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Dwyer AA, McDonald IR, Cangiano B, Giovanelli L, Maione L, Silveira LFG, Raivio T, Latronico AC, Young J, Quinton R, Bonomi M, Persani L, Seminara SB, Lee CS. Classes and predictors of reversal in male patients with congenital hypogonadotropic hypogonadism: a cross-sectional study of six international referral centres. Lancet Diabetes Endocrinol 2024; 12:257-266. [PMID: 38437850 PMCID: PMC10996025 DOI: 10.1016/s2213-8587(24)00028-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Although some male patients with congenital hypogonadotropic hypogonadism (CHH) undergo spontaneous reversal following treatment, predictors of reversal remain elusive. We aimed to assemble the largest cohort of male patients with CHH reversal to date and identify distinct classes of reversal. METHODS This multicentre cross-sectional study was conducted in six international CHH referral centres in Brazil, Finland, France, Italy, the UK, and the USA. Adult men with CHH (ie, absent or incomplete spontaneous puberty by age 18 years, low serum testosterone concentrations, and no identifiable cause of hypothalamic-pituitary-gonadal [HPG] axis dysfunction) were eligible for inclusion. CHH reversal was defined as spontaneous recovery of HPG axis function off treatment. Centres provided common data elements on patient phenotype, clinical assessment, and genetics using a structured, harmonised data collection form developed by COST Action BM1105. Latent class mixture modelling (LCMM) was applied to establish whether at least two distinct classes of reversal could be identified and differentially predicted, and results were compared with a cohort of patients without CHH reversal to identify potential predictors of reversal. The primary outcome was the presence of at least two distinct classes of reversal. FINDINGS A total of 87 male patients with CHH reversal and 108 without CHH reversal were included in the analyses. LCMM identified two distinct reversal classes (75 [86%] in class 1 and 12 [14%] in class 2) on the basis of mean testicular volume, micropenis, and serum follicle-stimulating hormone (FSH) concentration. Classification probabilities were robust (0·998 for class 1 and 0·838 for class 2) and modelling uncertainty was low (entropy 0·90). Compared with class 1, patients in class 2 had significantly larger testicular volume (p<0·0001), no micropenis, and higher serum FSH concentrations (p=0·041), consistent with the Pasqualini syndrome (fertile eunuch) subtype of CHH. Patients without CHH reversal were more likely to have anosmia (p=0·016), cryptorchidism (p=0·0012), complete absence of puberty (testicular volume <4 cm³; p=0·0016), and two or more rare genetic variants (ie, oligogenicity; p=0·0001). Among patients who underwent genetic testing, no patients (of 75) with CHH reversal had a rare pathogenic ANOS1 variant compared with ten (11%) of 95 patients without CHH reversal. Individuals with CHH reversal had a significantly higher rate of rare variants in GNRHR than did those without reversal (nine [12%] of 75 vs three [3%] of 95; p=0·025). INTERPRETATION Applying LCMM to a large cohort of male patients with CHH reversal uncovered two distinct classes of reversal. Genetic investigation combined with careful clinical phenotyping could help surveillance of reversal after withdrawing treatment, representing the first tailored management approach for male patients with this rare endocrine disorder. FUNDING National Institutes of Health National Center for Advancing Translational Sciences; Ministry of Health, Rome, Italy; Ministry of University, Rome, Italy; National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health and Human Development; and the Josiah Macy Jr Foundation. TRANSLATION For the Italian translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Andrew A Dwyer
- National Institute of Child Health and Human Development, P50 Massachusetts General Hospital Harvard Center for Reproductive Medicine, Boston, MA, USA; William F Connell School of Nursing, Boston College, Chestnut Hill, MA, USA.
| | | | - Biagio Cangiano
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy; Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Luca Giovanelli
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy; Department of Endocrinology, Diabetes & Metabolism, Newcastle-upon-Tyne Hospitals, Newcastle-upon-Tyne, UK
| | - Luigi Maione
- Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Inserm U 1185, Physiologie et Physiopathologie Endocriniennes, Le Kremlin-Bicêtre, France
| | - Leticia F G Silveira
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Departamento de Clínica Médica, Disciplina de Endocrinologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil; Serviço de Endocrinologia, Departamento de Clínica Médica da Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Taneli Raivio
- Children's Hospital, Pediatric Research Center, University of Helsinki-Helsinki University Hospital, Helsinki, Finland; Translational Stem Cell Biology and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Ana Claudia Latronico
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Departamento de Clínica Médica, Disciplina de Endocrinologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Jacques Young
- Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Inserm U 1185, Physiologie et Physiopathologie Endocriniennes, Le Kremlin-Bicêtre, France
| | - Richard Quinton
- Department of Endocrinology, Diabetes & Metabolism, Newcastle-upon-Tyne Hospitals, Newcastle-upon-Tyne, UK; Translational & Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK; Department of Metabolism, Digestion & Reproduction, Imperial College London, London, UK
| | - Marco Bonomi
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy; Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Luca Persani
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy; Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Stephanie B Seminara
- National Institute of Child Health and Human Development, P50 Massachusetts General Hospital Harvard Center for Reproductive Medicine, Boston, MA, USA; Reproductive Endocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Christopher S Lee
- William F Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
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Zhuang J, Zhang N, Wang J, Jiang Y, Zhang H, Chen C. Initial clinical and molecular investigation of 20q13.33 microdeletion with 17q25.3/14q32.31q32.33 microduplication in Chinese pediatric patients. Mol Genet Genomic Med 2024; 12:e2429. [PMID: 38553934 PMCID: PMC10980884 DOI: 10.1002/mgg3.2429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 03/01/2024] [Accepted: 03/19/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Limited research has been conducted regarding the elucidation of genotype-phenotype correlations within the 20q13.33 region. The genotype-phenotype association of 20q13.33 microdeletion remains inadequately understood. In the present study, two novel cases of 20q13.33 microdeletion were introduced, with the objective of enhancing understanding of the genotype-phenotype relationship. METHODS Two unrelated patients with various abnormal clinical phenotypes from Fujian province Southeast China were enrolled in the present study. Karyotype analysis and chromosomal microarray analysis (CMA) were performed to investigate chromosomal abnormalities and copy number variants. RESULTS The results of high-resolution G-banding karyotype analysis elicited a 46,XY,der(20)add(20)(q13.3) in Patient 1. This patient exhibited various clinical manifestations, such as global developmental delay, intellectual disability, seizures, and other congenital diseases. Subsequently, a 1.0-Mb deletion was identified in the 20q13.33 region alongside a 5.2-Mb duplication in the 14q32.31q32.33 region. In Patient 2, CMA results revealed a 1.8-Mb deletion in the 20q13.33 region with a 4.8-Mb duplication of 17q25.3. The patient exhibited additional abnormal clinical features, including micropenis, congenital heart disease, and a distinctive crying pattern characterized by a crooked mouth. CONCLUSION In the present study, for the first time, an investigation was conducted into two novel cases of 20q13.33 microdeletion with microduplications in the 17q25.3 and 14q32.31q32.33 regions in the Chinese population. The presence of micropenis may be attributed to the 20q13.33 microdeletion, potentially expanding the phenotypic spectrum associated with this deletion.
