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PubMedDate not supplied

Doppler sonography in diagnosis of the acute scrotum.

Doppler sonography has been reported to be a reliable technique for diagnosing acute scrotum significantly decreasing the number of unnecessary surgeries. The aim of this paper was to demonstrate the superiority and validity of Doppler sonography over conventional sonography for differential diagnosis of the acute scrotum. In the period from 2002-2004, 300 patients underwent ultrasound examination of the testicles at the Institute of Radiology in Novi Sad. This prospective randomized study included 100 patients, whereas the target group consisted of 50 patients with the diagnosis of the acute scrotum. The control group consisted of 50 patients with the diagnosis of varicocele. The examinations were done using Siemens Versa Pro equipment and 7,5 MHz probes. On the basis of ultrasound examination, the target group was divided into three groups: 1. Inflammation, 2. Torsion, 3. Miscellaneous. Depending on the disease, the accuracy of diagnosis was confirmed by surgery, clinical findings and control sonographic examination. A functional correlation exists between Doppler diagnosis and final diagnosis in the inflammation and torsion. Resistive indexes (RI) were lower in inflammation, because of hyperemia. In cases with intratesticular hyperemia, the average RI was 0,454 and in those with supratesticular hyperemia 0,575. In cases with torsion, only one patient with appendiceal torsion had normal intratesticular blood flow. In diagnostics of the acute scrotum, Doppler sonography is superior over conventional sonography and more precise in differential diagnostics. RI are good quantitative parameters of hyperemia.

Acute Disease↗
PubMed1992

[The content of DNA, RNA and protein and the fresh weight:DNA, protein:DNA and RNA:DNA ratios in tissue of male calves, bulls, short-scrotum bulls and oxen during the growth period].

In male calves, in bulls, in short scrotum bulls and in oxen of different age the content of DNA, RNA and protein in various tissues (cerebrum, cerebellum, spinal cord, ventricles, lung, liver, cortex of the kidney, spleen, testicles, M. semimembranosus) was analysed. The fresh weight: DNA-, the protein: DNA- and the RNA: DNA-ratios were calculated. In the age of 78 weeks the short scrotum bulls had a body weight of 577 +/- 44, the bulls of 550 +/- 21 and the oxen of 462 +/- 41 kg. The testicles of the short scrotum bulls were smaller than that of the bulls. The differences in the content of DNA, RNA and protein per g tissue between male calves, bulls, short scrotum bulls and oxen of the same age were in part significant. The total content of DNA, of RNA and of protein for the 78 weeks old as well as the number of nuclei of the lung, the liver, the spleen and the testicles for the 6 and 78 weeks old animals were calculated. The biochemical parameters can be used for the characterization of the inhibition of growth of the different organs of calves and cattle by malnutrition and diseases.

Animals↗
PubMed1991

[The content of beta-carotene, vitamin A and ascorbic acid in different tissues of bulls, short-scrotum bulls and oxen of different body weights].

Analyses of the liver of bulls of different age show, that the concentration of beta-carotene in the age of 6 to that of 25 weeks increased only from 0.43 +/- 0.16 to 1.66 +/- 0.27 and that of vitamin A from 11.49 +/- 5.87 to 13.90 +/- 5.21 micrograms/g fresh weight. The concentration of beta-carotene and of vitamin A in the testis of bulls and of short scrotum bulls up to an age of 15 weeks was similar; thereafter the concentration in the short scrotum bulls was higher. At an age of 72 weeks the concentration of vitamin A in the liver of bulls (219.17 +/- 51.86) was higher (p less than 0.01) than in that of the short scrotum bulls (144.11 +/- 27.79) and that of the oxen (135.51 +/- 41.26 micrograms/g fresh weight). Analyses of the concentration of ascorbic acid in 8 different tissues of bulls and short scrotum bulls at 6 various periods show, that the highest values mostly were found in December.

Animals↗
PubMed1989

[Hydatid torsion as a cause of acute scrotum--clinical, sonographic and anatomic aspects].

Out of 82 patients with acute swelling of the scrotum, 25 (30.5%) had hydatid torsion. Hydatid torsion was the second most common cause of acute scrotal swelling in the entire patient group. In the group of patients up to 14 years of age (n = 36), hydatid torsion was found in 47.2% and was the most common cause of acute scrotal swelling, followed by torsion of the spermatic cord. Only 3 patients had torsion of an appendage of the epididymis. All other patients (n = 22) had torsion of the hydatid of Morgagni (appendage of the testicle). A difference in anatomical structure and vascularization during childhood seems to be the most important aspect regarding hydatid torsion and hemorrhagic infarction. Ultrasonographic examination of the scrotum and checking to see if the typical physical signs are present can help in making the exact diagnosis. In 13 patients with hydatid torsion, the scrotum was examined with ultrasound high-frequency transducers (7.5, 10 and 12 MHz). In 4 patients, the diagnosis was hydatid torsion, as determined by ultrasonography. Two patients were treated conservatively with a daily follow-up including a clinical examination and investigation of the scrotum with ultrasound. The patients recovered very quickly and the acute symptoms resolved within a few days in virtually all instances. Thus, in cases where the diagnosis is proven and the course of the disease is reasonably mild and painless, conservative management of intrascrotal hydatid torsion is possible and can be an effective means of treatment in lien of surgical intervention.

