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American Family Physician Nov 2016Inflammation of the epididymis, or epididymitis, is commonly seen in the outpatient setting. Etiology and treatment are based on patient age and the likely causative... (Review)
Review
Inflammation of the epididymis, or epididymitis, is commonly seen in the outpatient setting. Etiology and treatment are based on patient age and the likely causative organisms. Epididymitis presents as the gradual onset of posterior scrotal pain that may be accompanied by urinary symptoms such as dysuria and urinary frequency. Physical findings include a swollen and tender epididymis with the testis in an anatomically normal position. Although the etiology is largely unknown, reflux of urine into the ejaculatory ducts is considered the most common cause of epididymitis in children younger than 14 years. Neisseria gonorrhoeae and Chlamydia trachomatis are the most common pathogens in sexually active males 14 to 35 years of age, and a single intramuscular dose of ceftriaxone with 10 days of oral doxycycline is the treatment of choice in this age group. In men who practice insertive anal intercourse, an enteric organism is also likely, and ceftriaxone with 10 days of oral levofloxacin or ofloxacin is the recommended treatment regimen. In men older than 35 years, epididymitis is usually caused by enteric bacteria transported by reflux of urine into the ejaculatory ducts secondary to bladder outlet obstruction; levofloxacin or ofloxacin alone is sufficient to treat these infections. Because untreated acute epididymitis can lead to infertility and chronic scrotal pain, recognition and therapy are vital to reduce patient morbidity.
Topics: Adolescent; Adult; Age of Onset; Anti-Bacterial Agents; Chlamydia Infections; Chlamydia trachomatis; Epididymitis; Humans; Male; Neisseria gonorrhoeae; Risk Factors; Sexually Transmitted Diseases; Urethritis; Young Adult
PubMed: 27929243
DOI: No ID Found -
The New England Journal of Medicine Mar 2017
Topics: Diabetes Mellitus, Type 2; Fournier Gangrene; Humans; Liver Diseases, Alcoholic; Male; Middle Aged; Perineum; Scrotum; Tomography, X-Ray Computed
PubMed: 28328332
DOI: 10.1056/NEJMicm1609306 -
Translational Andrology and Urology Aug 2017Scrotal surgery encompasses a wide-variety of surgical techniques for an even wider variety of indications. In this manuscript, we review our indications, techniques,... (Review)
Review
Scrotal surgery encompasses a wide-variety of surgical techniques for an even wider variety of indications. In this manuscript, we review our indications, techniques, and pit-falls for various reconstructive scrotal surgeries as-well-as surgical tips for placement of testicular prostheses. Penoscrotal webbing (PSW) is an abnormal, often-problematic distal insertion of scrotal skin onto the ventral penile shaft. There are several effective and straightforward techniques used to revise this condition, which include simple scrotoplasty, single- or double-Z-plasty, or the VY-flap scrotoplasty. Reconstruction is also commonly indicated following scrotal skin loss caused by infection, trauma, lymphedema, hidradenitis, and cancer. Although initial management of these conditions often involves scrotal skin removal, repair of expansive scrotal skin loss can be technically difficult and can be accomplished by using one of several skin flaps or skin grafting. Split-thickness skin grafting of scrotal defects can be accomplished easily, and provides durable results.
PubMed: 28904904
DOI: 10.21037/tau.2017.07.06 -
Ugeskrift For Laeger Mar 2023This case report describes Fournier's gangrene in a 35-year-old male following elective inguinal orchiectomy for testicular cancer. The aetiology was unknown, possibly...
This case report describes Fournier's gangrene in a 35-year-old male following elective inguinal orchiectomy for testicular cancer. The aetiology was unknown, possibly beginning in the bottom of the scrotum following orchiectomy, alternatively through the scrotal skin after hair removal prior to surgery. Survivors from Fournier's gangrene often suffer from severe long-term morbidity, and multidisciplinary treatment is important for outcome optimization.
Topics: Humans; Male; Adult; Fournier Gangrene; Testicular Neoplasms; Orchiectomy; Scrotum; Pelvis
PubMed: 36896604
DOI: No ID Found -
Archivos Espanoles de Urologia Jun 2020To provide a priority algorithm for determinate diagnostic, therapeutic and follow-up procedures regarding at testicular cancer, adjusted by institutional requirements....
OBJECTIVES
To provide a priority algorithm for determinate diagnostic, therapeutic and follow-up procedures regarding at testicular cancer, adjusted by institutional requirements. Testicular cancer patient assessment during COVID-19 Pandemia.
