Usefulness of Doppler-color ultrasonography and identification of resistance indexes as early indicators of testicular infarction secondary to orchiepididymitis

The testicular infarction can be a rare complication of the orchiepididymitis. The ultrasonography appearance of the partial infarctions creates confusion with expansive intratesticular processes. We present three cases of focal testicular infarction associated with orchiepididymitis, stressing the usefulness of the Color doppler sonography for detecting the avascular nature o these lesions. The determination of de indeces of resistance (IR) in the doppler spectrum of intratesticular arteries showed a highly increased vascular resistance in respect of the healthy testicle. In patients with grave orchiepididymitis vein drainage can be affected due to compressive edema or to thrombosis, causing the raising of the resistance indeces. Acknowledging the avascular resistance of the focal post-orchiepididymitis infarction we can prevent unnecessary orchiectomy.     

Brucellar orchiepididymitis

The brucellosis is an unusual entity whose incidence has diminished due to the improvement in preventive measures. We have carried out a retrospective study of all the patients admitted in our service between 1996 and 1998, with diagnosis of orchitis. Two of the 31 patients admitted for this reason presented a final diagnosis of brucellar orchiepididymitis. Both patients presented clinic of affectation from the general state accompanied by resistance to habitual antibiotic treatment. The patient's epidemic antecedents, accompanied by the suitable clinical evolution took to the suspicion of orchiepididymitis of brucellar etiology, with change in the antibiotic rule. The diagnosis of the process was obtained by means of serologic tests and blood cultures.     

Xanthogranulomatous orchitis. Report of 7 cases

The xanthogranulomatosis orchiepididymititis is a benign and a rare disease. Its etiology is unknown. It creates diagnosis, therapeutic and etiological problems. The diagnosis is hardly made because of the variability of the clinical findings. The confusion is mainly made with a malignant tumor, and sometimes with a simple orchiepididymitis. Orchidectomy is usually performed. We report seven cases of orchiepididymitis characterized by their antibiotherapeutic resistance, the destruction of the testis which needed a surgical removal. The diagnosis is established after the histological study of the testis. The etiology is not yet known. The authors study the clinical evolution and therapeutic characteristics of our serial comparing with the literature data.     

Unusual benign paratesticular tumor in an infant mimicking rhabdomyosarcoma

Paratesticular tumors are extremely rare, with paratesticular rhabdomyosarcoma being the most common finding. A 6-month-old boy presented with an asymptomatic, right intrascrotal mass whereby the testicle was surrounded by a friable lipomatous tumor. Frozen section revealed an inflammatory process, negative for malignancy. Tumorectomy with vaginal resection was performed, maintaining the testicle and excretory ducts. Histopathologic findings showed a juvenile xanthogranuloma, a non-Langerhans histiocytosis commonly described in infants in the skin and skeletal muscle. The patient is doing well 2 years after surgery and is the first such case reported in the literature with successful conservative treatment.     

Immunologic aspect of testicular torsion: detection of antisperm antibodies in contralateral testicle

OBJECTIVE: To evaluate the immunologic etiology in unilateral testicular torsion, an experimental study in rats was carried out. MATERIALS AND METHODS: 75 adult Wistar rats included in the study program were divided into six different groups according to a torsion-detorsion procedure. Torsion degree was kept constant for all animals (720 degrees ). Anti-rat immunoglobulin G (IgG) antibodies against spermatozoa antigens were identified in contralateral testicular tissue after 1 month following detorsion and/or orchiectomy of the twisted testicle. RESULTS: We revealed antibody formation in animals subjected to unilateral torsion for 12 and 24 h, which then followed by detorsion of the testicle. IgG was identified especially on basal membrane of the tubules. CONCLUSIONS: As the controversy on the exact mechanism of testicular damage in unilateral torsion still continues, our findings showed that a possible immunological etiology may play an important role in this respect.     

Aggressive diagnostic approach indicated in testicular sarcoidosis

A twenty-nine-year-old black male presented with a testicular mass and hilar adenopathy. Histologic sections of the testis showed the 3 by 2 by 2-cm mass was an inflammatory granuloma due to sarcoidosis. The epididymides were involved bilaterally. The initial differential diagnosis included: sarcoidosis, testicular neoplasm, an infectious process, or a combination of the three. Biopsy of the testicle is recommended to confirm the diagnosis of sarcoidosis. We believe there are only 6 reported cases of clinically detected testicular sarcoidosis.     