Acute Disease↗
PubMedDate not supplied

[Epididymitis in children: cause of acute scrotum].

The acute epididymitis in children is an uncommon disease which occurs mainly in adolescents. The pediatric surgeon must remember this illness whenever he observes a child with acute scrotum. The aim of this study is to review our experience at the Pediatric Surgery Department in Siena with 17 children (mean age: 7.53 years) underwent to surgery for acute scrotum and affected by primitive acute epididymitis without any other local or systemic associated disease. Our study shows that in children the acute epididymitis is more common than testicular torsion. It is often quite difficult to find the origin of epididymitis in children with no genito-urinary anomalies; so the acute scrotum and in particular the epididymitis require a standardized diagnostic and therapeutic approach based on an accurate physical exam, quickly feasible diagnostic procedures and a prompt surgical exploration of the scrotum.

Acute Disease↗
PubMed1977

On the use of the scrotum for feeding larval ixodid ticks on hosts.

The efficacy of feeding larval stages of Amblyomma variegatum, Hyalomma rufipes and Boophilus decoloratus on the ears and scrotum of sheep is compared. The effect of age of larvae on the number that engorged on the animal was also investigated. A significantly greater number of larvae fed on scrotum than on ears. The greatest number of larvae engorged when they were fed on the scrotum or ear within 1-4 days of hatching. The older the larvae, the less the number that fed. The economic advantages of adopting the scrotal method for rearing larval tick stages as well as the implication under natural conditions of younger larvae feeding in large numbers are discussed.

Animal Feed↗
PubMed2004

Imaging of the scrotum in children.

Clinical examination of the scrotum is difficult due to the small size of the testes and the epididymis in infants and young children, and eliciting patients' history is challenging. Therefore imaging of the scrotum in childhood bears great importance. Ultrasound is the standard imaging technique of choice providing the clinicians with a definitive diagnosis in most cases. However, in conditions of testicular torsion and epididymoorchitis--the most common differential diagnosis of scrotal pain--ultrasound findings can be inconclusive and further evaluation is required. Since there is a large overlap between paediatric and adult pathology, differences from adults in anatomy and pathology must be considered when evaluating the paediatric scrotum.

Child↗
PubMed1989

Surgical correction of complete bifid scrotum using subcutaneous pedicle flaps; a report of two cases.

A method of surgical correction for the separation and severe transposition of the scrotum associated with perineal hypospadias is reported. Although this is a rare congenital anomaly, we have treated two cases in the past 7 years. A technique has been devised by which the scrotum is divided into two subcutaneous pedicle flaps, enabling complete correction of the transposed penis and scrotum.

Humans↗
PubMed1981

Automated water-path ultrasonic examination of scrotum.

A new method of examining the scrotum by ultrasound with an automated water-path scanner is described. This method allows immobility of the scrotum in a more acceptable and painless way than in contact scanning methods. Panoramic scans of the entire scrotum and precision tomographic plane placement are advantages over conventional techniques. A description of normal scrotal anatomy includes the mediastinum of the testis, an important scrotal landmark. Representative cases of benign and malignant scrotal disease are presented to emphasize the utility of water-path scanning.

Adolescent↗
PubMed1998

Acute scrotum due to edidymo-orchitis associated with vasal anomalies in children with anorectal malformations.

Epididymo-orchitis, an uncommon cause of acute scrotum in prepubertal boys, is infection or inflammation of epididymis and testis. Epididymo-orchitis may be associated with urinary tract infections or reflux of urine predisposed by an underlying vasal anomaly. Two infants with anorectal malformations who presented with acute scrotum are reported. The surgical exploration of the testes showed findings consistent with epididymo-orchitis. Further radiological investigations of urinary tract showed vasal anomalies in both patients. If a patient with anorectal malformation presents with acute scrotum, epididymo-orchitis should be suspected initially. Evaluations should be directed toward defining predisposing vasal anomaly, and appropriate therapeutic measures should be undertaken to prevent recurrences.

Anal Canal↗
PubMed2002

Effect of age and genetic group on characteristics of the scrotum, testes and testicular vascular cones, and on sperm production and semen quality in AI bulls in Brazil.