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Affiliation(s)
- Jianlong Zhuang
- Prenatal Diagnosis Center, Quanzhou Women's and Children's HospitalQuanzhouChina
| | - Na Zhang
- Prenatal Diagnosis Center, Quanzhou Women's and Children's HospitalQuanzhouChina
| | - Junyu Wang
- Prenatal Diagnosis Center, Quanzhou Women's and Children's HospitalQuanzhouChina
| | - Yuying Jiang
- Prenatal Diagnosis Center, Quanzhou Women's and Children's HospitalQuanzhouChina
| | - Hegan Zhang
- Department of GynecologyQuanzhou Women's and Children's HospitalQuanzhouChina
| | - Chunnuan Chen
- Department of NeurologyThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
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Tavakkoli Tabassi K, Tafazoli N, Hamidi Alamdari D, Soltani S. Penile Enhancement Using Biodegradable Scaffolds Covered with Platelet-rich Plasma-Fibrin Glue, Mesenchymal Stem Cells for Micropenis. Urol J 2024; 21:126-132. [PMID: 38581149 DOI: 10.22037/uj.v20i.7915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 03/05/2024] [Indexed: 04/08/2024]
Abstract
PURPOSE Evaluation of preliminary cosmetic and functional outcomes of biodegradable scaffolds covered with platelet-rich plasma in penile girth augmentation. MATERIALS AND METHODS Between June 2016 and June 2018, 36 males who had a mean age of 28.91 years (range 20 - 48 years) with micropenis underwent this procedure. A mixture of platelets-fibrin glue and mesenchymal cells obtained from dermal fat tissue were prepared. Then the mixture was seeded on the pretreated tube-shaped poly lactic-co-glycolic acid scaffold and underwent a whole day of incubation. Following penile degloving, scaffolds were surgically implanted within the interface region of dartos and Buck's fascia. The 5-point Likert scoring scale was used to evaluate the patients' satisfaction with surgery. RESULTS Patients followed up for 6-12 (8 ± 2.86) months. The penile length in an erected state before surgery was 6.5 - 12.5 cm (9.08 ± 1.6) which enhanced to 7 - 14 cm (10.59 ± 1.71) after surgery (P < .0001). The penile girth before and after surgery were 8.49 ± 1.53 and 10.91 ± 1.96 cm, respectively (P < .0001). An augment in penile length and girth of 1.5 and 2.6 cm were achieved, respectively. Patients appraised surgical intervention on a rating of one to five. The highest possible score (5) was assigned by 27 %, 33 % expressed a very good mark (4), and 19 % gave a good mark (3). CONCLUSION Covering the scaffold with a mixture of Platelets-Fibrin glue and mesenchymal cells seems a safe and feasible method for penile reconstruction surgery. More studies should be done to determine the effect of platelets- fibrin glue and mesenchymal cells for treating micropenis.
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Affiliation(s)
- Kamyar Tavakkoli Tabassi
- Mashhad center for reconstructive Urology, Department of Urology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran .
| | - Nooshin Tafazoli
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran .
| | - Daryoush Hamidi Alamdari
- Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran .
| | - Salman Soltani
- Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Cesilia C, Nugraha HG, Siregar S, Nataprawira HM. The challenges in diagnosing isolated epididymal tuberculosis (TB) in an adolescent male: a case report. BMC Urol 2024; 24:61. [PMID: 38504239 PMCID: PMC10949577 DOI: 10.1186/s12894-024-01442-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/29/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Genitourinary tuberculosis (GUTB) is a common form of extrapulmonary TB (EPTB) in children. An example of GUTB is epididymal TB, which usually presents unspecific chronic clinical manifestations. Definitive diagnosis can be conducted based on bacteriologic confirmation and histopathologic results, but this is challenging due to the paucibacillary nature of EPTB. Therefore, we reported the challenges in diagnosing isolated epididymal TB in an adolescent male. CASE PRESENTATION A 16-year-old male presented to respirology clinic with painful swelling of the left scrotum for 3 months before visiting to the hospital. The symptoms were associated with persistent coughing for 2 months, and physical examination of the left scrotum showed swelling accompanied by cardinal signs. A palpable hard mass was found on the left scrotum, with firm borders, measuring 7 × 4 cm. Laboratory examination and tumor markers were within normal limits, although leukocyturia was found, and the urine culture was negative. Genital ultrasound (US) showed epididymitis sinistra with septal hydrocele, while magnetic resonance imaging (MRI) indicated inhomogeneous left epididymitis with bilateral inguinal lymph node enlargement. Although TB evaluation presented a negative purified protein derivative (PPD) test and bacteriologic examination, chest X-ray (CXR) showed perihilar lymphadenopathy. Based on the clinical and radiologic results suggesting TB, the patient was diagnosed with isolated epididymal TB and received quadruple antituberculosis therapy (ATT) for 6 months. After treatment, the left testicle size started to shrink and was equal to the right testicle, also, there were no signs of inflammation, the body weight increased by 5 kg, and cough disappeared. Sperm analysis at the end of treatment indicated teratozoospermia, which was subsequently treated by the urologic surgery department. CONCLUSIONS Biopsy and bacteriologic confirmation for TB epididymitis were challenging to perform in the clinical setting. Epididymal TB should be considered in adolescent males with complaints of chronic scrotal swelling and pain. Clinical judgment based on history taking, physical examination, and radiologic features supporting TB features could be helpful in accurate and fast diagnosis for favorable outcome.
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Affiliation(s)
- Citra Cesilia
- Division of Respirology, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/ Hasan Sadikin General Hospital, Pasteur Street No. 38, Sukajadi, Bandung, West Java, 40161, Indonesia
| | - Harry Galuh Nugraha
- Department of Radiology, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Pasteur Street No. 38, Sukajadi, Bandung, West Java, 40161, Indonesia
| | - Safendra Siregar
- Department of Urology Surgery, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Pasteur Street No. 38, Sukajadi, Bandung, West Java, 40161, Indonesia
| | - Heda Melinda Nataprawira
- Division of Respirology, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/ Hasan Sadikin General Hospital, Pasteur Street No. 38, Sukajadi, Bandung, West Java, 40161, Indonesia.
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Caldito EG, Caldito NG, Kaul S, Piette W, Mehta S. Erythromelalgia. Part II: Differential diagnoses and management. J Am Acad Dermatol 2024; 90:465-474. [PMID: 37364616 DOI: 10.1016/j.jaad.2023.02.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 06/28/2023]
Abstract
The management of erythromelalgia is challenging and requires multidisciplinary effort. Patient education is crucial as unsafe self-administered cooling techniques can lead to significant morbidity, including acral necrosis, infection, and amputation. The goal of management is pain control, reduction of flare frequency, and prevention of complications. This text is focused on the management of erythromelalgia and several other incompletely understood and under-recognized neurovascular disorders such as red scrotum syndrome, red ear syndrome, facial flushing, and complex regional pain syndrome.
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Affiliation(s)
| | | | - Subuhi Kaul
- Division of Dermatology, John H Stroger Hospital of Cook County, Chicago, Illinois
| | - Warren Piette
- Division of Dermatology, John H Stroger Hospital of Cook County, Chicago, Illinois; Department of Dermatology, Rush University Medical Center, Chicago, Illinois
| | - Shilpa Mehta
- Division of Dermatology, John H Stroger Hospital of Cook County, Chicago, Illinois.
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Ding X, Ding S, Liu P. Idiopathic scrotal calcinosis. Asian J Surg 2024; 47:1178-1179. [PMID: 38036349 DOI: 10.1016/j.asjsur.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/03/2023] [Indexed: 12/02/2023] Open
Affiliation(s)
- Xijie Ding
- Department of Urology, Jinhu County Hospital of Traditional Chinese Medicine, Jiangsu Province, Jinhu, 211600, China
| | - Shunguo Ding
- Department of Urology, Jinhu County Hospital of Traditional Chinese Medicine, Jiangsu Province, Jinhu, 211600, China
| | - Ping Liu
- Department of Urology, Jinhu County Hospital of Traditional Chinese Medicine, Jiangsu Province, Jinhu, 211600, China.