Pathogenesis of testicular atrophy in spermatic cord torsion in childhood

Results of experiments (in 123 immature male rats) and clinical investigations (in 22 children) have shown that changes in a testicle resulting from torsions of the spermatic cord are dependent not only on the time from the moment of torsion and its degree, but also on a disturbance of the hemato-testicular barrier and a developing auto-immune process in the operated testicle.     

Use of cytomedins in combined therapy of surgical infections

Under study was the influence of cytomedins on the system of immunity in patients with developed surgical infection in a traumatology clinic. The investigation of immune reactions under conditions of purulent infection of different etiology has shown the necessity to include the up-to-date and purposeful immunomodulating therapy (cytomedins) in the complex of treatment which allows arrest of the inflammatory process in the wound in earlier terms.     

Tumors of cryptochid testis

After comparing the statistics of Department of Urology of the Cochin Hospital (Paris) with international series, the author raises three questions: 1) is there a relation between the level of descent of the testicle and secondary development of carcinoma? 2(What is the incidence of orchidopexy on secondary development of carcinoma, and 3) is there a specific histology of tumors of the undescended testicle? After raising these questions, the author goes on to discuss the etiology of the tumors, and their treatment.     

Tiny nodule in the testicle: Case report of a sertoli cell tumor

Sex cord-stromal tumors of the testis are rare. We report on a small Sertoli cell tumor in the testicle. According to published reports, a nodular lesion on the testicle has a variety of differential diagnoses. Preoperatively, it is very difficult to differentiate between a tumorous lesion and an inflammatory change. When a tiny nodule in the testicle is encountered, we propose limited, testicular-sparing surgery according to the frozen section diagnosis.     

Preoperative diagnosis of testicular torsion

Based on the premise that a “torqued” testicle is avascular whereas one with an inflammatory process has increased vascularity, rectilinear scans can be used to facilitate or direct therapy in scrotal conditions. Our study is in its embryonic stage. We are awaiting determination of its overall diagnostic accuracy, not only in torsion and epididymitis but also in neoplasia and any other entities that might lend themselves to this modality.     

Malacoplaquia testicular: aportación de un nuevo caso y revisión de la literatura científica

Malakoplakia is a uncommon chronic granulomatous condition of a benign nature preferentially occurring in the genitourinary tract. Testes are affected in 12% of cases, and the first case of testicular malakoplakia was reported in 1958. Forty cases have been reported worldwide since that date. We report a new case of testicular and epididymal malakoplakia in a 68-year-old male patient diagnosed of complicated orchiepididymitis who underwent orchidectomy to rule out a malignant tumor. The histopathological study demonstrated a chronic inflammatory infiltrate with histiocytes with an eosinophilic cytoplasm containing the characteristic Michaelis-Gutmann bodies diagnostic of malakoplakia.In connection with this new case and because of its unusual presentation, the literature on testicular malakoplakia is reviewed.     

Spermatozoa-containing simple cysts of the rete testis

Simple cysts of the testis are rare benign lesions of uncertain etiology. We report 2 spermatozoa-containing cysts of the rete testis found incidentally in the left testicle of a 56-year-old man evaluated by ultrasound for hydrocele. The presence of spermatozoa in the cyst fluid has not been observed previously and confirms the connection of the cysts with the seminiferous tubular system.     

Bilobed testicle in children: diagnosis and management

Bilobed testicle is an extremely rare testicular malformation in children. It may be presumed that this condition could be an incomplete expression of polyorchidism; however, the etiology of both entities remains unknown. In this report, a 3-year-old boy presented with a right bilobed testicle mimicking a testicular tumour. Since there are insufficient data in the pediatric literature presenting the ideal management of bilobed testicles, we believe it is important to report this case to provide more information about this condition. Although rare, bilobed testis should be considered in the differential diagnosis of a testicular mass. Surgical treatment is not mandatory, and conservative follow-up may play a role.     

