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PubMedDate not supplied

Testicular hamartomas in Cowden disease.

We report a case of testicular hamartomas in association with Cowden disease. Clinical examination of the patient, a 39-year-old man, revealed a palpable mass in the right side of the scrotum. Sonographic examination showed that the mass was either a spermatocele or an epididymal cyst and that multiple hyperechoic lesions were present in both testes. On subsequent MRI, the appearance of these lesions was consistent with that of fat-containing hamartomas. Testicular biopsy was not performed, but follow-up serial sonographic examination was recommended. To our knowledge, this report is the first to describe testicular hamartomas as a probable manifestation of Cowden disease.

Adult↗
PubMed2005

Tubular ectasia of the epididymis: a sign of postvasectomy status.

PURPOSE: To find out if "tubular ectasia of the epididymis" is suggestive of postvasectomy status. METHODS: Tubular ectasia of the epididymis is defined as enlargement of the epididymis with multiple interfaces (i.e., a speckled appearance). We found 24 cases exhibiting tubular ectasia of the epididymis over a period of six years. We reviewed the sonographic findings of tubular ectasia of the epididymis and evaluated the prevalence of associated findings. RESULTS: In 24 patients with tubular ectasia of the epididymis, 16 cases were bilateral, five were right-sided, and three were left-sided. Twenty-one patients had history of vasectomy, of the three remaining cases, 1 had history of inguinal hernia repair, one had prostatitis, and one had undetermined etiology. Associated abnormalities included dilated vas deferens (n = 4), tubular ectasia of the testis (n = 2), large spermatoceles (n = 6), hydrocele (n = 3), and varicocele (n = 4). In 2 cases, spermatic granulomas were suspected. CONCLUSION: Tubular ectasia of the epididymis is suggestive of postvasectomy epididymis. This sonographic feature is helpful in evaluating a patient with scrotal discomfort. However, this sign can also be associated with other causes of vas obstruction.

Adult↗
PubMed2006

Inguinal orchiectomy for the extra testis with suspected tumor in a polyorchidic patient: a case report.

A 29-years-old male patient presented with complaint of the small size of his left testicle. The physical examination revealed a normal right testicle with 15 cc volume, a small left testicle (5 cc) and a 4 cc mass under the left testicle, which was thought to be a spermatocele. Ultrasonographic imaging was performed and the mass was defined as a third testicle with a heterogenic epididymis. Scrotal magnetic resonance imaging (MRI) confirmed the diagnosis. An inguinal exploration was performed, which resulted in a left orchiectomy and biopsy of the superior left testicle. The pathologic examination revealed hyperplasia with microcystic changes in the orchiectomy specimen and severe hypospermatogenesis in the biopsy sample. There were no significant changes in semen analysis after the operation.

Adult↗
PubMed2006

Disruption of the SLC26A3-mediated anion transport is associated with male subfertility.

Male subfertility in congenital chloride diarrhea (CLD) was possible after identification of expression of an epithelial Cl-/HCO3- exchanger SLC26A3 in the male reproductive tract and by the observation that adult men with CLD had very few children. A prospective clinical and laboratory study among eight adult Finnish men with CLD revealed constant oligoasthenoteratozoospermia but normal spermatogenesis, high chloride and low pH in seminal plasma, and three spermatoceles, suggesting that male subfertility is a clinical manifestation of CLD and could be caused by an analogous defect in the epithelial Cl-/HCO3- and water transport, as described for the CLD intestine.

Adolescent↗
PubMed2005

Pure (non-papillary) serous cystadenoma of the epididymis: a histologic and immunohistochemical study.

A 44-year-old man presented with painless right scrotal swelling of 2 years duration. A cystic tumor strictly attached to the head of the epididymis was surgically resected. The pathologic examination revealed a unilocular cyst with a thin fibrous capsule, lined by ciliated cubical or cylindrical columnar cells, mostly arranged in a single layer. No papillary projection could be detected. Immunohistochemical staining was positive for epithelial membrane antigen, low- and high molecular weight cytokeratins, progesterone receptor, vimentin, and S-100 protein, but was negative for carcinoembryonic antigen, CD10, p53 protein, and calretinin. Single MIB-1 positive cells were noted. Histologic and immunohistochemical features suggest a Müllerian origin or differentiation. The lesion was diagnosed as pure serous cystadenoma of the epididymis, possibly originating from vestigial remnants of the Müller duct in male. The differential diagnosis to spermatocele and adenomatoid tumor of the epididymis is discussed.

