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Folia Medica Cracoviensia Dec 2023Epididymal cysts are benign cystic formations of the epididymis that usually appear in adolescence or early adulthood. Their frequency doubles after the age of 14-15....
Epididymal cysts are benign cystic formations of the epididymis that usually appear in adolescence or early adulthood. Their frequency doubles after the age of 14-15. Obstruction in the epididymal efferent ductules with subsequent prostenotic dilatation of them, as well as dysgenesis due to hormonal disorders during fetal or postnatal life, are possible. At the 1st Department of Pediatric Surgery of A.U.Th. we treated 11 cases of boys at the age of 11-16 who presented with acute scrotum because of an epididymal cyst. The diagnosis was confirmed by ultrasound scanning . Due to persistent symptomatology, patients underwent surgical exploration and removal of the cyst. The postoperative care of the patients was uncomplicated with immediate remission of symptoms. In one case, ipsilateral acute epididymitis occurred after 10 days, which was successfully treated with antibiotic therapy. It is reported that approximately 50% of epididymal cysts involute within an average of 17 months. In conclusion, using the data obtained from the review, of the small in number of international bibliography studies, it is proposed conservative treatment of asymptomatic cysts with diameter smaller than 1 cm and surgical excision [1] of large asymptomatic cysts with diameter greater than 1 cm, which do not regress after a follow-up of 24-48 months, cysts, regardless of their diameter, responsible for persistent symptoms and in the manifestation of acute scrotal symptoms due to inflammation, intravesical bleeding or secondarily torsion of the epididymis.
Topics: Male; Child; Adolescent; Humans; Adult; Spermatocele; Epididymis; Cysts; Scrotum; Ultrasonography
PubMed: 38578344
DOI: 10.24425/fmc.2023.148757 -
CytoJournal 2017Epididymal lesions are uncommon in clinical practice. Few case series has been described in the literature documenting the role of cytology in the evaluation of...
BACKGROUND
Epididymal lesions are uncommon in clinical practice. Few case series has been described in the literature documenting the role of cytology in the evaluation of epididymal nodules. This study was undertaken to analyze the cytomorphology of epididymal nodules and to evaluate role of fine-needle aspiration biopsy (FNAB) in early definitive diagnosis of epididymal nodules.
MATERIALS AND METHODS
A total of seventy cases of epididymal nodules were aspirated over a period of 6 years in the Department of Pathology. These cases were taken from the cytology record as a part of this study. The aspiration was performed using 22/23-gauge needle. Smears were stained with May-Grunwald-Giemsa and Papanicolaou stains. Special stains and immunocytochemistry were performed, wherever required.
RESULTS
The cytological features were adequate to establish the diagnosis in sixty cases. The lesions diagnosed were tuberculosis 16 (22.85%), spermatoceles 12 (17.14%), benign cystic lesion 8 (11.42%), encysted hydrocele 8 (11.42%), acute suppurative lesion 6 (8.57%), filariasis 4 (5.71%), chronic epididymitis 3 (4.28%), nodular fasciitis 1 (1.42%), epidermal inclusion cyst 1 (1.42%), and cystic adenomatoid tumor 1 (1.42%). Ten cases were inadequate to establish the diagnosis. FNAB was useful in diagnosis of 86% of cases. Infectious lesions of the epididymis were more common than neoplastic lesions. Patients with infection responded well to medical treatment.
CONCLUSIONS
FNAB is an easily available technique for palpable lesions of epididymis, and it helps in making an early, near definitive diagnosis of epididymal lesions. It also helps to avoid unnecessary surgical interventions and helps in timely management.
PubMed: 29259652
DOI: 10.4103/cytojournal.cytojournal_51_16 -
La Pediatria Medica E Chirurgica :... Jun 2019Torsion of an epididymal cyst is an extremely rare cause of acute scrotum in children and in young boys. Its reported incidence is 5-20%. The treatment is usually... (Review)
Review
Torsion of an epididymal cyst is an extremely rare cause of acute scrotum in children and in young boys. Its reported incidence is 5-20%. The treatment is usually conservative. Many cases (up to 60%) regress spontaneously, especially if below 3 cm. Few cases have been reported in Literature (7 cases/2018). We add our patient as eighth case. He was a 13-year-old boy who was admitted for acute scrotum. Ultrasound excluded torsion of the testis and he was managed for 5 day conservatively. Based on clinical history and physical exam, we decided to perform a prompt surgery that revealed a torsion of epididymal cyst that was confirmed by histological exam.