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7
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Solomon MP. Commentary on: The Efficacy of Injection Penile Girth Enhancement as an Option for Small Penis Syndrome Management. Aesthet Surg J 2023; 44:92-94. [PMID: 37260080 DOI: 10.1093/asj/sjad168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/02/2023] Open
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8
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Boiko MI, Notsek MS, Boiko OM. The Efficacy of Injection Penile Girth Enhancement as an Option for Small Penis Syndrome Management. Aesthet Surg J 2023; 44:84-91. [PMID: 37194455 DOI: 10.1093/asj/sjad152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND In recent years aesthetic injection techniques with soft tissue fillers have become popular worldwide due to their effectiveness, safety, and low cost. There is no standard approach to the management and follow-up of patients seeking penile enlargement procedures described in the literature, and the surgical penile enlargement methods are controversial. OBJECTIVES The goals of this study were to assess the effect of injection penile girth enlargement on sexual relationship satisfaction, confidence, and self-esteem, and to evaluate the clinical efficacy and safety of this procedure for the management of men with small penis syndrome (SPS). METHODS This was a single-center, clinical case series study executed from January 2019 to February 2021, which involved 148 men who were unsatisfied with the shape of their normal-size penises and requested penis girth correction. RESULTS A total of 132 patients completed full treatment and follow-up. Mean girth enlargement was 1.7 ± 0.32 cm for the midshaft and 1.5 ± 0.32 cm for the glans of the penis. Satisfaction with sexual life improved. Mean scores increased by 17.9 ± 3.04 points for sexual relationship satisfaction and by 12.2 ± 3.17 points for confidence. The mean score for self-esteem increased by 8 ± 2.8 and by 4.3 ± 0.97 points for overall relationship satisfaction. CONCLUSIONS Penile enlargement with hyaluronic acid injection positively affects sexual relationship satisfaction, confidence, and self-esteem of men with SPS. The rate of psychosocial improvement does not correlate with penile size changes. It is a simple, safe, and effective technique that can be used in daily clinical practice. LEVEL OF EVIDENCE: 4
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Rutigliani L, Agrawal P, Herati AS. The impact of subcentimeter cysts on chronic scrotal pain. Asian J Androl 2023; 25:750-752. [PMID: 37147938 DOI: 10.4103/aja202311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/06/2023] [Indexed: 05/07/2023] Open
Affiliation(s)
- Luca Rutigliani
- School of Clinical Medicine, The University of Cambridge, Cambridge CB20SP, UK
| | - Pranjal Agrawal
- The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
| | - Amin Sedaghat Herati
- The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
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10
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Patel ST, Contractor QQ, Nayak CS, Rathi PM. Synchronous pancreatic and scrotal tuberculosis: Double jeopardy. J Postgrad Med 2023; 69:231-233. [PMID: 36751759 PMCID: PMC10846806 DOI: 10.4103/jpgm.jpgm_558_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/19/2022] [Accepted: 10/03/2022] [Indexed: 01/27/2023] Open
Abstract
We describe a patient who presented with scrotal swelling followed by non-healing and discharging scrotal sinuses, following local trauma and was initially suspected to have an infected scrotal hematoma. An evaluation revealed it to be scrotal tuberculosis. He also complained of upper abdominal pain and on transabdominal ultrasonography was detected to have a mass in the head of the pancreas. Evaluation of the pancreatic mass revealed it to be pancreatic tuberculosis. Both lesions responded well to anti-tubercular therapy. This is an unusual case of two rare sites of extrapulmonary tuberculosis presenting simultaneously in the same individual. Care needs to be exercised while evaluating any non-healing ulcers or sinuses and mass lesions in countries endemic for tuberculosis as this disease can be a great masquerader.
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Affiliation(s)
- ST Patel
- Department of Gastroenterology, Mumbai, Maharashtra, India
| | - QQ Contractor
- Department of Gastroenterology, Mumbai, Maharashtra, India
| | - CS Nayak
- Department of Dermatology, Topiwala National Medical College and BYL Nair Ch Hospital, Mumbai, Maharashtra, India
| | - PM Rathi
- Department of Gastroenterology, Mumbai, Maharashtra, India
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11
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Moreno-Alfonso JC, San Basilio Berenguer M, Nava B, Amesty V, Rivas Vila S, Lobato R, López-Pereira P, Martínez-Urrutia MJ. A Pelvic Cyst in an Adolescent Male Presenting With Hematospermia. Urology 2023; 180:e308-e309. [PMID: 37473920 DOI: 10.1016/j.urology.2023.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/17/2023] [Accepted: 06/30/2023] [Indexed: 07/22/2023]
Affiliation(s)
- Julio César Moreno-Alfonso
- Pediatric Surgery Department, Hospital Universitario de Navarra, Pamplona, Spain; Universidad Pública de Navarra, Pamplona, Spain.
| | | | - Borja Nava
- Pediatric Urology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Virginia Amesty
- Pediatric Urology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Susana Rivas Vila
- Pediatric Urology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Roberto Lobato
- Pediatric Urology Department, Hospital Universitario La Paz, Madrid, Spain
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Cleva M, Montaldo L, Graziani G, Bruschi E, Valentino M. Zinner's Syndrome: Case report of a Developmental Anomaly of the Mesonephric Duct. J Radiol Case Rep 2023; 17:57-64. [PMID: 38090641 PMCID: PMC10713230 DOI: 10.3941/jrcr.v17i8.5055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Zinner's syndrome is a rare congenital malformation characterized by the association of unilateral renal agenesis with ipsilateral seminal vesicle cyst and ejaculatory duct obstruction. Most patients are asymptomatic until the third or fourth decade of life when the syndrome is associated with dysuria, perineal pain, infertility, and painful ejaculation. In this report, we present the common imaging findings of this rare developmental anomaly involving the mesonephric duct in a 48-year-old male patient experiencing pelvic pain, recurrent dysuria, and pollakiuria.
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Affiliation(s)
- Mirco Cleva
- Radiology Department, Sant’Antonio Abate Hospital, Tolmezzo, Italy
| | - Luca Montaldo
- Radiology Department, Sant’Antonio Abate Hospital, Tolmezzo, Italy
| | | | - Ennio Bruschi
- Radiology Department, Sant’Antonio Abate Hospital, Tolmezzo, Italy
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Sedrak M, Song A, Greenstein J, Hahn B. Man With Scrotal Pain. Ann Emerg Med 2023; 82:111-114. [PMID: 37349066 DOI: 10.1016/j.annemergmed.2023.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 01/11/2023] [Accepted: 01/25/2023] [Indexed: 06/24/2023]
Affiliation(s)
- Miriam Sedrak
- Department of Emergency Medicine, Staten Island University Hospital, Staten Island, NY
| | - Alexander Song
- Department of Radiology, Staten Island University Hospital, Staten Island, NY
| | - Josh Greenstein
- Department of Emergency Medicine, Staten Island University Hospital, Staten Island, NY
| | - Barry Hahn
- Department of Emergency Medicine, Staten Island University Hospital, Staten Island, NY
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Guo BC, Wu HP. Atypical symptoms of testicular torsion in a 7-year-old child: A case report. Medicine (Baltimore) 2023; 102:e33709. [PMID: 37144991 PMCID: PMC10158923 DOI: 10.1097/md.0000000000033709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/17/2023] [Indexed: 05/06/2023] Open
Abstract
RATIONALE Testicular torsion accounting for 25% of acute scrotal disease, is an acute surgical condition. Atypical presentations of testicular torsion may lead delay diagnosis. PATIENT CONCERNS A 7-year-old boy was admitted to the pediatric emergency department with continuous and progressive left scrotal pain for 2 days, associated symptoms and signs included left scrotal swelling and erythema. The pain started 4 days ago as left lower abdominal pain which then migrated to the left scrotum. DIAGNOSES Physical examination showed left scrotum skin redness, swelling, local heat, tenderness, high-riding testis, absence of the left side cremasteric reflex and a negative Prehn's sign. Subsequent point of care ultrasound of scrotum revealed increased volume of the left testicle, inhomogeneous hypo-echoic left testis, and no detectable flow in the left testis. Left testicular torsion was diagnosed. INTERVENTIONS Surgical examination confirmed testicular torsion showing 720° counterclockwise rotation of the spermatic cord with ischemic changes in the left testis and epididymis. OUTCOMES The patient was stabilized and discharged after left orchiectomy, right orchiopexy and antibiotic therapy. LESSONS Symptoms of testicular torsion may be atypical, especially in prepubertal age. Detailed history, physical examination, point of care ultrasound usage and timely urologist consultation and intervention are important for prompt rescue to prevent testicular loss, testicular atrophy, and eventual impairment of fertility.
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Affiliation(s)
- Bei-Cyuan Guo
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Han-Ping Wu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Pediatrics, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
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15
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Cunha Ramos M, Nicola MRC, Bezerra NTC, Sardinha JCG, Sampaio de Souza Morais J, Schettini AP. Genital ulcers caused by sexually transmitted agents. An Bras Dermatol 2022; 97:551-565. [PMID: 35868971 PMCID: PMC9453525 DOI: 10.1016/j.abd.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/11/2022] [Accepted: 11/17/2020] [Indexed: 11/24/2022] Open
Abstract
Genital ulcers (GUs) represent a diagnostic challenge and can be secondary to neoplastic and inflammatory processes of different causes. Among those of infectious etiology, there are sexually transmitted infections (STIs), a very frequent reason for seeking the health service. The most common agents are herpes simplex virus and Treponema pallidum and, more rarely, Haemophilus ducreyi, Klebsiella granulomatis and Chlamydia trachomatis. A careful dermatological examination offers important diagnostic elements; however, atypical manifestations are very common. Distinctive characteristics of ulcers to look out for include their margin, edge, bottom, and base. Regional lymph node chain alterations should be evaluated regarding their number, size, mobility, consistency, inflammation, and pain on palpation. Diagnostic tests have variable sensitivity and specificity, and molecular tests are currently considered the reference exams. The rapid immunochromatographic tests represented a significant advance, as they can be performed with blood obtained from the digital pulp, offer results in up to 30 minutes, and do not require a laboratory structure. The treatment of persons affected by GU/STIs must be immediate, as it aims to prevent complications, as well as reduce transmission. It is not always considered that people with GUs/STIs have varying degrees of depression, anxiety, and self-reproach, with an impact on relationships. Establishing a bond and trusting the professional is essential for adherence to treatment and preventive measures that must be discussed individually.
