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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 -
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 -
Andrology Sep 2021Multiparametric MRI (mpMRI) of the scrotum has been established as a useful second-line diagnostic tool for the investigation of scrotal diseases. Recently,... (Review)
Review
BACKGROUND
Multiparametric MRI (mpMRI) of the scrotum has been established as a useful second-line diagnostic tool for the investigation of scrotal diseases. Recently, recommendations on clinical indications for scrotal MRI were issued by the Scrotal and Penile Imaging Working Group of the European Society of Urogenital Radiology.
OBJECTIVE
To update current research on when to ask for an MRI of the scrotum.
METHODS
PubMed database was searched for original articles and reviews published during 2010-2021.
RESULTS
Eighty-three articles fulfilled the search criteria. Scrotal MRI is mainly recommended after inconclusive US findings or inconsistent with the clinical examination and should be asked in the following cases: differentiation between intratesticular and paratesticular lesions (in rare cases of uncertain US findings), characterization of paratesticular and intratesticular lesions (when US findings are indeterminate), discrimination between germ cell and sex cord-stromal testicular tumors, local staging of testicular malignancies (in patients planned for testis-sparing surgery), differentiation between seminomas and non-seminomatous tumors (when immediate chemotherapy is planned and orchiectomy is delayed), assessment of acute scrotum and scrotal trauma (rarely needed, in cases of non-diagnostic US findings) and detection and localization of undescended testes (in cases of inconlusive US findings). Although preliminary data show promising results in the evaluation of male infertility, no established role for mpMRI still exists.
CONCLUSION
Multiparametric MRI of the scrotum, by assessing morphologic and functional data represents a valuable problem-solving tool, helping to improve our understanding on the nature of scrotal pathology and the process of spermatogenesis. The technique may improve patient care and reduce the number of unnecessary surgical procedures.
Topics: Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Male; Practice Guidelines as Topic; Scrotum; Societies, Medical; Testicular Diseases
PubMed: 33964115
DOI: 10.1111/andr.13032 -
Deutsches Arzteblatt International Jun 2012The acute scrotum in childhood or adolescence is a medical emergency. Inadequate evaluation and delays in diagnosis and treatment can result in irreversible harm, up to... (Review)
Review
BACKGROUND
The acute scrotum in childhood or adolescence is a medical emergency. Inadequate evaluation and delays in diagnosis and treatment can result in irreversible harm, up to and including loss of a testis. Various diseases can produce this clinical picture. The testis is ischemic in only about 20% of cases.
METHODS
This review is based on a selective literature search, the existing clinical guideline, and the authors' experience.
RESULTS
The clinical approach to the acute scrotum must begin with a standardized, rapidly performed diagnostic evaluation. Dopper ultrasonography currently plays a central role. Its main use is to demonstrate the central arterial blood supply and venous drainage of the testis. The resistance index of the testicular vessels should also be determined.
CONCLUSION
Physical examination and properly performed Doppler ultrasonography enable adequate evaluation of the acute scrotum in childhood and adolescence. In the rare cases of diagnostic uncertainty, immediate surgical exposure of the testis remains the treatment of choice.
Topics: Adolescent; Child; Child, Preschool; Diagnosis, Differential; Epididymitis; Humans; Infant, Newborn; Male; Scrotum; Spermatic Cord Torsion; Ultrasonography
PubMed: 22787516
DOI: 10.3238/arztebl.2012.0449 -
Andrology Sep 2021Scrotal ultrasonography is an essential diagnostic tool in daily clinical practice. The availability of new-generation ultrasound machines characterized by clearly... (Review)
Review
BACKGROUND
Scrotal ultrasonography is an essential diagnostic tool in daily clinical practice. The availability of new-generation ultrasound machines characterized by clearly improved image quality, low health cost, and higher patient safety, represents only some characteristics of ultrasound investigation. The usefulness of scrotal ultrasonography is particularly evident in the period of life from infancy to puberty, during which males undergo important morphofunctional changes, and several pathological conditions may occur.
OBJECTIVES
This pictorial review primarily aimed to investigate the aspects of ultrasonography related to the normal physiological development of the gonads from mini-puberty to pubertal onset. This study also aimed to provide an update on the use of ultrasonography in main andrological pathologies that may occur during this period. The conditions that are discussed in depth are: cryptorchidism, inguinoscrotal hernias, and hydrocele in the neonatal phase; acute scrotum, epididymo-orchitis, and testicular cancers in childhood; and hypogonadism, varicoceles, testicular microlithiasis, and oncohematological pathology in puberty.
DISCUSSION
We provided an ultrasound slant for all the above-mentioned pathologies while purposely avoiding excessive deepening of the pathogenetic, clinical, and therapeutic aspects. Studying the ultrasound aspects of the gonads also facilitates differential diagnosis between various conditions and represents a good aid in evaluating therapeutic success (e.g., in hypogonadism or postsurgical evaluation of varicoceles and cryptorchidism).