Testicular torsion in children

The observations of 40 children with testicle torsion have shown results of the surgical treatment to depend not only on duration of the postoperative period but also on the degree of torsion and anatomical peculiarities of the spermatic cord. The preserved during operation testicle where non-recognized irreversible lesions have already occurred due to torsion can in later period result in the appearance of antisperm antibodies and threat of a lesion of the contralateral testicle.     

Les torsions sur testicules cryptorchides

Purpose:

Cryptorchidism is a rather frequent pathology in urology. It is associated with a high risk of infertility and degeneration. It also seems to be associated with a high risk of torsion. This entity is poorly studied in the literature. We studied the cases of torsion on cryptorchid testicles hospitalized at our service, to better characterize this pathology and reduce the rate of orchidectomy.

Methods:

We underwent a retrospective study of all the cases of torsion on a cryptorchid testicle hospitalized in our service of urology between 1999 and 2007.

Results:

The age of patients was between 7 months and 39 years. Torsion touched the right testicle in 53% of the cases. Patients experienced a brutal pain of the inguinal area with an under cutaneous mass inflammatory and a painful and empty homolateral scrotum. In 60% of the cases, the diagnosis was late and an orchidectomy was carried out. In the other cases, a lowering of the testicle was done with the controlateral orchidopexy.

Conclusion:

Even though torsions on a cryptorchid testicle are rare, we should not ignore them. The early diagnosis will make it possible to save and lower the testicle, and track a possible degeneration.     

The use of an electrolytic solution of sodium hypochlorite in acute suppurative diseases of the soft tissues]

The effect of electrolysis sodium hypochlorite solution (ENaClO) on the course of an inflammatory process in 233 patients with purulent pathology of different etiology was studied. ENaClO was obtained by means of electrolysis of the isotonic sodium chloride solution in the electrochemical cell. It was established that ENaClO had a pronounced bactericidal action contributing to acceleration of an inflammatory focus clearance of purulent-necrotic masses, stimulation of local immunity, activation of reparative processes.     

Retro-umbilical ectopic testicle: report of a case.

A case of a retro-umbilical ectopic testicle in a 13-year-old cryptorchid boy is reported. To our knowledge this has not been reported previously. There is no definite explanation for this highly aberrant ectopia. During the neonatal period the boy had an umbilical suppuration that required drainage. This may offer a possible explanation since the consequent healing process could have pulled the peritoneum upwards, dragging the testicle with it. Despite the high position of this testicle (and previous operation on the other side) it was easy to cross over both testes successfully to the heterolateral scrotum.     

淫羊藿苷与睾酮治疗亚急性衰老雄性大鼠的实验研究

目的观察淫羊藿苷及睾酮对D-半乳糖所致亚急性衰老大鼠血清SOD活性、T、E2含量,睾丸组织P16蛋白表达与细胞凋亡的影响。方法随机将40只SD成年雄性大鼠分为正常对照组、模型组、淫羊藿组、睾酮组。检测各组大鼠血清SOD活性、T、E2含量,HE染色观察睾丸组织变化,SP法观察睾丸组织P16蛋白表达情况,TUNEL法检测睾丸生殖细胞凋亡情况。结果D-半乳糖致亚急性衰老大鼠血清SOD活性、T含量下降,与正常组比较差异显著(P<0．01,P<0．01);各组E2变化无统计学意义。睾丸组织出现退行性变化,睾丸生殖细胞P16阳性细胞百分率(PI)和凋亡指数增加,较正常组差异显著(P<0．01);淫羊藿组和睾酮组SOD活性增加,T水平升高,生殖细胞凋亡指数下降,较模型组差异显著,睾丸组织的退行性变化明显改善。淫羊藿组生殖细胞P16阳性细胞百分率较模型组差异显著(P<0．01),而睾酮组变化无显著意义。结论与睾酮相比,淫羊藿不仅可以提高亚急性衰老雄性大鼠血清SOD活性和雄激素水平,减少生殖细胞凋亡,改善睾丸组织的退行性变化,还可通过抑制生殖细胞衰老基因P16蛋白表达这一途径延缓性腺衰老。