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Affiliation(s)
- Mauro Cunha Ramos
- Sanitary Dermatology Outpatient Clinic, Secretaria Estadual de Saúde do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Maria Rita Castilhos Nicola
- Sanitary Dermatology Outpatient Clinic, Secretaria Estadual de Saúde do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | | | - José Carlos Gomes Sardinha
- Fundação Alfredo da Matta, Instituição ligada à Secretaria de Estado de Saúde do Governo do Estado do Amazonas, Manaus, AM, Brazil
| | | | - Antônio Pedro Schettini
- Fundação Alfredo da Matta, Instituição ligada à Secretaria de Estado de Saúde do Governo do Estado do Amazonas, Manaus, AM, Brazil
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16
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Saltarelli MA, Ferrante R, Marcello FD, David D, Valentinuzzi S, Pilenzi L, Federici L, Rossi C, Stuppia L, Tumini S. A Novel Heterozygous Mutation of the CYP17A1 Gene in a Child with a Micropenis and Isolated 17,20-Lyase Deficiency. Int J Environ Res Public Health 2022; 19:ijerph19116880. [PMID: 35682463 PMCID: PMC9180258 DOI: 10.3390/ijerph19116880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 02/05/2023]
Abstract
Disorders of sexual development (DSDs) are characterized by a heterogeneous group of congenital conditions associated with atypical development of the sex chromosomes, gonadal or anatomical sex. We report the case of a child with an isolated micropenis, a typical feature of the 46,XY DSD showing low basal testosterone levels and post-stimulation with the hCG test. Molecular analysis using a next-generation sequencing (NGS) panel of 50 genes involved in DSDs was performed, revealing a heterozygous mutation, c.1040G > ANM_000102.4, in the CYP17A1 gene. Sanger sequencing was used to confirm the gene variant detected by NGS; it was also performed to his parents, revealing the presence of the same mutation in the mother, who presented no features of the disease. Then, the serum steroid profile was determined by liquid chromatography coupled to tandem mass spectrometry analysis. Interestingly, this analysis highlighted low levels of testosterone, progesterone, and dehydroepiandrostenedione, as also confirmed by a stimulus test with ACTH. These results suggest that, in some cases, heterozygous mutations in recessive genes involved in adrenal steroidogenesis can also affect the patient’s phenotype.
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Affiliation(s)
- Maria Alessandra Saltarelli
- Department of Maternal and Child Health, UOSD Regional Center of Pediatric Diabetology, Chieti Hospital, 66100 Chieti, Italy; (M.A.S.); (F.D.M.); (D.D.); (S.T.)
| | - Rossella Ferrante
- Department of Psychological, Health and Territory Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (L.P.); (C.R.); (L.S.)
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (S.V.); (L.F.)
- Correspondence:
| | - Francesca Di Marcello
- Department of Maternal and Child Health, UOSD Regional Center of Pediatric Diabetology, Chieti Hospital, 66100 Chieti, Italy; (M.A.S.); (F.D.M.); (D.D.); (S.T.)
| | - Daniela David
- Department of Maternal and Child Health, UOSD Regional Center of Pediatric Diabetology, Chieti Hospital, 66100 Chieti, Italy; (M.A.S.); (F.D.M.); (D.D.); (S.T.)
| | - Silvia Valentinuzzi
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (S.V.); (L.F.)
- Department of Pharmacy, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Lucrezia Pilenzi
- Department of Psychological, Health and Territory Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (L.P.); (C.R.); (L.S.)
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (S.V.); (L.F.)
| | - Luca Federici
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (S.V.); (L.F.)
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Claudia Rossi
- Department of Psychological, Health and Territory Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (L.P.); (C.R.); (L.S.)
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (S.V.); (L.F.)
| | - Liborio Stuppia
- Department of Psychological, Health and Territory Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (L.P.); (C.R.); (L.S.)
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (S.V.); (L.F.)
| | - Stefano Tumini
- Department of Maternal and Child Health, UOSD Regional Center of Pediatric Diabetology, Chieti Hospital, 66100 Chieti, Italy; (M.A.S.); (F.D.M.); (D.D.); (S.T.)
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17
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Lin H, Yang H, Fu JF, Yuan K, Huang W, Wu GP, Dong GJ, Tian DH, Wu DX, Tang DW, Wu LY, Sun YL, Pi LJ, Liu LP, Shi W, Gu LG, Huang ZH, Wang LQ, Chen HY, Li Y, Yu HY, Wei XR, Cheng XO, Shan Y, Liu X, Xu S, Liu XP, Luo YF, Xiao Y, Yang GM, Li M, Feng XQ, Ma DX, Pan JY, Tang RM, Chen R, Maimaiti DY, Liu XH, Cui Z, Su ZQ, Dong L, Zou YL, Liu J, Wu KX, Li Y, Li Y. [Analysis of clinical phenotype and genotype of Chinese children with disorders of sex development]. Zhonghua Er Ke Za Zhi 2022; 60:435-441. [PMID: 35488637 DOI: 10.3760/cma.j.cn112140-20210927-00828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To explore the heterogeneity and correlation of clinical phenotypes and genotypes in children with disorders of sex development (DSD). Methods: A retrospective study of 1 235 patients with clinically proposed DSD in 36 pediatric medical institutions across the country from January 2017 to May 2021. After capturing 277 DSD-related candidate genes, second-generation sequencing was performed to analyzed the heterogeneity and correlation combined with clinical phenotypes. Results: Among 1 235 children with clinically proposed DSD, 980 were males and 255 were females of social gender at the time of initial diagnosis with the age ranged from 1 day of age to 17.92 years. A total of 443 children with pathogenic variants were detected through molecular genetic studies, with a positive detection rate of 35.9%. The most common clinical phenotypes were micropenis (455 cases), hypospadias (321 cases), and cryptorchidism (172 cases) and common mutations detected were in SRD5A2 gene (80 cases), AR gene (53 cases) and CYP21A2 gene (44 cases). Among them, the SRD5A2 mutation is the most common in children with simple micropenis and simple hypospadias, while the AMH mutation is the most common in children with simple cryptorchidism. Conclusions: The SRD5A2 mutation is the most common genetic variant in Chinese children with DSD, and micropenis, cryptorchidism, and hypospadias are the most common clinical phenotypes. Molecular diagnosis can provide clues about the biological basis of DSD, and can also guide clinicians to perform specific clinical examinations. Target sequence capture probes and next-generation sequencing technology can provide effective and economical genetic diagnosis for children with DSD.
