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PubMed1994

Semen characteristics of Ile-de-France rams of different age and physical condition.

A breeding soundness examination (BSE) involving animal physical examination, scrotal circumference (SC) and semen evaluation was undertaken on 80 Ile-de-France rams at a government breeding farm, 32 km south-west of Casablanca (Morocco) from March to May 1988. A large percentage of rams (21.4%) was found to be unfit for breeding due to physical and genital abnormalities; 11 and 5% had disorders of the feet and respiratory system; upon genital palpation, 17.5, 13.8 and 7.5% of animals had orchitis, epididymitis and posthitis, respectively. The SC increased with age from 28.8+/-3.2 cm at </=2 yr to 35.4+/-3.5 cm at 4 yr or more (P<0.001). The quality of semen was significantly (P<0.01) depressed by orchitis and epididymitis (P<0.01) but not by ram age. Semen volume decreased from 1.1+/-0.6 ml in rams with normal genitalia to 0.5+/-0.4 and 0.25+/-0.2 ml in animals with orchitis and epididymitis, respectively. Similarly, sperm cell concentration declined from 2.5+/-1.2 to 1.1+/-0.7 and 1.6+/-1.2 billion per ml, while sperm motility dropped from 81.5+/-12.3% to 58.3+/-14.3 and 61.3+/-26.5%. The percentage of abnormal spermatozoa was also higher among rams with orchitis (24.3+/-17.5%) and epididymitis (20.7+/-24.3%) than among rams with normal genitalia (6.4+/-6.2%). We concluded that older rams need better health care to improve their semen production properties that may be influencing fertility.

Journal Article↗
PubMedDate not supplied

[Epidemiology and causes of autoimmune male infertility].

To study epidemiology and etiopathogenesis of male autoimmune infertility, we examined ejaculate samples from 3660 males of reproductive age, clinico-laboratory data on 560 males from infertile couples with antispermal antibodies (ASAB), 647 males without ASAB and 40 fertile males. Ejaculate was tested according to WHO recommendations, ASAB were identified by mixed agglutination reaction (MAR) and flow cytofluorometry (FCFM), infections of the reproductive tract (IRT)--by polymerase chain reaction (PCR). Experiments were made on 136 white non-inbred mature male rats and 40 mature female rats: 1/3 of the only testis was removed in male rats, then morphology of the operated on testis was studied as well as real fertility. ASAB were detected in 18% males of reproductive age. Factors of risk of antispermal immunity are the following: IRT (52%), varicocele (35%), blunt scrotal injuries without orchitis (21%) and previous epididymoorchitis (6%), obstruction (3%), cryptorchism and anejaculation (1%). Absolute risk of immune infertility makes up 67% after orchitis and epididymoorchitis, 66% after blunt scrotal injuries without clinical orchitis, 39-43% in clinical and previously operated varicocele, 32% after IRT. Combination of the risk factors raises immune infertility probability 1.2-4.1 fold. The efficacy of antibiotic therapy for bacterial IRT in ASAB is described. It is shown than it is possible to preserve spermatogenesis after testicular trauma by stimulation of its regeneration. Immunological mechanisms of male autoimmune infertility are analysed. Thus, main causes of male autoimmune infertility are mechanical, infectious or other affection of the testis leading to impairment of hematotesticular barrier, varicocele increases the risk of autoimmune reactions and orchitis after traumas; cross-over interaction between antigenic determinants of sperm and IRT; obstruction of the ejaculatory tract; specific features of antiinfectious immunity.

Animals↗
PubMed1990

[Immunoglobulin classes: M, A, G in blood serum of patients with mumps].

The levels of immunoglobulins of: M, A, G classes in 65 patients (11 women and 54 men) ill from epidemic parotitis, at acute phase and after subsidence of symptoms, were determined. The results of examinations were considered in two categories. One of them concerned all the patients, the other one comprised the patients with three groups of complications: meningitis, orchitis and joint occurrence of meningitis and orchitis. No deviations from the norm were found in IgM and IgA levels, both in acute phase and during convalescence. An increase of IgG content was observed only in the initial phase of epidemic parotitis. Taking into consideration the complications during the disease there was obtained an increase of IgM level in the patients with joint occurrence of meningitis and orchitis only in acute phase. Increased IgG values in the course of mumps concerned the patients with meningitis and orchitis and could be still observed after subsidence of the symptoms of the disease.

Adolescent↗
PubMed1997

A 25-year review of the acute scrotum in children.

