is a rare disease. The treatment depends on histology of second tumor and its stage. TRT is mandatory for patient undergoing bilateral orchidectomy to address lack if testosterone.
PubMed: 38046261
DOI: 10.1016/j.eucr.2023.102612 -
Asian Journal of Surgery Mar 2024
Topics: Male; Humans; Spermatic Cord Torsion; Testis; Scrotum
PubMed: 38042657
DOI: 10.1016/j.asjsur.2023.11.099 -
Cureus Nov 2023Inguinal hernia is amongst the most common acute abdominal disease that presents in the Emergency Department (ED). Pathologically, it involves the displacement and...
Inguinal hernia is amongst the most common acute abdominal disease that presents in the Emergency Department (ED). Pathologically, it involves the displacement and herniation of abdominal, pelvic, or groin tissue through weaknesses in the abdominal wall. Many inguinal hernias are simple and asymptomatic, managed conservatively without the need for surgical intervention. However, under rare circumstances, hernias are susceptible to significant complications requiring emergent surgery. This report follows the case of a 61-year-old Hispanic-American male presenting to the ED with signs of a complex strangulated inguinal hernia and consequent infarction of the testis with Fournier's Gangrene. Clinical evaluation elucidated a one-week worsening abdominal pain, non-reducible painful inguinal hernia, nausea, vomiting, constipation, groin discoloration, dysuria, and a history of failed primary hernia repair during childhood. The patient underwent emergent surgery to excise ischemic-necrotic portions of the sigmoid colon, creation of end-colostomy, non-mesh repair of inguinal hernia, and right-sided complete orchiectomy with the removal of adjacent scrotal-Dartos tissues and spermatic cord due to Fournier's Gangrene. This report provides both a report for a potentially preventable consequence in one of the most common surgical presentations and a review of the multi-disciplinary expertise that is required in the surgical management of complex inguinal hernias.
PubMed: 38024026
DOI: 10.7759/cureus.48510 -
Cureus Oct 2023Hydrocele represents a commonly encountered pathological condition characterized by the development of scrotal swelling. In contrast, spermatic cord hydrocele is a...
Hydrocele represents a commonly encountered pathological condition characterized by the development of scrotal swelling. In contrast, spermatic cord hydrocele is a relatively rare condition that arises from the abnormal closure of the processus vaginalis. This condition entails the accumulation of fluid within the spermatic cord, and although hydrocele itself is a frequently observed ailment affecting roughly 100 out of 100,000 men, encysted hydrocele of the spermatic cord is a seldom-seen variant. Furthermore, it is noteworthy that spermatic cord hydrocele tends to be more prevalent in the pediatric population compared to adults. In our clinical practice, a patient presented with swelling localized to the right hemi-scrotum and was initially diagnosed as suffering from a chronic right-sided hydrocele of the tunica vaginalis. However, during the surgical intervention, the true nature of the condition became evident, as it was determined to be an encysted hydrocele of the cord. This case report chronicles the diagnostic journey surrounding hydrocele, highlighting the distinction in surgical management between encysted hydrocele and vaginal hydrocele of the testis.
PubMed: 38022017
DOI: 10.7759/cureus.47782 -
Cureus Oct 2023This case report describes a rare occurrence of ectopic adrenal cortical tissue (EACT) in the undescended testis (UDT) of an adult male patient. The patient presented...
This case report describes a rare occurrence of ectopic adrenal cortical tissue (EACT) in the undescended testis (UDT) of an adult male patient. The patient presented with an empty left scrotum since birth, and a magnetic resonance imaging (MRI) confirmed the diagnosis of left-side UDT. Orchidectomy was performed, and a microscopic examination revealed a UDT with EACT. The patient had no significant medical or surgical history and had a normal preoperative hormonal profile. EACT is usually found incidentally during surgical procedures and is more common in children than adults. This case emphasizes the importance of investigating adrenal rests due to the potential of neoplastic transformation or hormonal activity. The case report concludes that EACT of the UDT is still a possibility in the adult patient population.
PubMed: 38021737
DOI: 10.7759/cureus.47640 -
Scientific Reports Nov 2023Testicular torsion is a common urologic emergency and one of the causes of infertility in males. It has been reported that ligustrazine may decrease oxidative stress and...