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Affiliation(s)
- H Lin
- Department of Endocrinology, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China
| | - H Yang
- Department of Urology, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China
| | - J F Fu
- Department of Endocrinology, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China
| | - K Yuan
- Department of Endocrinology, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China
| | - W Huang
- Department of Endocrinology, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China
| | - G P Wu
- Department of Endocrinology, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China
| | - G J Dong
- Department of Endocrinology, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China
| | - D H Tian
- Department of Urology, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China
| | - D X Wu
- Department of Urology, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China
| | - D W Tang
- Department of Urology, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China
| | - L Y Wu
- Department of Genetics and Metabolism, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China
| | - Y L Sun
- Department of Children's Gynecology, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China
| | - L J Pi
- Department of Pediatrics, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - L P Liu
- Department of Metabolism, Hebei Children's Hospital, Shijiazhuang 050031, China
| | - W Shi
- Department of Urology, Hebei Children's Hospital, Shijiazhuang 050031, China
| | - L G Gu
- Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - Z H Huang
- Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - L Q Wang
- Department of Endocrinology and Metabolism, Genetics, Xi'an Children's Hospital, Xi'an 710003, China
| | - H Y Chen
- Department of Endocrinology and Metabolism, Genetics, Children's Hospital of Soochow University, Suzhou 215300, China
| | - Y Li
- Department of Endocrinology, Jinan Children's Hospital, Jinan 250000, China
| | - H Y Yu
- Department of Pediatric Surgery, Jinan Children's Hospital, Jinan 250000, China
| | - X R Wei
- Department of Endocrinology and Metabolism, Genetics, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450000, China
| | - X O Cheng
- Department of Endocrinology and Metabolism, Genetics, Chengdu Women's and Children's Central Hospital, Chengdu 611731, China
| | - Y Shan
- Department of Pediatric Endocrinology and Metabolism, Genetics, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - X Liu
- Department of Endocrinology and Metabolism, Genetics, Maternal and Child Health-Care Hospital in Guiyang, Guiyang 550003, China
| | - S Xu
- Department of Endocrinology, Wuxi Children's Hospital, Wuxi 214023, China
| | - X P Liu
- Department of Endocrinology and Metabolism, Genetics, Guangdong Women and Children Hospital, Guangzhou 511442, China
| | - Y F Luo
- Department of Pediatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y Xiao
- Department of Pediatrics, the Second Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an 710004, China
| | - G M Yang
- Department of Endocrinology and Metabolism, Genetics, Jiangxi Provicial Children's Hospital, Nanchang 330006, China
| | - M Li
- Department of Pediatric Endocrine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250014, China
| | - X Q Feng
- Department of Endocrinology and Metabolism, Genetics, Children's Hospital of Shanxi Province, Taiyuan 030013, China
| | - D X Ma
- Department of Pediatrics, Guizhou Provincial People's Hospital, Guiyang 550002, China
| | - J Y Pan
- Department of Pediatrics, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - R M Tang
- Department of Pediatrics, Boai Hospital of Zhongshan Affiliated to Southern Medical University, Zhongshan 528403, China
| | - Ruimin Chen
- Department of Endocrinology, Fuzhou Children's Hospital of Fujian Medical University, Fuzhou 350005, China
| | - D Y Maimaiti
- Department of Pediatrics, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
| | - X H Liu
- Department of Pediatrics, Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China
| | - Z Cui
- Department of Pediatric Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Z Q Su
- Department of Endocrinology, Shenzhen Children's Hospital, Shenzhen 518023, China
| | - L Dong
- Department of Pediatrics, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou 450009, China
| | - Y L Zou
- Department of Child Health Care, Linyi Peoples Hospital, Linyi 276000, China
| | - J Liu
- Department of Pediatrics, the Second Affiliated Hospital of Nanchang University, Nangchang 330006, China
| | - K X Wu
- Department of Pediatrics Endocrinology and Metabolism, Genetics, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Y Li
- Department of Pediatrics, the Affiliated Yantai Yuhuangding Hospital, Yantai 264000, China
| | - Yuan Li
- Department of Pediatrics, First People's Hospital of Yunnan Province, Kunming 650032, China
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18
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Zhu H, Chen Y, Niu Y, Zhang Y, Chen L. A novel variant in WNT5A responsible for Robinow syndrome in a male fetus with limb shortening and agenesis of the penis. Clin Dysmorphol 2022; 31:71-73. [PMID: 34750320 DOI: 10.1097/mcd.0000000000000401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Haiyan Zhu
- Departments of Gynecology and Obstetrics
| | | | - Yanyan Niu
- Departments of Gynecology and Obstetrics
| | - Yunshan Zhang
- Ultrasound Medicine, The Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Lei Chen
- Departments of Gynecology and Obstetrics
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19
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Gupta A, Croake A, Rubens D, Dogra V. Do Not Get It Twisted: Common and Uncommon Manifestations of Testicular Torsion. J Ultrasound Med 2022; 41:271-283. [PMID: 33885184 DOI: 10.1002/jum.15723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 06/12/2023]
Abstract
Color flow and spectral Doppler ultrasound are the backbone of scrotal imaging when evaluating acute scrotal pain. Testicular Torsion is one of the most common causes of acute scrotal pain but can be a challenging diagnosis both clinically and sonographically. This article will review the pertinent Doppler ultrasound findings that can help make the diagnosis of both complete and partial torsion. A review of other causes of testicular ischemia will also be included as these pathologies can mimic Testicular Torsion.
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Affiliation(s)
- Akshya Gupta
- Department of Imaging Sciences, University of Rochester, Rochester, New York, USA
| | - Alexander Croake
- Department of Imaging Sciences, University of Rochester, Rochester, New York, USA
| | - Deborah Rubens
- Department of Imaging Sciences, University of Rochester, Rochester, New York, USA
| | - Vikram Dogra
- Department of Imaging Sciences, University of Rochester, Rochester, New York, USA
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20
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Abstract
A 23-year-old male presented with complaints of gradually increasing swelling of the left hemiscrotum. Preliminary ultrasound scan revealed a heterogeneous, predominantly solid lesion showing raised internal vascularity with few cystic areas in the paratesticular region, towards the midline with both testes seen separately from the lesion. To rule out presence of locoregional or distant metastases, a CT scan was done which revealed a well-defined, intrascotal, extratesticular, heterogeneous, moderately enhancing mass lesion with cystic areas in the scrotal sac with no significant lymphadenopathy or obvious distant metastasis. Subsequent MRI done for surgical planning revealed a heterogeneous signal intensity lesion with cystic areas and areas of haemorrhage with focal loss of fat planes with the left corpora cavernosa at the root of the penis. The patient underwent an inguinoscrotal exploration with excision of the left paratesticular mass. Final histopathology suggested an undifferentiated high grade pleomorphic sarcoma. Paratesticular tumours while rare are an important cause of scrotal swelling. Exact histological identification of tumour subtype is not possible based on imaging but preoperative multi-modality imaging has an important role in identifying tissue of origin, differentiating benign from malignant lesions, surgical planning and assessing the need for adjuvant CT/RT.
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21
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Wang Y, Qin M, Fan L, Gong C. Correlation Analysis of Genotypes and Phenotypes in Chinese Male Pediatric Patients With Congenital Hypogonadotropic Hypogonadism. Front Endocrinol (Lausanne) 2022; 13:846801. [PMID: 35669683 PMCID: PMC9164197 DOI: 10.3389/fendo.2022.846801] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/10/2022] [Indexed: 11/13/2022] Open
Abstract
Congenital hypogonadotropic hypogonadism (CHH) can be divided into Kallmann syndrome (KS) and normosmic HH (nHH). The clinical and genetic characteristics of CHH have been studied in adults, but less in pre-adults. The medical records of patients with CHH in our gonad disease database from 2008 to 2020 were evaluated. In total, 125 patients aged 0 to 18 years were enrolled in our study. KS patients had a higher incidence of micropenis compared with nHH (86.2% vs. 65.8%, p=0.009), and 7 patients (5.6%) had hypospadias. Among the 39 patients with traceable family history, delayed puberty, KS/nHH, and olfactory abnormalities accounted for 56.4%, 17.9%, and 15.4%, respectively. In total, 65 patients completed the hCG prolongation test after undergoing the standard hCG test, and the testosterone levels of 24 patients (22.9%) were still lower than 100 ng/dL. In 77 patients, 25 CHH-related genes were identified, including digenic and trigenic mutations in 23 and 3 patients, respectively. The proportion of oligogenic mutations was significantly higher than that in our previous study (27.7% vs. 9.8%). The most common pathogenic genes were FGFR1, PROKR2, CHD7 and ANOS1. The incidence rate of the genes named above was 21.3%, 18.1%, 12.8% and 11.7%, respectively; all were higher than those in adults (<10%). Most mutations in CHH probands were private, except for W178S in PROKR2, V560I in ANOS1, H63D in HS6ST1, and P191L and S671L in IL17RD. By analyzing family history and genes, we found that both PROKR2 and KISS1R may also be shared between constitutional delay of growth and puberty (CDGP) and CHH. L173R of PROKR2 accounts for 40% of the CHH population in Europe and the United States; W178S of PROKR2 accounts for 58.8% of Chinese CHH patients. Micropenis and cryptorchidism are important cues for CHH in children. They are more common in pediatric patients than in adult patients. It is not rare of Leydig cell dysfunction (dual CHH), neither of oligogenic mutations diagnosed CHH in children. Both PROKR2 and KISS1R maybe the potential shared pathogenic genes of CDGP and CHH, and W178S in PROKR2 may be a founder mutation in Chinese CHH patients.