CONCLUSION
Scrotal ultrasonography is now globally recognized as the necessary completion of clinical-laboratory overview in gonads evaluation. This diagnostic procedure is even more indispensable in the infancy-childhood-puberty period for the evaluation of normal gonadal development as well as diagnosis of other possible diseases.
Topics: Adolescent; Child; Child, Preschool; Genital Diseases, Male; Humans; Infant; Infant, Newborn; Male; Medical Illustration; Puberty; Scrotum; Ultrasonography
PubMed: 34048149
DOI: 10.1111/andr.13056 -
Dermatology Online Journal Sep 2018Genital rejuvenation encompasses not only the nonsurgical interventions but also the surgical procedures that are utilized to improve the functional aspects and/or... (Review)
Review
Genital rejuvenation encompasses not only the nonsurgical interventions but also the surgical procedures that are utilized to improve the functional aspects and/or enhance the aesthetic presentation of the genitalia of women (vaginal rejuvenation) and men (scrotal rejuvenation). Vaginal rejuvenation was introduced into the medical literature in 2007; yet, within the last decade, physician and patient interest in this field has markedly increased. In contrast, the term scrotal rejuvenation was only coined in 2018. Rejuvenation of the genitalia may be considered for hair-associated (alopecia and hypertrichosis), morphology-associated (vulvovaginal atrophy, excess clitoral or labial tissue, scrotal wrinkling, and vaginal or scrotal laxity), and vascular-associated (angiokeratomas) changes of the vagina and scrotum. As women and men gain insight into the conditions that are amendable to genital rejuvenation, the demand for vaginal rejuvenation and scrotal rejuvenation will likely increase. Genital rejuvenation may become the next frontier in medical and cosmetic dermatology and dermatologists have the opportunity to provide rejuvenation of the vagina and scrotum for their patients.
Topics: Cosmetic Techniques; Female; Genitalia, Female; Humans; Male; Rejuvenation; Scrotum; Skin Aging; Skin Diseases; Vagina; Vulva
PubMed: 30677826
DOI: No ID Found -
Indian Pediatrics Nov 2014
Topics: Genital Diseases, Male; Humans; Iatrogenic Disease; Infant, Newborn; Male; Rectal Diseases; Scrotum
PubMed: 25432240
DOI: No ID Found -
Abdominal Radiology (New York) Apr 2018Multiparametric US is increasingly recognized as a valuable problem-solving technique in scrotal pathologies. Compared to conventional Doppler modes, contrast-enhanced... (Review)
Review
Multiparametric US is increasingly recognized as a valuable problem-solving technique in scrotal pathologies. Compared to conventional Doppler modes, contrast-enhanced ultrasonography (CEUS) has higher sensitivity in assessing the presence or absence of flows, and to improve differentiation between poorly vascularized tumors and non-neoplastic, avascular lesions. Characterization of benign and malignant complex cysts is improved. In trauma patients, CEUS can help evaluating the viability of testicular parenchyma. In patients with severe epididymo-orchitis, it allows unequivocal assessment of post-inflammatory ischemic changes and abscess formation. CEUS does not add significantly to conventional Doppler modes in spermatic cord torsion. Attempt of differentiating benign and malignant tumors remains a research tool. In the clinical practice, elastography has a limited role for tumor characterization. The majority of malignant tumors are stiff at elastography, but they may display soft areas, or appear globally soft. A quantitative evaluation of testicular stiffness is feasible using shear-wave elastography. Potential clinical applications for elastographic modes could include work-up of infertile patients.
Topics: Contrast Media; Genital Diseases, Male; Humans; Male; Microbubbles; Scrotum; Sensitivity and Specificity; Ultrasonography
PubMed: 29460046
DOI: 10.1007/s00261-018-1510-7 -
The Pan African Medical Journal 2014
Topics: Angiokeratoma; Genital Neoplasms, Male; Humans; Male; Middle Aged; Scrotum; Skin Neoplasms
PubMed: 25977739
DOI: 10.11604/pamj.2014.19.376.5874 -
Italian Journal of Pediatrics Mar 2022Median raphe cyst is usually benign and asymptomatic male genitalia lesions. Although uncommon, infection may be a complication.
BACKGROUND
Median raphe cyst is usually benign and asymptomatic male genitalia lesions. Although uncommon, infection may be a complication.
CASE PRESENTATION
We report the case of a 4-year-old child presented to the emergency department for a serpiginous and redness lesion extended from the basis of the penis until the perineum. An infected median raphe cyst was suspected, and the patient underwent surgical treatment and antibiotic therapy with complete resolution of symptoms. Liquid culture resulted positive for Serratia Marcescens.
CONCLUSION
Infection is a rare complication, especially in childhood. To prevent relapses and clinical symptoms, the majority of authors recommend surgical excision followed by primary closure. In case of infections caused by Serratia Marcescens, chronic granulomatous disease should always be rule out.
Topics: Anti-Bacterial Agents; Child, Preschool; Cysts; Humans; Male; Pelvis; Perineum; Scrotum
PubMed: 35241137
DOI: 10.1186/s13052-022-01224-7