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PubMedDate not supplied

Scrotal pathology in pediatrics with sonographic imaging.

Scrotal pathology in pediatrics ranges from the more benign hydrocele and varicocele to acute testicular torsion requiring emergent surgery. Malignant testicular tumors can be insidious in onset or may present acutely when trauma brings a swollen scrotum to the patient's or physician's attention. Three common conditions can present as an acute scrotum, all of which can suggest testicular torsion clinically. Epididymitis often has a less acute onset than testicular torsion, although it does not always present with a straightforward diagnosis. Although it is generally an inflammatory process affecting males from 9 to 14 years of age, it can be seen in younger males with Henoch-Schonlein purpura and Kawasaki disease. Torsion of the appendix of the testis and epididymis can present acutely and mimic acute testicular torsion and generally occurs from 6 to 12 years of age. Testicular torsion itself usually occurs from 12 to 18 years of age and usually results from the anatomical "bell-and-clapper" deformity. Infarction of the testis can occur within as early as 4 to 6 hours after torsion, depending on the duration of symptoms and degree of twist of the spermatic cord. Advances in ultrasound technology in recent years have made ultrasound the examination of choice for imaging scrotal pathology, whether acute or chronic in nature. Doppler technology has tremendously increased the radiologist's ability to assess flow within the prepubertal testicle, which allows assessment of viability in the undescended testis as well as in neonatal torsion. The ability of ultrasound to diagnose the pathogenesis of the acute scrotum is unsurpassed by any other imaging modality. Ultrasound is a readily available, noninvasive examination without radiation that provides excellent anatomic detail and serves as an important and tremendously helpful imaging modality in all types of pediatric scrotal pathology.

Adolescent↗
PubMed2006

[Ultrasound of the scrotum].

Ultrasound is an excellent tool for the diagnosis of benign or malignant intra- and extratesticular lesions depending on their structure and location in the scrotum. Besides the sonographic appearance, the clinical history and the location of a scrotal mass is crucial for the differential diagnosis between benign and malignant masses. In cases of acute scrotum or of vascular and inflammatory lesions, Doppler ultrasound is mandatory. This article gives a systematical survey of the most frequent scrotal lesions and their appearance in ultrasound.

Abscess↗
PubMed2001

Benign scrotal pathology: should all patients undergo surgery?

OBJECTIVE: To evaluate the justification for operative intervention in patients undergoing surgery for benign scrotal pathology, and to assess the associated morbidity. PATIENTS AND METHODS: Consecutive patients in two surgical firms who underwent surgery for benign intrascrotal pathology over a 5-year period were studied retrospectively. RESULTS: In all, 102 patients were included in the study (mean age 51.6 years, range 16-86). Most patients had either epididymal cysts (59) or hydroceles (31) or a combination of the two (eight). Some patients (37) underwent ultrasonography before surgery. The indications for surgery were deemed to be strong in 25% of patients but weak or absent in the remainder. Complications occurred in 31 patients, being minor in 18, but significant in 13, resulting in four re-admissions to hospital. There was no significant difference in the complication rate between those patients with strong indications for surgery (37%) and those with weak indications (28%). CONCLUSIONS: Surgery for benign intrascrotal pathology is frequently undertaken for weak clinical indications and carries significant associated morbidity. This could be avoided in many cases by simple reassurance. Judicious use of ultrasonography is advised. A policy of selective surgical intervention is strongly advocated.

Adolescent↗
PubMed1980

The control of male fertility by 6-chloro-6-deoxysugars.

1. 6-Chloro-6-deoxyglucose (24 mg/kg/day) produces a rapid and reversible antifertility effect in the male rat but high doses (greater than 200 mg/kg/day) produce spermatocoeles. In the mouse repeated high doses (480 mg/kg/day) cause paralysis of the hind limbs but there is no effect on fertility. 2. Spermatozoa from rats treated with 6-chloro-6-deoxyglucose (24 mg/kg/day) are unable to metabolize glucose and rapidly become exhausted when glucose is the only substrate supplied. Glycolysis is inhibited at the glyceraldehyde 3-phosphate dehydrogenase reaction. These spermatozoa can obtain energy by oxidizing pyruvate or lactate. 3. The side effects prevent the use of 6-chloro-6-deoxyglucose by humans but a fuller understanding of their mode of action may lead to the development of compounds with a more selective attack on spermatozoa.