The objectives were to determine the effects of age and genetic group on characteristics of the scrotum, testes and testicular vascular cones (TVC), and on sperm production and semen quality in 107 Bos indicus, B. taurus and cross-bred bulls at three artificial insemination (AI) centers in Brazil. In addition, predictors of sperm production and semen quality were identified. In general, scrotal circumference (SC), scrotal shape score, scrotal neck perimeter, and testicular size (length, width and volume) increased (P < 0.05) with age. Although there were no significant differences among genetic groups for SC or testicular size, B. indicus bulls had the least pendulous scrotal shape, the shortest scrotal neck length, and the greatest scrotal neck perimeter (P < 0.05). Fat covering the TVC was thinner (P < 0.05) in bulls < or = 36 months of age and in B. taurus bulls than in older bulls and B. indicus bulls, respectively. Age and genetic group did not affect testicular ultrasonic echotexture. B. indicus bulls tended (P < 0.1) to have the lowest average scrotal surface temperature (SST). In general, ejaculate volume, total number of spermatozoa and number of viable spermatozoa increased (P < 0.05) with age. However, there was no significant effect of age on sperm concentration, motility, major and total defects. The proportion of spermatozoa with minor defects was highest (P < 0.05) in bulls 37-60 months of age. B. indicus bulls had higher (P < 0.01) sperm concentration, total number of spermatozoa and number of viable spermatozoa than B. taurus bulls, with intermediate values for cross-bred bulls. Increased sperm production was associated with increased testicular volume, SC, TVC fat cover, and SST top-to-bottom gradient. Decreased semen quality was associated with increased SC and bottom SST, and decreased scrotal shape, scrotal neck perimeter and vascular cone diameter. In summary, age and genetic group affected the characteristics of the scrotum, testes, and TVC, sperm production and semen quality. In addition, characteristics of the scrotum, testes and TVC were associated with sperm production and semen quality in bulls and could be assessed for breeding soundness evaluation.

Aging↗
PubMedDate not supplied

Retrospective review of paediatric patients with acute scrotum.

BACKGROUND: The purpose of the present study was to evaluate the historical features and physical examination findings in boys presenting with acute scrotum and to determine the reliability of these modalities to make the correct clinical diagnosis. METHODS: A retrospective review of all boys presenting with acute scrotal/testicular pathology between January 1994 and December 1998 was performed. RESULTS: Two hundred and four boys were included in the study: 110 with torsion of the testicular appendage (TA), 40 with testicular torsion (TT), 29 with epididymo-orchitis (EO) and 25 with other diagnoses. Seventeen boys were managed conservatively. With the exception of symptom duration, there was no statistically significant difference between boys with TA, TT and EO. Boys with TT sought medical attention significantly earlier (median: 9.5 h) than those with TA (median: 48 h). Boys requiring an orchidectomy (n = 8) presented later than those who did not (median 30 vs 9 h; P < 0.05): seven (88%) were under 7 years of age. The testicular salvage rate was 88% and 36% with a pain duration of <12 h and >12 h, respectively. The preoperative clinical diagnosis was correct in 80% of those boys who underwent surgical exploration. Testicular torsion was misdiagnosed clinically in five boys. Late testicular atrophy was not observed in the present study. CONCLUSIONS: Most boys presenting with acute scrotum have TA. The history and physical examination can reliably identify those boys who can be managed conservatively. Routine surgical exploration is no longer justified in all boys with acute scrotum.

Acute Disease↗
PubMed2000

Color Doppler sonography in the diagnosis of acute scrotum in boys.

Evaluation of acute painful scrotum is difficult and imaging studies have been reported to be unreliable in detecting testicular torsion. In order to assess the value of color Doppler sonography in acute scrotal disease, the authors reviewed 65 consecutive boys, ranging in age from 1 to 16 years. The study demonstrated absent or diminished flow signals in 11 patients. All of them had a surgical intervention, and in 8 of them, a testicular torsion was confirmed. 54 boys had a symmetrical or increased flow signal on the affected side. Just 5 boys among this group underwent surgical exploration. On follow up, none of the 54 patients with good flow signals proved to have a testicular torsion. Sonography and color Doppler sonography helped to differentiate epididymitis and torsion of a testicular appendage as a basis for further investigations and correct conservative therapy. In detecting a testicular torsion, color Doppler sonography yielded a positive predictive value of 73%, a sensitivity of 100% and a negative predictive value of 100%. We therefore conclude, that Doppler sonography can reliably rule out testicular torsion so that routine scrotal exploration in cases of acute scrotum is no longer necessary. By reducing the number of emergency operations and hospitalization days, color Doppler sonography can cut down the total cost of managing acute painful scrotum in boys.

Acute Disease↗
PubMed1993

Photoperiod-mediated increases in serum concentrations of inhibin, follicle-stimulating hormone, and luteinizing hormone are accentuated in adult shortened-scrotum rams without corresponding decreases in testosterone and estradiol.