Adult↗
PubMed1995

Case report: ultrasound and MRI findings in a scrotal epidermoid cyst.

Intrascrotal masses in the adult are worrisome due to their possible malignancy. Most intratesticular masses are malignant whereas most extratesticular masses are benign. The differential diagnosis of intrascrotal cysts usually includes simple testicular cysts, intratesticular epidermoid and dermoid cysts, tunica albuginea cysts, epididymal cysts and spermatoceles [1-7]. This case report describes a large epidermoid cyst of the scrotum presenting as an enlarging scrotal tumour.

Aged↗
PubMed1976

Some gross observations of the epididymides following vasectomy: a clinical study.

In 114 vasectomized men, 220 epididymides were grossly examined during vasovasostomy. Fullness, distention, turgidity, thickening, induration, and other gross changes of the epididymides, including the formation of cystic spermatic granuloma, or spermatocele, indicated inadequate removal of spermatozoa and testicular fluid from the sequestrated proximal seminal ducts and the epididymis. Further studies are necessary to determine whether the epididymal changes following vasectomy have any effect on sperm morphology and sperm physiology. The information obtained from these studies possibly may explain the poor pregnancy rates in the spouses of successfully vasanastomosed patients.

Epididymis↗
PubMed1978

Changes in the structure and function of the testes and epididymides in vasectomized rams.

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.

Animals↗
PubMed1990

Vasectomy reversal in central Europe: results of questionnaire of urologists in Austria, Germany and Switzerland.

A detailed questionnaire was sent to urologists in Austria, Switzerland and West Germany on the frequency of contraceptive vasectomies, vasectomy reversal, technique and success rates. The response rate was 859 of 2,137 (40.2%). The rate of annual contraceptive vasectomies averaged 28,519 or 378 vasectomies per million inhabitants. The rate of vasovasostomies and vasoepididymostomies was 8.3 and 3.8 procedures per million inhabitants, respectively. A macroscopic technique was used by 9.5% of the responding urologists, loupes were used by 58.5% and an operating microscope by 32%. The majority (74.1%) preferred a 1-layer technique and an unstented anastomosis (84.4%). The average patency and pregnancy rates were 73 and 47%, respectively, for vasovasostomy and 45 and 18%, respectively, for vasoepididymostomy. A total of 78 alloplastic spermatoceles was reported, with detection of motile spermatozoa in 19 and pregnancy in 1.

Austria↗
PubMed1995

Detached ciliary tufts in the epididymis: a lesson in applied anatomy.

We report a case of detached ciliary tufts (DCTs) discovered in the aspirate from an epididymal cyst in a 30-year-old man undergoing epididymal exploration for obstructive azoospermia. The specimen was initially misdiagnosed as a parasite due to its appearance and spontaneous motion on fresh smear. Since standard urology and histology texts identify ciliated cells only in the efferent duct of the male genital tract, the source of DCTs in this patient was mysterious. However, on further review, histologic studies have demonstrated that the first portion of the epididymis represents an extension of the efferent ducts and is lined with cilia. The fact that the caput epididymis is composed of branched efferent ducts has significant implications for our understanding of congenital absence of the vas, epididymal sperm aspiration, spermatoceles, and epididymal physiology.

Adult↗
PubMed2001

Semen characteristics after vasectomy in the ram.

The objective of this study was to monitor the changes in semen characteristics in vasectomized rams and to determine if infertility was present 14 days after vasectomy. Experiments were performed using five cross-breed rams, aged between 18 and 30 months. Semen was collected weekly by artificial vagina from 2 months before to 5 months after vasectomy. After sexual rest for 10 days, vasectomy was performed by the cranial midscrotal approach. In all ejaculates the volume, concentration, total sperm number, motility and morphology (normal spermatozoa, loose heads) were determined and sperm viability (SYBR-14/PI) was evaluated in all semen samples collected after vasectomy. In the first ejaculate obtained 14 days post vasectomy all rams showed a significant (P < 0.05) drop in mean volume (from 1.2 to 0.5 mL), total sperm count (from 5176.8 to 51.1 x 10(6)) and morphologically normal sperm (from 84.1 to 15.7%), when compared to the last prevasectomy collection. We could also demonstrate a positive correlation (r = 0.89) between the individual cumulative total number of spermatozoa after vasectomy and the scrotal circumference measured before vasectomy. Sperm motility and viability could never be demonstrated after vasectomy and normal spermatozoa continuously decreased concomitant with an increase in loose heads. On post mortem examination 5 months after surgery, spermatocele formation and multiple sperm granulomas were present in all five rams. Our results show that in the first ejaculate collected by artificial vagina 14 days after vasectomy, no motile and viable spermatozoa could be detected. Despite weekly collections during a 5-month period after sterilization, azoospermia could never be achieved.