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Affiliation(s)
- Yi Wang
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, Beijing, China
- Department of Endocrinology, Genetics and Metabolism, National Center for Children’s Health, Beijing, China
| | - Miao Qin
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, Beijing, China
- Department of Endocrinology, Genetics and Metabolism, National Center for Children’s Health, Beijing, China
| | - Lijun Fan
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, Beijing, China
- Department of Endocrinology, Genetics and Metabolism, National Center for Children’s Health, Beijing, China
| | - Chunxiu Gong
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, Beijing, China
- Department of Endocrinology, Genetics and Metabolism, National Center for Children’s Health, Beijing, China
- *Correspondence: Chunxiu Gong,
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22
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Sleshi S, Alemu AA, Dagnew Z, Aynalem BY. Parent-adolescent discussion about reproductive health issues and associated factors among parents in Debre Markos town, northwest, Ethiopia: a cross-sectional study. Pan Afr Med J 2022; 41:266. [PMID: 35734317 PMCID: PMC9187988 DOI: 10.11604/pamj.2022.41.266.32447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/13/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction adolescence is a transition phase from being a child to an adult. Open positive parent-adolescent communication on reproductive health issues has many positive effects on adolescents, families, and society. Methods a community-based cross-sectional study design was employed, and a multistage sampling technique was used. Data were collected through face-to-face interviews with pre-tested structured questionnaires. After data collection, data were coded and entered using Epi data version 3.1 and analysed using SPSS version 25 statistical software. Binary logistic regression analysis was used to ascertain the association between explanatory variables and the outcome variable. Variables with a P value less than 0.25 in the bivariable analysis and P-value < 0.05 in the multivariable analysis and corresponding 95% CI of odds ratio were considered to declare a result as statistically significant. Results this study has revealed parent-adolescent discussion on reproductive health issues was 55.2%. Age 45-54 (AOR=2.37, 95% CI: 1.28-4.39) and 55-64 (AOR=2.54, 95% CI: 1.15-5.56) years, male parents (AOR= 0.51, 95% CI: 0.29-0.89) and monthly income above 158 USD (AOR=3.31, 95% CI: 1.79-6.12) were statistically significant. Conclusion more than half of the parents discuss reproductive health issues with adolescents. Age 45-54 and 55-64 years, male parents, and higher incomes were the factors that allowed parent-adolescent discussion on reproductive health issues.
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Affiliation(s)
- Sefanit Sleshi
- Health Science College, Debre Markos University, Debre Markos, Ethiopia
| | | | - Zewdu Dagnew
- Health Science College, Debre Markos University, Debre Markos, Ethiopia
| | - Bewket Yeserah Aynalem
- Health Science College, Debre Markos University, Debre Markos, Ethiopia
- Corresponding author: Bewket Yeserah Aynalem, Health Science College, Debre Markos University, Debre Markos, Ethiopia.
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Hogan D, Hayes B, Keohane C, Hennessey DB. High grade non-germinal centre-like diffuse large B-cell lymphoma double expressor presenting as a hydrocoele. BMJ Case Rep 2021; 14:e247381. [PMID: 34972783 PMCID: PMC8721003 DOI: 10.1136/bcr-2021-247381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2021] [Indexed: 11/03/2022] Open
Abstract
A 72-year-old man was referred to our urology outpatient department with a left hemi-scrotal swelling increasing in size over a matter of weeks, initially suspicious for a left hydrocoele. Initial investigation with ultrasound (US) identified a heterogenous enlargement of the left testis and epididymis with a soft tissue mass extending through the inguinal canal. Subsequent CT detected this soft tissue mass to extend along the left gonadal vein to the level of the left renal vein. A biopsy of the retroperitoneal mass confirmed a diagnosis of diffuse large B-cell lymphoma. Immunohistochemical staining further categorised this lymphoma as double expressor but not double hit.Through multidisciplinary team involvement the patient was treated with combination steroids and chemotherapy. Given the scrotal involvement this was considered a sanctuary site for chemotherapy therefore the patient also received radiotherapy to the scrotum. He recovered well following his treatment. This case highlights how early specialist referral can identify rare variants of disease. Essential preoperative imaging with US prior to treating a presumed hydrocoele prevented inappropriate surgical excision. A multidisciplinary team approach improved the patient's outcome and is hoped to have improved his chances of recurrence-free survival.
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Affiliation(s)
- Donnacha Hogan
- Department of Urology, Mercy University Hospital, Cork, Ireland
| | - Brian Hayes
- Department of Histopathology, Cork University Hospital, Cork, Ireland
| | - Clodagh Keohane
- Department of Haematology, Mercy University Hospital, Cork, Ireland
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24
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Latypov VR, Kluev MV, Novikov SI. [Treatment of ischemic penile and scrotum gangrene]. Urologiia 2021:124-126. [PMID: 34967173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Gangrene of the penis is a rare condition manifesting with purulent necrotization of penile tissues and systemic inflammatory response. In more than 90% of cases, the cause of the development of the penile and scrotal gangrene is rapidly progressive necrotizing fasciitis of polymicrobial etiology, which predominantly affected the external genital organs. Isolated cases of penile gangrene development when using the restraining rings of the penis are described in literature (condom urine collection bag, rings for erection, etc.). Cases of penile and scrotum gangrene, when treatment with bilateral orchiectomy and penectomy is required are quite rare. We present the case of penlie and scrotum gangrene in an 86-year-old patient with mental disorders. The cause of gangrene was long-term forced position of the patient with infringement of the penis and scrotum by the thighs. Active intensive therapy, surgical removal of the penis, scrotum and testicles and urine diversion by the imposition of a trocar cystostomy saved the patients life and he was discharged from the hospital in a satisfactory condition.
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Affiliation(s)
- V R Latypov
- Siberian State Medical University of the Ministry of Health of Russia Siberian State Medical University Tomsk, Russia
| | - M V Kluev
- Siberian State Medical University of the Ministry of Health of Russia Siberian State Medical University Tomsk, Russia
| | - S I Novikov
- Siberian State Medical University of the Ministry of Health of Russia Siberian State Medical University Tomsk, Russia
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25
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Cruyt L, Mutluoglu M, Vandenbulcke R, Rosseel F, Gryspeerdt S, De Smet K. Hold before sacrificing the testis! There may be another possibility. A case of tuberculosis epididymo-vasitis. ARCH ESP UROL 2021; 74:808-810. [PMID: 34605424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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26
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Nordenskjöld A, Nordenström A, Holmdahl G. [On micropenis, diagnosis and differential diagnoses]. Lakartidningen 2021; 118:21077. [PMID: 34498244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The term inconspicuous penis in children covers both micropenis with a penile length less than 2.5 SD for age and other conditions with a normal length of corpora, but when the penis looks smaller due to other diagnoses. Micropenis in a newborn is a serious condition that needs immediate attention by a paediatric endocrinologist. The boy should have a continuous support until adulthood. Other conditions that resembles micropenis are for example buried or webbed penis that only affects the skin or the adherence of the skin to the penile body, so that penis looks smaller even though the corpora are of normal length. Such conditions are treated and often operated by pediatric urologists. A proper clinical examination distinguishes between these diagnoses and gives a possibility to direct the child to the proper treatment without unnecessary concern for the parents.
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Affiliation(s)
| | - Anna Nordenström
- professor, överläkare, barnendokrinologiska verksamheten, Astrid Lindgrens barnsjukhus, Karolinska universitetssjukhuset, Stockholm
| | - Gundela Holmdahl
- docent, överläkare, barnkirurgiska verksamheten, Astrid Lindgrens barnsjukhus, Karolins-ka universitetssjukhuset, Stockholm
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27
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Gong QQ, Dou ZL, Wang X, Zhang KY, Chen H, Gao JG, Sun XY. Epididymal initial segment-specific Cre recombinase activity in Lcn8-Cre knock-in mice. Mol Biol Rep 2021; 48:6015-6023. [PMID: 34328598 DOI: 10.1007/s11033-021-06604-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/26/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sperm acquire the ability to fertilize ova through a complex process of epididymal maturation. To identify the functions of genes expressed in the proximal epididymis, mouse models specific to this region are needed. METHODS AND RESULTS A Lcn8-Cre knock-in mouse line was generated using CRISPR/Cas9 technology. A 37 bp coding sequence of Lcn8 from the ATG start codon was replaced by an NLS-Cre-polyA cassette, resulting in Cre expression and the absence of Lcn8. Epididymal initial segment-specific Cre expression was identified using RT-PCR and western blotting, and the spatial-temporal Cre activity was further confirmed by using the Rosa26tdTomato reporter mice. Immunofluorescence staining showed that active Cre recombinase was present in the principal cells. Histological analyses of sperm and epididymides, and the four-month mating tests, were used to confirm that Cre expression did not affect normal development and male fecundity. CONCLUSIONS The novel Lcn8-Cre mice can be used to establish epididymal initial segment-specific conditional knock-out mouse models.