Topics: Acute Disease; Adolescent; Humans; Male; Scrotum; Spermatic Cord Torsion; Spermatocele; Ultrasonography
PubMed: 31232012
DOI: 10.4081/pmc.2019.210 -
Fertility and Sterility Mar 1984The testicular biopsy, spermiogram, and hormonal assays performed on 23 infertile adult men with no other apparent cause of infertility than bilateral retractile testes...
The testicular biopsy, spermiogram, and hormonal assays performed on 23 infertile adult men with no other apparent cause of infertility than bilateral retractile testes are reported. Both luteinizing hormone and testosterone levels were normal, while follicle-stimulating hormone levels were normal or increased. The spermiogram showed oligozoospermia, asthenozoospermia, and severe teratospermia (tapering, amorphous, and immature forms). All the testicular specimens presented several focal histologic lesions, which were distributed in a mosaic pattern. The most frequent lesions were tubular lumen dilation, tubular diameter reduction, tunica propria thickening, tubular hyalinization, hypoplastic tubules, spermatocele, athrocytosis, vacuolation, or oncocytic transformation of Sertoli cell cytoplasm, maturation anomalies of spermatids, sloughing of immature spermatids, maturation arrests at the level of spermatids, primary spermatocytes or spermatogonia, germ cell hypoplasia, germ cell absence, peritubular and perivascular lymphocytic infiltrates, and venous angiectasis. These lesions seem to represent different progressive stages of tubular atrophy due to a temporary partial occlusion of the excretory ducts. This obstruction is probably caused by venous ectasia, which may be related to positional changes experienced by the testes during retraction.
Topics: Adult; Humans; Infertility, Male; Male; Oligospermia; Seminiferous Tubules; Sertoli Cells; Sperm Maturation; Spermatogonia; Spermatozoa; Testicular Diseases; Testis; Varicocele
PubMed: 6698232
DOI: No ID Found -
La Pediatria Medica E Chirurgica :... May 2018Epididymal cysts (ECs) are relatively common in adults, rare in children. Normally their treatment is conservative. They may be situated anywhere in the organ,... (Review)
Review
Epididymal cysts (ECs) are relatively common in adults, rare in children. Normally their treatment is conservative. They may be situated anywhere in the organ, frequently in the region of the head. Torsion of these cysts is extremely rare in both children and adults, causing acute scrotal swelling. The diagnosis is intraoperative. A 16-year-old boy was referred to our Divisional Clinic by the treating physician for scrotal swelling appeared 4 months earlier. Absence of a history of minor scrotal trauma. Ultrasonography showed a 40×50 mm fluid-filled right para-testicular mass. We performed surgery finding a large black cyst connected to the head of the epididymis with 720°-degrees rotation. Histology revealed an acquired EC. The particularity of our case is due to the absence of symptoms in association with a big EC twisted of 720° degrees. This is the only case reported in literature. All patients with EC torsion reported presented symptoms related to acute scrotum.
Topics: Adolescent; Humans; Male; Scrotum; Spermatic Cord Torsion; Spermatocele; Testicular Diseases; Ultrasonography
PubMed: 29871476
DOI: 10.4081/pmc.2018.162 -
Journal of Andrology 1984Artificial spermatoceles were implanted into three patients with congenital absence of the vas. In each case, the testicular biopsy demonstrated normal spermatogenesis,...