Controversy persists with regard to the diagnosis and treatment of the acute scrotum in children. The differential diagnosis includes torsion of the testis, torsion of one of the appendices testis and epididymo-orchitis. Clinical differentiation is notoriously difficult and our policy has been to explore the scrotum of all who present with signs of an acute scrotum. The medical records of 199 boys aged less than 13 years who presented with an acute scrotum at Red Cross War Memorial Children's Hospital in Cape Town during the period 1970-1996 were retrospectively reviewed. Diagnosis was made clinically in all cases. Sixty-two boys (31%) were found on exploration to have torsion of the testis (mean age 6.3 years), the left side being affecting 2.5 times more frequently than the right (1 neonate had bilateral torsion), 62 (31%) had torsion of testicular appendages and 56 (28%) had epididymo-orchitis. Nineteen were grouped separately and 13 (6.5%) of these were treated conservatively. Boys needing an orchidectomy (N = 38) for testicular torsion presented three times later than those who did not (48 v. 16.5 hours). Successful conservation of the testis was directly related to the time interval of symptom development and surgical derotation. Boys with torsion of a testicular appendage presented later (mean 51 hours) and were older (mean 10 years) than boys in the other two groups. Those with epididymo-orchitis were younger (mean 3.3 years) and 40% were younger than 1 year. Only in one-third was there any clinical supportive evidence of the diagnosis. Surgical complications were infrequent. We advocate expedient surgical exploration and derotation with contralateral orchidopexy, since clinical differentiation between torsion of the testis, testicular appendages and epididymo-orchitis is inexact, even with highly specialised investigation such as Doppler ultrasound and radionuclide scanning, which may not be widely available, may delay definitive treatment and suggest a lack of urgency where time is of the essence.

Acute Disease↗
PubMed1994

A case of testicular nocardiosis and literature review.

A case of epididymo-orchitis due to Nocardia asteroides in a liver transplant recipient is reported. Nocardiosis is an extremely rare cause of epididymo-orchitis. Four other cases published in the English language medical literature are reviewed. All patients were immunocompromised, and other organs were affected simultaneously. Clinically the infection presented as a painful enlargement of the testicle with few inflammatory signs. Mortality was high (3/5), and in the two survivors long-term sulfonamide therapy was combined with orchiectomy. Nocardiosis should be considered in the diagnosis of epididymo-orchitis in the immunocompromised host.

Adult↗
PubMed2005

Early-onset Escherichia coli sepsis presenting as acute scrotum in preterm infant.

Epididymitis, or epididymo-orchitis, and infected hydrocele are unusual in the neonatal period. It is critical to differentiate them rapidly from testicular torsion to salvage the affected testis and avoid unnecessary surgical exploration. Escherichia coli is an important gram-negative bacteria causing diverse neonatal infections and is also the common bacteria causing epididymo-orchitis from an ascending route. We report the case of a preterm infant affected with epididymo-orchitis and infected hydrocele caused by early-onset E. coli sepsis. We highlight the importance of sampling proper cultures and using suitable antibiotics after excluding testicular torsion in a neonate with an acute scrotum.

Acute Disease↗
PubMed2002

Short-term prophylaxis with deoxyspergualin prevents testicular autoimmunity in mice.

The effects of the treatment with the immunosuppressant deoxyspergualin on the development of experimental autoimmune orchitis were studied. The results showed that C3H/He mice immunized with testicular germ cells and treated daily with either 0.3 or 3 mg/kg body weight deoxyspergualin during days 15-20 post-immunization developed experimental autoimmune orchitis lesions with a significantly lower incidence and severity than did the control mice treated under the same experimental conditions with phosphate buffered saline (PBS). The effects of deoxyspergualin were clearly dose-dependent, and the higher dose of the drug also markedly reduced the degree of delayed type hypersensitivity responses against testicular germ cells. These data suggest that deoxyspergualin may be worthy of consideration for the prevention/treatment of human immunoinflammatory orchitis.

Animals↗
PubMedDate not supplied

[Brucellar orchiepididymitis].

Brucellosis is a cause of human disease, especially in regions whose brucellosis in animals is enzootic. Brucella orchitis is a rare complication of systemic brucellosis (2-14%). Necrotizing orchitis is posible and it must be distinguished from necrotizing involvement arising from other pathogens (TB or Salmonella). Treatment with specific antimicrobial medication helps to avoid unnecessary orchiectomy and prevent infectious disease in the contralateral testis as well as systemic manifestations. We report a case of brucellar epididymo-orchitis presenting as an acute scrotal mass in a 19 years old male who lived in a city. The anamnesis was crucial in the diagnosis of this rare testicular infection. We review the diagnosis and management of this patology.