MATERIAL AND METHODS
Review of relevant manuscript published up to date, draft creation correctedt hough modified nominal group until final corrected manuscript.
RESULTS
A lack of scientific evidence exists through a large amount of manuscripts. The authors support prioritizing diagnostic and therapeutic procedures. Once priorities have been established, that will facilitate providing each patients the limited resources. Initial diagnostic procedures for testicular cancer such as scrotal US, orchiectomy, staging CT and adjuvant treatment (if required) are priority. Reducing the usage of chemotherapy with respiratory toxicity and increasing the usage ofgrowth factors during chemotherapy treatment are the main stakeholders of treatment. Besides, providing active surveillance on non-risk factor clinical stage I is alsoa priority. In case of positive COVID-19, it is important to high light that the vast majority of patients are tentatively cured.
CONCLUSIONS
During de-escalation phases, patients diagnosed with testicular cancer should receive priority care during initial assessment. The follow-ups of patients with low -risk and without recurrence for a long time, might be delayed.
Topics: Betacoronavirus; COVID-19; Chemotherapy, Adjuvant; Coronavirus Infections; Humans; Lymph Node Excision; Male; Neoplasm Recurrence, Local; Neoplasm Staging; Orchiectomy; Pandemics; Pneumonia, Viral; SARS-CoV-2; Testicular Neoplasms
PubMed: 32538809
DOI: No ID Found -
Journal of Clinical Ultrasound : JCU Nov 2022During the Coronavirus Disease 2019 (COVID-19) pandemic, patients present to hospitals with a wide range of symptoms. Some of these symptoms include acute orchitis and...
BACKGROUND
During the Coronavirus Disease 2019 (COVID-19) pandemic, patients present to hospitals with a wide range of symptoms. Some of these symptoms include acute orchitis and epididymitis. The goal of this research is to see if COVID-19 infection and scrotal infection are associated.
MATERIALS AND METHODS
Patients with a COVID-19 (+) who agreed to a scrotal ultrasound (US) examination were studied prospectively in a tertiary care center between October 2021 and February 2022. The severity of the disease was used to divide patients into groups. Patients diagnosed with acute scrotal infection based on scrotal ultrasonography findings were compared in these groups, as were their age, comorbidities, and laboratory data.
RESULTS
The median age of the 213 participants was 61.7 ± 8.3. During the ultrasonographic examination of the patients, 15 (7%), 8 (3.7%), 17 (7.9%), and 40 (18.7%) were diagnosed with acute orchitis, acute epididymitis, acute epididymo-orchitis, and scrotal infection, respectively. Acute scrotal infection was far more common in patients with a higher clinical severity of the disease. The patients' comorbidities were also assessed, and it was discovered that they were statistically more common in the same group.
CONCLUSIONS
Even if there are no clinical symptoms, ultrasonography can help detect acute scrotal infection in COVID-19 patients. Furthermore, in groups with higher clinical severity, this association is more likely to be seen. It is critical to understand this in order to avoid complications.
Topics: Male; Humans; Epididymitis; Orchitis; COVID-19; Scrotum; Ultrasonography; Acute Disease
PubMed: 35775362
DOI: 10.1002/jcu.23263 -
Atencion Primaria Mar 2020
Topics: Genital Diseases, Male; Humans; Insecticides; Male; Penile Diseases; Permethrin; Pruritus; Scabies; Scrotum; Young Adult
PubMed: 31109721
DOI: 10.1016/j.aprim.2019.04.003 -
Journal of Endocrinological... Feb 2024Human papillomavirus (HPV) infection is the most common sexually transmitted disease, in males and females worldwide. While the role of HPV in female diseases is well... (Review)
Review
PURPOSE
Human papillomavirus (HPV) infection is the most common sexually transmitted disease, in males and females worldwide. While the role of HPV in female diseases is well known and largely studied, males have negligibly been included in these programs, also because the proportion of women suffering and dying from HPV-related diseases is much larger than men. The aim of this review is to focus on HPV-related diseases in male patients.
METHODS
We performed a literature analysis on the electronic database PubMed. We considered randomized trials, observational and retrospective studies, original articles having as topic the relationship between HPV male infection and the following items: oral, anal penile cancers, warts, condylomas, male infertility, altered sperm parameters, anti-sperm antibodies (ASA). We also included experimental in vitro studies focused on the effects of HPV infection on oocyte fertilization, blastocyst development, and trophoblastic cell invasiveness. In addition, studies describing the adjuvant administration of the HPV vaccination as a possible strategy to promote HPV clearance from semen in infected males were included.