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Affiliation(s)
- Qian-Qian Gong
- Shandong Provincial Key Laboratory of Animal Cell and Developmental Biology, School of Life Sciences, Shandong University, Qingdao, China
| | - Zhi-Lin Dou
- Shandong Provincial Key Laboratory of Animal Cell and Developmental Biology, School of Life Sciences, Shandong University, Qingdao, China
| | - Xiao Wang
- Shandong Provincial Key Laboratory of Animal Cell and Developmental Biology, School of Life Sciences, Shandong University, Qingdao, China
| | - Ke-Yi Zhang
- Shandong Provincial Key Laboratory of Animal Cell and Developmental Biology, School of Life Sciences, Shandong University, Qingdao, China
| | - Hao Chen
- Institute of Reproductive Medicine, Medical School of Nantong University, Nantong, China
| | - Jian-Gang Gao
- Shandong Provincial Key Laboratory of Animal Cell and Developmental Biology, School of Life Sciences, Shandong University, Qingdao, China
| | - Xiao-Yang Sun
- Shandong Provincial Key Laboratory of Animal Cell and Developmental Biology, School of Life Sciences, Shandong University, Qingdao, China.
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Tramma D, Gogou M, Lambropoulos V. Acute Scrotal Pain and a Different Use of an Old Imaging Method. Pediatr Emerg Care 2021; 37:e79-e80. [PMID: 30045354 DOI: 10.1097/pec.0000000000001561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT The differential diagnosis of scrotal pain in childhood is a challenge for every primary care physician. We report the case of a 5-year-old boy presenting to the emergency department owing to acute left scrotal pain. Ultrasound screening revealed a Morgagni hydatid in the left testis, which was surgically removed. X-rays revealed microcalcifications of the cyst wall and stroma, signs indicative of chronic inflammation. Results of histological examination confirmed radiographic evaluation. No similar use of x-rays has been described in literature before, to the best of our knowledge. A brief discussion also follows about Morgagni hydatid in childhood.
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Affiliation(s)
| | | | - Vasilios Lambropoulos
- Department of Pediatric Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
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Liu T, Li X, Huang L, Li H, Cai K, Jiang J, Chen N, Zhang W, Tang J, Zhang M, Zhao D, Ye J, Zhang C, He T, Liu B, Ye Y, Chen J. Zinner syndrome: an updated pooled analysis based on 214 cases from 1999 to 2020: systematic review. Ann Palliat Med 2021; 10:2271-2282. [PMID: 33474966 DOI: 10.21037/apm-20-1997] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/14/2020] [Indexed: 11/06/2022]
Abstract
Zinner syndrome (ZS) is a rare anomaly of the Wolffian duct. We searched for case reports and case series to identify the most effective methods for examination and treatment. The PubMed/Medline, Embase, and Scopus databases were searched. Our searches yielded 160 case reports/case series and included 214 patients. The mean age at diagnosis was 29.35 years. The R:L distribution was 1:1. The most common symptoms were: frequency (24.3%), dysuria (23.1%) and perineal pain (20.2%) in ZS patients with clinical symptoms. The diagnostic investigations used most frequently were magnetic resonance imaging (MRI) (67.8%) and ultrasonography (65.0%). Maximum flow rate on uroflowmetry, semen ejaculate volume, sperm count, and sperm motility were significantly lower in patients with ZS. Among 193 patients with treatment details, 65.8% underwent surgery; 9.8% underwent aspiration; 24.3% were followed with observation. Two patients died after surgery; all other patients remained asymptomatic after surgery. Fifty-two patients had complications and comorbidities. In patients with ZS, the most common symptoms are seminal vesicle cyst enlargement and compression of the bladder, ureter, and reproductive system. The diagnosis mostly depends on radiological examination. Surgery may be effective, but complications may occur.
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Affiliation(s)
- Tianzhu Liu
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Xiaodan Li
- Department of Gynecology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Lesheng Huang
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Hongyi Li
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Kaili Cai
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Jinghua Jiang
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Nianli Chen
- Department of Urology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Wanchun Zhang
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Jiahui Tang
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Meng Zhang
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Dan Zhao
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Jingzhi Ye
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Chengfeng Zhang
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Tao He
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Bo Liu
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Yongsong Ye
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Jun Chen
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Zhuhai, China
- Department of Radiology, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, China
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30
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Abstract
Acute vasitis is a rare infection of the vas deferens. Clinical presentation and disease rarity can cause difficulty in correctly diagnosing this condition. Adjuncts to aid diagnosis can be used that include ultrasound scan (USS) or computed tomography. We report a unique case of acute vasitis following vasectomy, reversal and subsequent re-do vasectomy diagnosed using USS.
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31
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Chen HT, Huang H, Ma H, Li S. [Correlation of micropenis with abnormal chromosomal karyotype in peripheral blood lymphocytes]. Zhonghua Nan Ke Xue 2020; 26:1006-1009. [PMID: 34898071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To explore the relationship between micropenis and chromosomal karyotype abnormality. METHODS We collected the clinical data on 375 children with congenital micropenis treated in Wuhan Children's Hospital from July 2018 to April 2020, analyzed their chromosomal karyotype in the peripheral blood lymphocytes and investigated the correlation of chromosomal karyotype abnormality with micropenis. RESULTS Of the 375 cases of micropenis, 28 (7.5%) were found with chromosomal karyotype abnormality, including 21 cases of abnormal sex chromosomal karyotype (2 cases of 47,XXY, 1 case of 47,XYY, 1 case of 48,XXXY, 12 cases of 46,X,Yqh-, 4 cases of 46,X,Yqh+, and 1 case of 46,X,inv[Y][p11q11]), accounting for 75% of the total cases of abnormal karyotype. Autosomal karyotype abnormality was detected in 7 cases, constituting 25% of the total cases of abnormal karyotype, including 2 cases of 46,XY,inv (9)(p12q13), 1 case of 46,XY,14pstk +, 1 case of 46,XY,15cenh +, 1 case of 46,XY,15ps +, 1 case of 46,XY,13pstk +, and 1 case of 46,XY,1qh +. The detection rate of abnormal sex chromosomal karyotype was significantly higher than that of autosomal abnormal karyotype. CONCLUSIONS Chromosomal karyotype abnormality, especially the abnormal karyotype of sex chromosome, can cause the abnormality of the reproductive organ, which may be one of the important causes of micropenis.
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Affiliation(s)
- Hai-Tao Chen
- Department of Urology, Wuhan Children's Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430016, China
| | - Hui Huang
- Department of Urology, Wuhan Children's Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430016, China
| | - Hui Ma
- Department of Urology, Wuhan Children's Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430016, China
| | - Shuang Li
- Department of Urology, Wuhan Children's Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430016, China
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32
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Matellanes Palacios M, Sabater Abad J, Pont Sanjuan V. Misleading Genital Ulcer. Actas Dermosifiliogr (Engl Ed) 2020; 112:72. [PMID: 33065102 DOI: 10.1016/j.ad.2019.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/11/2019] [Accepted: 01/22/2019] [Indexed: 11/19/2022] Open
Affiliation(s)
| | - J Sabater Abad
- Servicio de Dermatología, Hospital Arnau de Vilanova, Valencia, España
| | - V Pont Sanjuan
- Servicio de Dermatología, Hospital Arnau de Vilanova, Valencia, España
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33
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王 宏, 赵 连, 洪 锴, 毛 加, 刘 德, 林 浩, 姜 辉. [Transurethral seminal vesiculoscopy in treatment of oligoasthenozoospermia secondary incomplete ejaculatory duct obstruction: A report of 8 cases]. Beijing Da Xue Xue Bao Yi Xue Ban 2020; 52:642-645. [PMID: 32773793 PMCID: PMC7433624 DOI: 10.19723/j.issn.1671-167x.2020.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To evaluate the utility of transurethral seminal vesiculoscopy with a slender ureteroscope in the treatment of severe oligoasthenozoospermia secondary incomplete ejaculatory duct obstruction (EDO). METHODS From March 2018 to September 2018, the clinical data of 8 patients with severe oligoasthenozoospermia secondary incomplete EDO treated by the technique of transurethral seminal vesiculoscopy in the Peking University Third Hospital Reproductive Center were analyzed. Preoperative routine included semen analysis, hormone determination, transrectal ultrasonography, pelvic magne-tic resonance examination and other examinations. All the patients were diagnosed with severe oligoasthenozoospermia secondary to incomplete EDO. All the patients were operated by the same surgeon with multiple cases of experience in transurethral surgery, and 1 year follow-up was conducted to evaluate the surgical effect. RESULTS The average age of the 8 patients was 29 years, and the average operation time was 32 min. Preoperative transrectal ultrasound indicated 6 cases of ejaculatory duct cyst or Mullerian cyst, 1 case of prostate calcification and bilateral seminal vesicle dilatation. The average maximum transverse diameter of the right seminal vesicle in pelvic MRI was 33.60 mm (24.63-42.28 mm), the average maximum transverse diameter of the left seminal vesicle was 32.85 mm (25.91-44.89 mm), the ave-rage maximum antero-posterior diameter was 27.99 mm (21.36-33.12 mm), the average maximum width of the seminal vesicle duct was 10.53 mm (5.93-19.39 mm). There were 5 cases of ejaculatory duct cyst, 2 cases of seminal vesicle hemorrhage, and 1 case of Mullerian cyst. The semen volume [(2.64±0.80) mL], the sperm concentration [(49.76±8.50)×106/mL], and the motility (grade a+b) [(25.76±6.48)%] in postoperation were significantly higher than those in preoperation [(1.46±0.50) mL, (28.78±5.17)×106/mL, and (2.88±0.93)%, P < 0.05]. Two patients conceived naturally during the follow-up of 6 months after surgery. There were no severe complications, such as retrograde ejaculation, urinary incontinence or rectal injury. CONCLUSION The technique of transurethral seminal vesiculoscopy is safe and effective for treating severe oligoasthenozoospermia secondary to incomplete EDO. However, due to the small sample size of this study, short follow-up time, and the uncertainty in seminal vesicle surgery, it still needs to be further confirmed by long-term follow-up studies with large samples.