Adult↗
PubMed2001

Doppler ultrasonography in testicular tumors presenting with acute scrotal pain.

PURPOSE: To determine whether Doppler ultrasonography (US) could be useful in the evaluation of testicular neoplasms presenting with acute scrotal pain. MATERIAL AND METHODS: We examined 18 patients with acute scrotal pain using Doppler US. Peak systolic and end-diastolic velocity measurements were performed at first admission and on completion of 1-week proper antibiotic treatment. Data were retrospectively reviewed and compared with findings of a control group of 17 age-matched subjects. RESULTS: Of the 18 patients evaluated, 11 were found to have testicular tumors and 7 testicular inflammation. Peak systolic and end-diastolic velocities were significantly increased in patients with testicular tumor (p<0.002) and orchitis (p<0.01) versus normal controls. Follow-up examination on completion of 1-week antibiotic treatment demonstrated persistent high velocity values in patients with tumor and normalization of velocity values in patients with orchitis. CONCLUSION: Our results support the concept that follow-up Doppler US examination is of value in patients with acute scrotal pain submitted to antibiotic treatment since it may contribute to the differentiation between orchitis and testicular tumor.

Acute Disease↗
PubMed1995

Mechanisms of autoimmune disease in the testis and ovary.

This article reviews recent research on autoimmune diseases of the testis and ovary based on two experimental approaches for induction of autoimmune diseases of the gonads (immunization with testis or ovary antigen, usually with adjuvant, and deliberate alteration of the immune system in normal animals, without injecting antigen or adjuvant). It has been found that the local testicular immunoregulatory environment partially impedes autoimmune responses to ontogenic testis antigens and regulatory T cells usually control pathogenic T cells that are found in the normal peripheral immune system. If the clonal balance of these CD4+ T cell subsets is tipped in favour of pathogenic T cells, autoimmune diseases of the gonads could ensue. Loss of regulatory T cells may occur through aberrant T cell development, or oophoritogenic T cells can be activated by non-ovarian peptides that crossreact with self peptides at the level of the T cell receptor. The inflammatory CD4 (Th1) T cell mechanism has been established to be a critical pathway for autoimmune orchitis and autoimmune oophoritis; tumour necrosis factor has been shown to be required for amplification of the pathogenic T cell response. Histopathology has suggested tissue locations wherein pathogenic T cells encounter testicular and ovarian target antigens. Antibodies bind to both testicular and ovarian target antigens during the development of autoimmune orchitis and autoimmune oophoritis, but the precise role of the antibodies has not been determined. Resolution of this role may influence the clarification of the mechanism whereby autoantibody may access ejaculated human spermatozoa to cause infertility and the future of contraceptive vaccine development based on ovarian antigens. A novel mechanism of autoantibody induction and an immunogenetic approach to autoimmune oophoritis and orchitis, based on molecular linkage analysis of inbred mice, are also reviewed.

Animals↗
PubMed1984

Polyanions in syphilis: evidence that glycoproteins and macromolecules resembling glycosaminoglycans are synthesised by host tissues in response to infection with Treponema pallidum.

We investigated by means of radiolabelled precursors the source and nature of the polyanionic macromolecules present in rabbit tissues during active syphilis infection. Previous studies indicated that Treponema pallidum itself does not synthesise glycosaminoglycans, at least in vitro. In replicate experiments on unilaterally infected rabbits, tissue from the orchitic testis incorporated two to three times more 35S-sulphate and 3H-glucosamine (on a wet weight basis) than tissue from the non-orchitic contralateral testis. Incorporation of 35S-sulphate was independent of the number of viable T pallidum organisms present in the infested tissue, which suggested that incorporation represented biosynthesis by the host and not the treponeme. Testes from syphilitic rabbits two days after treatment with high doses (100 mg/kg) of penicillin incorporated less 35S-sulphate than untreated infected testes, but more than normal uninfected rabbit testes. This suggests that active syphilitic infection was necessary for maximum biosynthesis of the macromolecule(s) by host tissue. Hydrodynamic profiles showed incorporation of radiolabelled precursors into two distinct fractions of different sizes, which may represent a proteoglycan and a sulphated glycoprotein. Alcian blue staining of syphilitic testes at or after peak orchitis showed focal deposition of newly synthesised polyanionic components during peak orchitis and a more generalised fibrosis in testes after peak orchitis.

Alcian Blue↗
PubMed1995

Quantitative Doppler assessment of acute scrotal inflammation.