Testicular torsion is a common urologic emergency and one of the causes of infertility in males. It has been reported that ligustrazine may decrease oxidative stress and reduce ischemia-reperfusion injury. This study aims to investigate the protective effect of ligustrazine in ischemia-reperfusion injury after testicular torsion-detorsion. First, 40 rats were randomly and equally divided into TMP (Ligustrazine) group, the Testicular torsion (T/D) group, the Sham (Sham operation) group, and Control group. The left testis of rats in the TMP and T/D group was rotated for 2 h. The TMP group was intraperitoneally injected with ligustrazine solution and the T/D and the Sham groups were injected with normal saline. The left testes of four groups were obtained for assay on the 4th day after the operation. Average level of superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase (CAT) were higher in Sham and Control groups than T/D group and TMP group. Conversely, average level of malondialdehyde (MDA) and reactive oxygen species (ROS) was lower in Sham and Control groups than T/D group and TMP group. In contrast with the T/D group, SOD, GPX, and CAT enzymatic activities increased, whereas MDA and ROS content decreased in the TMP group (P < 0.05). Microscopic observation showed that the testicular tissue of the Sham and Control groups were basically normal. The TMP and T/D groups had significant testicular tissue damage, whereas the TMP group had less damage and apoptosis than the T/D group. The apoptotic index of germ cells in the TMP group (13.05 ± 4.41) was lower than the T/D group (30.23 ± 11.31) (P < 0.05) and higher (P < 0.05) than the Sham group (0.56 ± 0.29). So we found that Ligustrazine lowered ischemia-reperfusion injury after testicular torsion-detorsion by decreasing the reactive oxygen species and suppressing apoptosis.
Topics: Male; Humans; Rats; Animals; Spermatic Cord Torsion; Reactive Oxygen Species; Rats, Sprague-Dawley; Testis; Oxidative Stress; Reperfusion Injury; Superoxide Dismutase; Apoptosis; Malondialdehyde
PubMed: 37990048
DOI: 10.1038/s41598-023-47210-9 -
European Review For Medical and... Nov 2023The present research aimed to study the possible protective effects of Silymarin on testicular I/R injury in a rat model evaluated through histopathology and biochemical...
OBJECTIVE
The present research aimed to study the possible protective effects of Silymarin on testicular I/R injury in a rat model evaluated through histopathology and biochemical parameters.
MATERIALS AND METHODS
This research investigated the impact of Silymarin on IR damage in male Wistar albino rats. Animals were divided into three groups: group 1 (sham), group 2 (IR), and group 3 (IR+Silymarin).
RESULTS
There were no notable differences in the levels of malondialdehyde (MDA), myeloperoxidase (MPO), and glutathione (GSH) across the three groups (p=0.260, p=0.486 and p=0.803, respectively). Contrarily, the total antioxidant status (TAS) levels exhibited significant variations between groups (p=0.001). The total oxidant status (TOS) levels also differed significantly between groups (p=0.004). The tissue evaluations uncovered substantial differences in the Johnson score, which is used to gauge testicular damage. A distinct contrast was seen between Group 1 and Group 2, and also between Group 2 and Group 3, with an all-encompassing p-value lower than 0.01. The same significant disparities were found for the percentages of Bax and Annexin V immunostaining (p<0.01 for each), reflecting the inflammation and apoptosis brought about by ischemia-reperfusion and the protective effects of the treatment.
CONCLUSIONS
The outcomes of the current investigation showed that Silymarin could be a valuable agent for reducing testicular tissue damage following I/R injury.
Topics: Humans; Rats; Male; Animals; Spermatic Cord Torsion; Rats, Wistar; Silymarin; Oxidative Stress; Reperfusion Injury; Testis; Antioxidants; Glutathione; Malondialdehyde
PubMed: 37975368
DOI: 10.26355/eurrev_202311_34319 -
A Para-Scrotal Pleomorphic Liposarcoma Mimicking As Another Scrotum (Pseudo-Scrotum): A Case Report.Cureus Oct 2023Liposarcomas are a subtype of soft tissue sarcomas arising from lipoblasts, a mesenchymal cell lineage that commonly arises from deep tissues of the body. Though these...
Liposarcomas are a subtype of soft tissue sarcomas arising from lipoblasts, a mesenchymal cell lineage that commonly arises from deep tissues of the body. Though these are the most common subtypes, their early diagnosis still remains a challenge due to their varied presentation as a soft benign appearing growth. The pleomorphic variant has complex management due to its high recurrence rate and resistance to chemoradiation. Scrotal liposarcomas have been reported. But in the present case, a 69-year-old male who presented with a pedunculated swelling in the left groin mimicking a left hemi-scrotal swelling. It was a left para-scrotal pleomorphic liposarcoma which was totally extra-scrotal, and not related to the spermatic cord or testes. So, this is a rare case with a review of the literature presented here.
PubMed: 37937002
DOI: 10.7759/cureus.46569