Animals↗
PubMed1993

[Block of spermatic cord in surgery of the testis].

This study analyses 25 cases of spermatic cord blockade for scrotal surgery (hydrocele, spermatocele, tumor of epididymis). The spermatic cord was infiltrated, after identification of the pubic tubercle, with a mean total dose of 17 +/- 3 ml of a 2% lidocaine solution not containing adrenaline. The scrotal skin was infiltrated separately at the site of incision. Analgesia was excellent in 22 patients. The duration of analgesia was 82 +/- 33 min. No adverse effects occurred. It is concluded that the blockade of the spermatic cord is a convenient anaesthesia technique for testicular surgery.

Adult↗
PubMed1997

Conservative and surgical semen retrieval in patients with spinal cord injury.

Assisted semen retrieval was applied in 219 men with spinal cord injury (212 supranuclear, seven infranuclear lesions). Vibrostimulation in supranuclear lesions was successful in 133, and in five more after physostigmine injection. Electroejaculation was successful in all seven infranuclear lesions and in four supranuclear patients failing with vibrostimulation. Eight more supranuclear patients responded to electroejaculation and physostigmine. Surgical retrieval was applied in 27 patients. Nine Wagenknecht spermatoceles showed only one success, from all 18 implanted Brindley reservoirs semen could be collected. Three patients, in whom no pregnancy could be induced after Brindley reservoir implantation, had testicular sperm aspirated. In 109 patients who wanted to have offspring, 73 pregnancies could be induced in 46 couples, leading to 54 births (four twins), 16 abortions and three pregnancies. Conservative semen retrieval was possible in 82 of these men (63 pregnancies in 37 couples) and surgical methods were used in 27 (10 pregnancies in nine couples).

Adult↗
PubMed2000

Correlation between testicular biopsies (prepubertal and postpubertal) and spermiogram in cryptorchid men.

Twenty-one young men who underwent testicular biopsy and orchidopexy in infancy consulted owing to infertility and had biopsies again. The first and second biopsy specimens from these patients were compared by means of a semiquantitative study of the seminiferous tubules to evaluate the evolution of germ cells and to correlate these data with spermatozoon numbers. The infant testes showing lesions were classified into 3 types according to the mean tubular diameter and tubular fertility index: (1) slight lesions, (2) marked germinal hypoplasia, and (3) severe germinal hypoplasia. In the adult testes, spermatogenesis was evaluated by calculating the average numbers of spermatogonia, primary spermatocytes, young spermatids, and mature spermatids. These testes were classified as (1) normal; (2) having lesions in the adluminal compartment; (3) having lesions in the basal compartment; and (4) mixed atrophy. The number of differentiated spermatids was correlated with the expected number of spermatozoa in the ejaculate by a power regression curve. The observation of certain histologic lesions in the seminiferous tubules was assumed to indicate excretory duct obstruction: ectasia, indented outline of the seminiferous epithelium, intratesticular spermatocele, apical cytoplasmic vacuolation of Sertoli cells, and mosaic distribution of testicular lesions. There was a correlation between the prepubertal lesions and the degree of spermatogenesis in postpubertal biopsy specimens. The evolution of the 40 testes without regard to their location in infancy (cryptorchid or scrotal) was as follows. The 14 infant testes with a normal histologic pattern (5 testes) or minor lesions (9 testes) evolved to testes with lesions of the adluminal compartment (8 testes), mixed atrophy (4 testes), or lesions of the basal and adluminal compartments (2 testes). The 6 testes with marked germinal hypoplasia evolved to testes with mixed atrophy. The 20 testes with severe germinal hypoplasia evolved to testes with mixed atrophy (17 testes), Sertoli-cell-only tubules (2 testes), or lesions in the basal compartment (1 testis). In the 9 patients with a histologic pattern of obstruction bilaterally (6 men) or unilaterally (3 men), the expected number of spermatozoa according to the correlation curve was much higher than the actual number in the spermiogram. This means that the testes of many azoospermic men produce spermatozoa, and this finding corroborates the importance of testicular biopsy in infertility studies.