Animals↗
PubMed1982

[Sonography of the scrotal contents].

According to our examination of 266 patients, ultrasonography of scrotal contents, specifically of the testes, proves to be a highly reliable, non-invasive diagnostic method. The major advantage of this technique is the fact that it enables adequate evaluation of the testes and exclusion of tumours, even when examination by palpation seems difficult or impossible due to extratesticular alterations (e.g. hydrocele, epididymitis). By means of this method also small, non-palpable lesions of the testes may be clearly demonstrated.

Diagnosis, Differential↗
PubMed1971

Office urology.

Explore the source record for details and available documents.

Albuminuria↗
PubMed1987

Caudal view. Aid in testicular scanning.

A false-positive scan for testicular torsion can be obtained in a scrotal scan when either a hernia or hydrocele overlies the testicle. The case of a patient in whom a false-positive scan was avoided by the use of a caudal view is reported.

Adult↗
PubMed1999

Pronounced cystic transformation of the Rete testis. MRI appearance.

BACKGROUND: Cystic transformation of the rete testis is a little-known partial or complete obstruction of the spermatozoa-containing secretion of the head of the epididymis. Depending on its severity, either ectasia or a cystic transformation occurs, which spreads to the network of convoluted seminiferous tubules in the mediastinum testis. Findings in contrast-enhanced MRI examinations are characteristic and may help to differentiate this benign entity from malignant neoplasia. The authors present two pronounced cases in different stages, documenting the broad spectrum of possible involvement.

Aged↗
PubMed2004

Evaluating the risk of epididymal injury during hydrocelectomy and spermatocelectomy.

PURPOSE: We evaluated the risk of epididymal injury in patients undergoing hydrocelectomy and spermatocelectomy, and determined risk factors that may increase the chance of epididymal injury. To our knowledge the incidences of epididymal injury during hydrocelectomy and spermatocelectomy have not previously been reported. MATERIALS AND METHODS: The pathology reports of all patients undergoing hydrocelectomy and spermatocelectomy at a single institution from 1990 to 2003 were retrospectively reviewed to determine if a portion of the epididymis was present in the pathology specimen. Patients with epididymis present then underwent a chart review to determine possible risk factors for epididymal injury. RESULTS: A total of 338 adults underwent unilateral or bilateral hydrocelectomy from 1990 to 2003. Another 111 patients underwent spermatocelectomy during this period. In 19 patients (5.62%) epididymal injuries were documented during hydrocelectomy and in 19 (17.12%) epididymal injuries were documented during spermatocelectomy. No specific risk factors could be identified. CONCLUSIONS: The risk of epididymal injury during hydrocelectomy and spermatocelectomy is significant. Patients must be informed of this risk since epididymal injury may lead to infertility. To our knowledge this is the first published report documenting the incidence and risk of epididymal injury during hydrocelectomy or spermatocelectomy.

Adult↗
PubMed2006

Color Doppler ultrasonography as a routine clinical examination in male infertility.

AIM: We assessed the value of scrotal color Doppler ultrasonography as a routine examination in infertile men. METHODS: Color Doppler ultrasonography was performed in 545 infertile men with a mean age of 35.8 years to detect intrascrotal abnormalities. Findings were compared with those of physical examination. RESULTS: Intrascrotal abnormalities were detected by ultrasonography in 65.3% of patients. Of 374 abnormalities, 58.3% were undetected by physical examination. Left varicocele was found in 313 patients (57.4%); testicular microlithiasis in 30 (5.5%); epididymal cyst in 21 (3.9%); right varicocele in 4 (0.8%); and testicular cysts in 3 (0.6%). One occurrence each (0.2%) was found for testicular tumor, intrascrotal hemangioma, and hydrocele of the spermatic cord. Compared to ultrasonography, sensitivity in detecting left varicocele by physical examination was 58.4%; specificity, 79.3%; accuracy, 67.3%; and positive predictive value, 79.3%. Venous diameters in the pampiniform plexus were 3 mm or more in 61.5% of 130 subclinical left varicoceles. Of 30 patients with testicular microlithiasis, 14 had varicocele, 2 had epididymal cyst,s 3 had a history of mumps orchitis, 1 had retractile testis, and 1 had a history of orchiectomy for contralateral testicular tumor. CONCLUSIONS: The routine Color Doppler ultrasonography is valuable for diagnosing scrotal abnormalities in infertile men, frequently detecting non-palpable lesions.

Adult↗