PURPOSE: To establish quantitative Doppler criteria for acute unilateral epididymitis and/or orchitis. MATERIALS AND METHODS: Triplex ultrasonography (US) was used to prospectively evaluate 31 patients with acute hemiscrotal pain and 15 asymptomatic control subjects. Morphology and perfusion were assessed, and peak systolic velocities (PSVs) were recorded. Ratios of PSV were calculated by using values from the right and left sides. RESULTS: PSVs in control subjects differed significantly from those in patients (P < .0001). A PSV > or = 15 cm/sec produced diagnostic accuracy of 90% for orchitis and 93% for epididymitis: Five of six false-negative findings were in patients younger than age 15 years. Epididymal PSV ratios > or = 1.7 or testicular ratios > or = 1.9 were diagnostic of acute inflammation (P < .0001). In three cases, morphologic and color Doppler findings were normal and only the PSV ratios were diagnostic. CONCLUSION: PSV and PSV ratios provide diagnostic criteria for acute unilateral epididymitis and/or orchitis that are more accurate than morphologic evaluation and color flow imaging either alone or in combination.

Acute Disease↗
PubMed2003

[Evaluation of color Doppler flow imaging in the diagnosis and differential diagnosis of spermatic cord torsion].

OBJECTIVE: To distinguish spermatic cord torsion from acute orchitis by color Doppler flow imaging (CDFI). METHODS: Thirteen patients with acute orchialgia were examined by CDFI. The clinical data of diagnosis and treatment were reviewed and analyzed. RESULTS: The findings of CDFI showed lower or even no blood flow in the testes in 8 cases, which were diagnosed as spermatic cord torsion. Among them, 1 received manual detorsion and 7 were proved by operations. The other 5 showed abundant blood flow signal in the testes and were diagnosed as acute orchitis or epididymo-orchitis. After the use of antibiotics, their symptoms were relieved and the blood flow of the testes reduced upon reexamination. CONCLUSIONS: CDFI plays an important role in the diagnosis and differential diagnosis of spermatic cord torsion, and could be regarded as a detecting method of first choice for patients of acute orchialgia.

Adolescent↗
PubMed2003

[Orchi-epididymitis].

The term orchiepididymitis encompasses inflammation of the epididymis and/or testis, i.e. epididymitis, orchitis, and true orchiepididymitis. Epididymitis is defined as inflammation of the epididymis. Young adults are predominantly affected, with a frequency peak between 20 and 40 years of age. The cause is usually an infectious agent, and the main route of access to the epididymis is retrograde propagation through the vas deferens. From puberty to 35 years of age, many cases are sexually transmitted. The main causative agents are Chlamydia trachomatis and Neisseria gonorrhoeae. In prepubertal children and in adults older than 35 years of age, epididymitis is among the commonplace genitourinary infections usually caused by enterobacteria. A urinary tract abnormality, most notably an obstruction of the distal urinary tract, is often the cause of the infection. Orchitis, a less common condition, is defined as inflammation of the testis. Again, most cases are related to an infection. Dissemination of the organism occurs either via the bloodstream, particularly with viruses (the most classic example being orchitis due to mumps) or by direct spread from a focus in the epididymis (producing true orchiepididymitis). In patients younger than 35 years of age who have urethritis and suspected sexually transmitted disease, tetracyclines are the best agents and can be given intravenously at first if needed. Tetracyclines are effective not only on C. trachomatis but also on N. gonorrhoeae. This last agent also responds to other antimicrobials, such as ceftriaxone. Macrolides and second-generation quinolones are also effective on C. trachomatis. Typically, treatment is given for 3 weeks. Sexual partners should be evaluated and treated. In patients older than 35 years who have positive urine cultures for bacteria, urinary tract symptoms, a prior diagnosis of a urinary tract abnormality, or a history of a recent endourethral procedure, treatment can be given orally provided the symptoms are of moderate intensity. Either extra-strength cotrimoxazole or second-generation quinolones should be used. Patients with severe disease should be admitted for parenteral therapy with an aminoglycoside and a cephalosporin in combination, followed by oral cotrimoxazole or a second-generation quinolone. If needed, the antibiotics should be changed according to antibiotic susceptibility test results.

Adolescent↗
PubMed2004

Male infertility: risk factors in Mongolian men.