Relationships between "seasonal" changes in the secretion of gonadotropic (FSH, LH) and gonadal feedback (inhibin, testosterone, estradiol) hormones were examined in the adult ram. Eight Dorset x Leicester x Suffolk rams were kept in photoperiod-controlled rooms for 2 yr and subjected to alternating 4-mo periods of stimulatory (8 h light) and inhibitory (16 h light) day-lengths. The scrota of four rams were shortened at the outset to elevate testicular temperature and presumably impair inhibin secretion by Sertoli cells. Blood samples were collected serially from the jugular vein every 3 wk, and scrotal circumference of the four control rams were measured every 2 wk. Testicular recrudescence and regression were completed in the second month of the short- and long-day periods, respectively. Mean serum concentrations of testosterone and estradiol varied in synchrony across months (r = 0.42) and were similar between the groups of rams, except early in the short-day periods when testosterone was 50% lower in the shortened-scrotum rams because of smaller "seasonal" increases in testosterone pulse amplitude and baseline concentration. Increases in the secretion of gonadotropic hormones during testicular recrudescence were greater in magnitude (FSH) and/or of longer duration (FSH, LH pulse amplitude, and baseline LH) in rams with shortened scrota. In fact, mean FSH concentration was an average of 250% higher in the shortened-scrotum vs. the control rams throughout the last two photoperiod cycles. Mean inhibin concentration varied with month in accordance with FSH (r = 0.52) and either remained normal or was higher than usual (e.g., 55% during testicular regression) in the shortened-scrotum rams.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Constructing a scrotum in female-to-male transsexuals.

Genital construction in female-to-male transsexuals also should involve giving the labial region a scrotum-like appearance. A review of the literature on this subject is given. In our hospital, the construction of a scrotum in which testicular prostheses are implanted has been performed usually in combination with lengthening of the pars fixa of the urethra. A bifid scrotum is constructed using a V-Y advancement of the labial skin. Although implant expulsion (in 7 percent) and dislocation of implants (in 11 percent) were encountered in this series of 50 patients, the technique itself is easy to perform and seems to have few major drawbacks. The scars are small and hidden in the scrotal folds and hair. Tissue expansion prior to implantation of the testicular prostheses in the labial skin has proven to be unnecessary with this technique.

Adult↗
PubMed2004

Ultrasound of tropical and infectious diseases that affect the scrotum.

Ultrasonography of the scrotum permits assessment of testicular and extratesticular masses with high sensitivity. It can differentiate a variety of conditions involving the scrotum, testicles, and epididymis with similar clinical manifestations, including infectious and tropical diseases. The authors performed conventional and color Doppler ultrasonographic examinations in 76 patients who presented with scrotal pain, swelling, and/or tenderness. Their diagnoses included sexually transmitted disease (eg, gonorrhea, syphilis, chlamydial infection), tuberculosis, mumps, and various tropical diseases (eg, filariasis, leishmaniasis, schistosomiasis, paracoccidioidomycosis). The most common imaging findings were enlarged hypoechoic testes, hypervascularity, small hydroceles, and cutaneous edema. This report reviews these and other possible presentations of tropical and infectious diseases affecting the scrotum, emphasizing ultrasound findings that facilitate diagnosis.

Adolescent↗
PubMed2006

Accessory scrotum with multiple skeletal abnormalities.

Accessory scrotum is very uncommon. Here we report a 5-year old Caucasian boy presenting with an accessory scrotum localized to the left side of the pubic area. The penis and the primary scrotum were completely normal, containing two dependent testicles. On the right side of the body there was type B proximal femoral focal deficiency and there was also diastasis of the symphisis pubis. As observed in this case, abnormalities of two different embryological organ systems (accessory labioscrotal fold and proximal femoral focal deficiency) may occur concurrently at the same intrauterine time point as part of an overall embryologic mesenchymal disorder.

Abnormalities, Multiple↗
PubMed2003

Sonography of the scrotum.

Ultrasonography (US) with a high-frequency (7.5-10-MHz) transducer has become the imaging modality of choice for examination of the scrotum. US examination can provide information valuable for the differential diagnosis of a variety of disease processes involving the scrotum that have similar clinical manifestations (eg, pain, swelling, or presence of mass). The pathologic condition that may be at the origin of such symptoms can vary from testicular torsion to infection to malignancy. The ability of color and power Doppler US to demonstrate testicular perfusion aids in reaching a specific diagnosis in patients with acute scrotal pain. This review covers the anatomy of the scrotum and the scanning protocol for scrotal US, as well as detailed descriptions of disease processes and their US appearances. Newly described conditions such as intratesticular varicoceles and other benign intratesticular cystic lesions are also discussed.

Epididymis↗