Artificial spermatoceles were implanted into three patients with congenital absence of the vas. In each case, the testicular biopsy demonstrated normal spermatogenesis, and the dilated epididymal tubule was packed with spermatozoa. The ciliated epididymal mucosa appeared normal despite the tubular dilatation. The spermatoceles were constructed of expanded polytetrafluoroethylene, and they were microsurgically implanted over the cut end of the epididymis. The grafts were aspirated monthly for up to six months, and the aspirates containing spermatozoa were used for artificial insemination. Spermatozoa were consistently retrieved from each patient, but no pregnancies have resulted. The most obvious finding was that the spermatozoa lacked motility. In the discussion, other problems related to artificial spermatoceles are reviewed, including epididymal development and sperm maturation, aspiration techniques, and sperm storage.
Topics: Adult; Antibodies; Artificial Organs; Biocompatible Materials; Epididymis; Humans; Male; Polytetrafluoroethylene; Semen; Sperm Count; Sperm Motility; Spermatozoa; Testis; Vas Deferens
PubMed: 6469865
DOI: 10.1002/j.1939-4640.1984.tb00793.x -
Hinyokika Kiyo. Acta Urologica Japonica Sep 1986Testicular scanning with technetium-99m sodium pertechnetate was performed on 152 patients with a variety of intrascrotal lesions. Scrotal images were obtained serially...
Testicular scanning with technetium-99m sodium pertechnetate was performed on 152 patients with a variety of intrascrotal lesions. Scrotal images were obtained serially in the perfusion, tissue phase, illustrating the features of each phase in various clinical conditions. The relationship of scrotal imaging to the overall clinical presentation and evaluation of these patients is emphasized in testicular torsion of the testicular appendix, epididymitis, abscess, trauma, tumor, spermatocele, and varicocele. Technical problems of the scanning are also discussed.
Topics: Adult; Epididymitis; Genital Diseases, Male; Humans; Male; Radionuclide Imaging; Scrotum; Sodium Pertechnetate Tc 99m; Spermatic Cord Torsion; Testicular Neoplasms; Testis
PubMed: 3028109
DOI: No ID Found -
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 -
The Kaohsiung Journal of Medical... Jul 2007Spermatoceles are usually asymptomatic and often found incidentally during physical examination. We report a case of giant spermatocele that mimicked a hydrocele. A...
Spermatoceles are usually asymptomatic and often found incidentally during physical examination. We report a case of giant spermatocele that mimicked a hydrocele. A 55-year-old man suffered from right scrotal enlargement for several years. As the heavy sensation and scrotal soreness worsened in recent months, he came to our outpatient clinic for help. Hydrocele was suspected due to transilluminating appearance of the scrotal content. Surgical exploration was arranged and a giant spermatocele was found. Total excision of the spermatocele was performed and the patient recovered well. The specimen was sent for pathology and spermatocele with spermatozoa was noted.
Topics: Diagnosis, Differential; Humans; Male; Middle Aged; Spermatocele; Testicular Hydrocele
PubMed: 17606432
DOI: 10.1016/S1607-551X(09)70423-1 -
Fertility and Sterility Mar 1978Vasectomized rams were studied with regard to the structure and function of their testes and epididymides at different periods up to 3 years and 9 months after the...
Vasectomized rams were studied with regard to the structure and function of their testes and epididymides at different periods up to 3 years and 9 months after the operation, and compared with intact control rams. Control rams showed a marked seasonal pattern with higher values for size and weight of testes, diameter of seminiferous tubules, Sertoli cell ratios for germ cells, and size of cauda epididymidis immediately prior to and during the breeding season than at other times of the year. In vasectomized animals the seasonal pattern was ill-defined, the testicular parameters were lower, and the cauda epididymidis was larger than in intact rams. Spermatogenesis was qualitatively and quantitatively affected after vasectomy, with a sequential ebb-and-flow pattern of spermatogenic arrest and hypospermatogenesis. Epididymal changes included the development of multiple spermatoceles surrounded by a granulomatous reaction, and disturbances in the process of sperm maturation.
Topics: Animals; Epididymis; Male; Seasons; Sheep; Sperm Maturation; Spermatogenesis; Spermatozoa; Testis; Vasectomy
PubMed: 640056
DOI: 10.1016/s0015-0282(16)43166-3