Adult↗
PubMedDate not supplied

Evaluation of the carcinogenic potential of clofibrate in the FVB/Tg.AC mouse after oral administration--part I.

This study was conducted as part of the International Life Sciences Institute (ILSI) program to evaluate the carcinogenic potential of clofibrate, a nongenotoxic, peroxisome proliferator-activated receptor (PPAR) alpha agonist following oral administration to Tg.AC (transgenic) and wild-type FVB (nontransgenic) mice for a minimum for 6 months. Clofibrate was well tolerated at doses up to 500 (males) and 650 (females) mg/kg/day. Oral administration of clofibrate to Tg.AC or FVB (wild-type) male and female mice for 6 months did not result in the increased formation of neoplastic lesions. Epithelial hyperplasia in the urinary bladder (Tg.AC and FVB) and prostate gland (Tg.AC only), and interstitial-cell hyperplasia in the testes (Tg.AC) were noted at 500 mg/kg/day. Non-neoplastic nonproliferative findings included hepatic hypertrophy and hematopoietic changes (myeloid hyperplasia, myelodysplasia, lymphoid depletion, and erythropoiesis) in Tg.AC and FVB mice of both sexes; reproductive (cystic degeneration and dilatation, hypospermia, spermatocele, dilated inspissated protein) and urogenital (tubular-cell hypertrophy, degenerative/regenerative nephropathy, necrosis/fibrosis) changes in Tg.AC and FVB male mice; congestion in the lung in male Tg.AC mice; gall bladder dilatation in female Tg.AC mice; and adrenal (intracellular lipofuscinosis and atrophy) and heart (eosinophillic myofibers) findings in Tg.AC mice of both sexes and in female FVB mice. The results of this study indicate that the clofibrate is not carcinogenic when administered to Tg.AC mice by oral gavage for 6 months at doses up to 500 (males) and 650 (females) mg/kg/day, which did produce liver hypertrophy.

Animals↗
PubMed1998

The pathogenesis of benign prostatic hyperplasia: a proposed hypothesis and critical evaluation.

PURPOSE: We used expanding observations regarding effects of testicular epididymal plasma and nonandrogenic testis factor(s) (NATF) on prostate growth to propose and evaluate a hypothesis regarding the development of benign prostatic hyperplasia (BPH) in man. MATERIALS AND METHODS: Current experimental data regarding the presence of NATF were reviewed. The potential for their exposure to the prostate by various routes was assessed. These observations were coupled with recognized anatomical, histological and epidemiological characteristics of BPH to construct a hypothesis regarding its pathogenesis. RESULTS: In vivo observations in man, rats and dogs supported the systemic secretion of NATF. These factors probably are, at least in part, spermatogenesis related. In vitro evaluation of the effect of spermatocele derived testicular epididymal plasma on human prostate stromal cells indicated the presence of androgen independent and androgen synergistic stromal growth promoters. These factors have potential local and systemic access to the prostate. The almost ubiquitous development of a regional, histologically variegated nodular growth occurring in the prostate in the androgen diminished environment of the aging man is compatible with local as well as systemic exposure to an age associated secretion of NATF. CONCLUSIONS: We propose that human BPH is an induced phenomenon that is usually initiated by local episodic exposure of periurethral prostate to mitogens secreted by the testis/epididymis. Once initiated, isolated or complex interacting proliferative stimuli from the testis/epididymis and a variety of other sources may achieve exposure to the prostate by several routes and simulate prostate growth.

Animals↗
PubMed1976

Unusual masses in the spermatic cord: report of six cases and review of the literature.

Differential diagnosis of spermatic cord swellings includes direct inguinal hernia, hydrocele, spermatocele, hematocele, lipoma, tuberculosis, and filariasis. This communication focuses attention on other unusual swellings of the spermatic cord. Three cases of sarcoma, two cases of foreign body in the spermatic cord, and one case of vasitis are presented. Although unusual, these conditions should be considered in the differential diagnosis of spermatic cord swellings.

Adolescent↗