AIM: To determine the most common risk factors of male infertility in Mongolian men attending an infertility clinic. METHODS: A prospective, case-control study was conducted in which 430 men were enrolled. All the men had sought their first infertility evaluation between 1998-2002 in the State Research Center on Maternal Child Health, Ulaanbaatar, Mongolia. They were divided into two groups depending on the results of their semen analysis: 191 with abnormal semen and 239 with normal semen profile. Univariate and multivariate analyses were performed to determine any association between risk factors and semen abnormality. RESULTS: Logistic regression analysis demonstrated that the testicular volume, a history of sexually transmitted infections (STI), epididymitis and testicular damage all have statistically significant associations with semen abnormality, when controlled for multiple risk factors. Adjusted odds ratios of 3.4 for mumps orchitis, 2.3 for other orchitis and 3.9 for testicular injury were found. Gonorrhoea, the most commonly reported STIs in this study, gave an adjusted odds ratio of 1.0 for having one or more sperm abnormality. An adjusted odds ratio for subjects with a history of other STIs was 2.7. However, as a predictor of azoospermia, STIs had very high odds ratio, being 5.6 in patients with gonorrhoea and 7.6 in patients with other STIs. CONCLUSION: A history of pathology involving testicular damage appeared to have the strongest impact on male infertility in Mongolia. STIs have less impact on semen quality except when complicated by orchitis, epididymitis and vasal obstruction.

Adult↗
PubMed1982

The surgical management of acute bacterial epididymitis with emphasis on epididymotomy.

During the course of acute bacterial epididymitis of nonvenereal origin, severe epididymal inflammation and edema can produce compression of adjacent branches of the spermatic vessels, which can compromise the testicular vascular system. Scrotal fixation over the involved testicle heralds this event and indicates actual or impending epididymal suppuration. At this crucial moment either surgical decompression of the epididymis or epididymectomy is indicated to prevent ischemia of the testis and subsequent development of gangrenous epididymo-orchitis with testicular slough. Between 1956 and 1980, 14 epididymotomies were done, which resulted in salvage of 12 testicles (86 per cent). During the same period 10 patients with acute epididymitis had progression of the disease to gangrenous epididymo-orchitis, which necessitated orchiectomy. Epididymotomy can prevent progression of acute epididymitis to gangrenous epididymo-orchitis in many instances and is believed to have a role in the management of this troublesome affliction.

Acute Disease↗
PubMed1988

Evidence for active immunological regulation in prevention of testicular autoimmune disease independent of the blood-testis barrier.

It has long been considered that autoimmune disease of the testis is prevented by sequestration of testis-specific autoantigens on germ cells behind the blood-testis (BT) barrier. However, we now have evidence that not all such antigens are sequestered. Some appear to reside on germ cells in the basal compartment of the seminiferous tubule where they are accessible to antibodies and to circulating activated T cells. Mice immunized with syngeneic testis homogenate are found to have immunoglobulin G (IgG) bound to cells in the basal compartment before onset of orchitis. This IgG is absorbed from circulation by the testis and, therefore, found only in the serum of mice orchiectomized before immunization. When the IgG is eluted from the testis, it is found to react preferentially with testicular cells enriched in preleptotene spermatocytes. T cells from mice immunized with testis can be transferred to naive syngeneic mice where they infiltrate the testis to cause orchitis. This implies that the BT barrier does not need to be breached directly for specific T cells to have access to testicular autoantigens on antigen presenting cells. Thus, active systemic and/or local immunoregulatory mechanisms must operate to prevent testicular autoimmune disease. These mechanisms may operate at the level of suppressor T cells, nonspecific suppression in the local environment of the testis, antigen presentation in the testis, or lymphocyte trafficking in the testis. These mechanisms probably operate only on the afferent limb of the immune response since they are overridden and orchitis occurs once testis-specific activated T cells are generated.

Animals↗
PubMed1977

Immune responses to soluble antigens of treponemes.

Sonicates from five cultivable treponemes were used as antigens in delayed hypersensitivity tests and macrophage inhibition assays. Immunodiffusion analysis showed that the sonicate comprised two major antigenic components which were not distinguishable in the skin tests. The sonicate antigens elicited significant cell-mediated immunity in guinea-pigs. Treponema refringens biotype Nichols proved to induce the strongest delayed response. Delayed skin hypersensitivity to the antigens of Treponema pallidum was found in eight rabbits without orchitis, but not in six rabbits with T. pallidum orchitis. In contrast, the rabbits with syphilitic orchitis gave the strongest reactions with the non-pathogenic spirochetes. In terms of the cell-mediated immunity responses, Treponema phagedenis Reiter was found to be related to T. phagedenis Kazan 4 and Treponema denticola. Treponema scoliodontum was related to T. phagedenis Kazan 5, and T. refringens biotypes Nichols and refringens. The antigens of T. pallidum had the closest relationship to T. refringens biotypes refringens and Nichols ,T. phagedenis biotype Reiter, and T. scoliodontum. It was also demonstrated that some three of 12 human syphilitic sera reacted with the antigens of T. pallidum but not with control sera.

Animals↗