RESULTS
Regarding head and neck HPV-related diseases, the most important non-neoplastic disease is recurrent respiratory papillomatosis (RRP). Regarding neoplastic diseases, the proportion of head and neck cancers attributable to HPV has increased dramatically worldwide. In addition, nowadays, it is thought that half of head and neck squamous cell carcinomas (HNSCCs) cases in the United States are caused by infection with high-risk HPV. HPV is noteworthy in andrological practice too. It was described as having a high HPV prevalence, ranging between 50 and 70%, in male penile shaft, glans penis/coronal sulcus, semen as well as in scrotal, perianal, and anal regions. Moreover, in male patients, HPV infection has been associated, among other diseases, with penile cancers. HPV semen infection has been reported in about 10% in men from the general population and about 16% in men with unexplained infertility, although these data seem widely underestimated according to clinical experience. In particular, HPV semen infection seems to be most related to asthenozoospermia and to anti-sperm antibodies (ASAs).
CONCLUSIONS
HPV infection represents a health problem with a detrimental social and public impact. Despite this evidence, little has been done to date to widely promote vaccination among young males.
Topics: Humans; Male; Female; Papillomavirus Infections; Penile Neoplasms; Semen; Retrospective Studies; Spermatozoa; Antibodies
PubMed: 37770654
DOI: 10.1007/s40618-023-02192-3 -
Minerva Urologica E Nefrologica = the... Dec 2018Human papilloma virus (HPV) is the most common sexually transmitted pathogen and its potential role in the genesis of several diseases such as cervical, head and neck,... (Review)
Review
INTRODUCTION
Human papilloma virus (HPV) is the most common sexually transmitted pathogen and its potential role in the genesis of several diseases such as cervical, head and neck, anal and penile cancers, is now largely recognized. Aim of this review article was to evaluate and summarize the state of the art of HPV-related urogenital cancers, focusing on the potentially innovative methods for the diagnosis of infection that should be used to improve viral causative detection and prevent its diffusion through sexual intercourses.
EVIDENCE ACQUISITION
The initial search was carried out by using the Medline and the Google Scholar computerized databases through the selected key-words to identify the more recent literature on HPV epidemiology and its relationship with the main relevant urinary tract cancers. Studies were selected, extracted, analyzed and summarized. The PRISMA statement criteria were adopted and reported.
EVIDENCE SYNTHESIS
Polymerase chain reaction assay (HPV test) represents the best option for the diagnosis of HPV infection. Difficulties for the diagnosis in male are due to the site of investigation (glans, sub coronal sulcus, scrotum, urine, sperm) and the method adopted to take the sample (brushing, tissue biopsy). Due to these reasons several studies analyzed seemed to be incomparable. HPV infection is generally found in about 20% of heterosexual men. Its connection with cervical, anal, head and neck and penile cancer has been previously evidenced in 90%, 60%, 68% and 40% of cases respectively. In particular, HPV infection differed significantly among penile squamous cell carcinoma (SCC) subtypes ranging from 22.4% in verrucous subtype to 66.3% for the basaloid/warty subtype. Although the connection between prostate cancer and HPV infection has never been previously confirmed, forest plot analysis relative to a series of nine studies done during the last ten years, demonstrated a 7.7 objective risk (OR) for subjects with HPV infection to develop subsequent prostate cancer. On the other hand, some authors found comparable results in subjects with prostate cancer, benign prostate hyperplasia and prostate inflammation, thus demonstrating that this link still remains questionable. Similarly, the connection between HPV infection and urothelial, testicular and renal cancer continue to be hotly debated although HPV has been found in the urine, semen and renal tissue of patients respectively.
CONCLUSIONS
Integrated parts of HPV (E6 and E7 fractions) have been previously found in cervical, head and neck, anal and penile cancers. Conversely, although the evidence of concomitant HPV infection, integrated viral genome in cancer cells DNA had never been demonstrated in all the other genito-urinary tract cancers, and its role in the tumor genesis remain still largely debated. This is the reason why HPV infection should be tested in all patients with genitourinary cancer to better investigate about its potential role in the tumor genesis and development. Moreover, HPV infection option should be kept in mind when considering possible viral transmission to sexual partners.
Topics: Female; Humans; Kidney Neoplasms; Male; Papillomaviridae; Papillomavirus Infections; Penile Neoplasms; Sexually Transmitted Diseases, Viral; Testicular Neoplasms; Urogenital Neoplasms
PubMed: 30160386
DOI: 10.23736/S0393-2249.18.03141-7