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Affiliation(s)
- 宏斌 王
- 北京大学第三医院生殖医学中心, 北京 100191Peking University Third Hospital Reproductive Center, Beijing 100191, China
- 内蒙古自治区赤峰市宁城县中心医院泌尿外科, 内蒙古赤峰 024200Department of Urology, Ningcheng County Central Hospital, Chifeng 024200, Inner Mongolia, China
| | - 连明 赵
- 北京大学第三医院泌尿外科, 北京 100191Department of Urology, Peking University Third Hospital, Beijing 100191, China
| | - 锴 洪
- 北京大学第三医院泌尿外科, 北京 100191Department of Urology, Peking University Third Hospital, Beijing 100191, China
| | - 加明 毛
- 北京大学第三医院生殖医学中心, 北京 100191Peking University Third Hospital Reproductive Center, Beijing 100191, China
| | - 德风 刘
- 北京大学第三医院生殖医学中心, 北京 100191Peking University Third Hospital Reproductive Center, Beijing 100191, China
| | - 浩成 林
- 北京大学第三医院泌尿外科, 北京 100191Department of Urology, Peking University Third Hospital, Beijing 100191, China
| | - 辉 姜
- 北京大学第三医院泌尿外科, 北京 100191Department of Urology, Peking University Third Hospital, Beijing 100191, China
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34
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Torres-Gómez FJ, Fernández-Machín P, Poyato-Galán JM. Scrotal calcinosis ¿idiopathic? ARCH ESP UROL 2020; 73:568-569. [PMID: 32633254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Scrotal calcinosis, despite being described from time to time in the literature, is still considered a rare condition that affects individuals, usually young people...
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Affiliation(s)
| | - Pilar Fernández-Machín
- Área de Gestión Clínica de Biotecnología. Agencia Sanitaria Bajo Guadalquivir. Utrera. Sevilla. España
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35
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Pastoor H, Gregory A. Penile Size Dissatisfaction. J Sex Med 2020; 17:1400-1404. [PMID: 32444341 DOI: 10.1016/j.jsxm.2020.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/24/2020] [Accepted: 03/29/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Men concerned about their penis size often consult professionals working in urology, andrology, surgery, and sexual medicine. AIM To inform professionals in the sexual medicine field about small penis syndrome as a clinical syndrome and to provide recommendations for treatment. METHODS This was an overview of the existing literature combined with our extensive clinical experience. RESULTS Small penis syndrome is a syndrome with psychiatric comorbidities and social consequences that impair life. Men with these concerns tend to be susceptible for treatment that is not evidence based and potentially harmful. CLINICAL IMPLICATIONS Treatment of men with concerns about penis size should start with a thorough biopsychosocial assessment, followed by extensive psychoeducation, counselling, and psychological interventions, even if surgery is being considered. STRENGTHS & LIMITATIONS The strength of this study is the concise overview of the existing literature combined with clinical experience which leads to important recommendations. Limitation is that this is not a systematic review. CONCLUSION Complaints about penis size should be taken seriously, and a thorough biopsychosocial and multidisciplinary assessment is required.
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Affiliation(s)
- Hester Pastoor
- Registered Psychotherapist, Registered Sexologist, ECPS, PhD Student, Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - Angela Gregory
- COSRT Accredited Psychosexual Therapist, Division of Family Health, Department of Sexual Health, Chandos Clinic, Nottingham University Hospital Trust, Nottingham, United Kingdom
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36
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Dahl RH, Nielsen AL, Olsen AB, Tcacenco O, Naujokaite G, Christensen JB. [Infektiøs vasitis som differentialdiagnose til ingvinalhernie]. Ugeskr Laeger 2020; 182:V71000. [PMID: 32400386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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37
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Benson RM, Kirwan J, Moots RJ. A novel treatment in the management of genital ulceration in Behçet's disease. Clin Exp Rheumatol 2019; 37 Suppl 121:158. [PMID: 31577218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 03/01/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Rosalind M Benson
- Behçet's Syndrome Centre of Excellence, University Aintree, Liverpool, UK
| | - John Kirwan
- Behçet's Syndrome Centre of Excellence, University Hospital Aintree, Liverpool, UK
| | - Robert J Moots
- Behçet's Syndrome Centre of Excellence, University Hospital Aintree, Liverpool, UK.
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38
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Somiya S, Tamaki M, Fujikawa S, Yamada Y, Kamiyama Y, Kanaoka T. [A Case of Seminal Vesicle Cyst Incidentally Diagnosed during Rupture of Abdominal Subcutaneous Abscess]. Hinyokika Kiyo 2018; 64:193-195. [PMID: 29772623 DOI: 10.14989/actauroljap_64_4_193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Seminal vesicle cyst is a rare disease and is often asymptomatic. We present a case of huge seminal vesicle cyst connected to the abdominal wall and observed as a subcutaneous abscess. An 89-year-old man presented with asymptomatic spontaneous rupture of the left lower abdominal subcutaneous abscess. Computed tomography (CT) showed a relatively low intensity cystic mass located in the Retzius' space just below the abscess, surrounding the right bladder wall laterally and connecting to the right seminal vesicle posteriorly. Biopsy of the skin around the subcutaneous abscess and aspiration biopsy of the pelvic cystic fluid showed no evidence of malignancy. We diagnosed the lesion as a seminal vesicle cyst with bacterial infection. The patient was treated with antibiotics and there has been no relapse.
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Affiliation(s)
- Shinya Somiya
- The Department of Urology, Japanese Red CrossWakayama Medical Center
| | - Masahiro Tamaki
- The Department of Urology, Japanese Red CrossWakayama Medical Center
| | - Shohei Fujikawa
- The Department of Urology, Japanese Red CrossWakayama Medical Center
| | - Yuya Yamada
- The Department of Urology, Japanese Red CrossWakayama Medical Center
| | - Yuki Kamiyama
- The Department of Urology, Japanese Red CrossWakayama Medical Center
| | - Toshio Kanaoka
- The Department of Urology, Japanese Red CrossWakayama Medical Center
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39
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Shao GF, Ma TJ, Liu YQ, Li JJ, Wang WZ, Yuan MZ. [Real-time transrectal ultrasonography in seminal vesiculoscopy]. Zhonghua Nan Ke Xue 2017; 23:337-342. [PMID: 29714419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To compare three different pathways for transurethral seminal vesiculoscopy (SVS) and investigate the reliability and efficiency of transrectal ultrasonography (TRUS)-guided SVS (TRUS-SVS). METHODS We retrospectively analyzed 90 cases of seminal vesiculoscopy conducted directly through the ejaculatory duct or prostatic utricle or under the guide of TRUS. We compared the success rate and complications among the three approaches. RESULTS Operations were successfully performed in 87 (96.67%) of the 90 cases, 30 through the ejaculatory duct, 37 via the prostatic utricle, and 20 under the guide of TRUS, the operation time ranging from 25 to 75 minutes. Sperm was detected from the seminal vesicle fluid in (92.06%) of the azoospermia patients (58/63) during the surgery and in 77.78% of them (49/63) in semen analysis at 1 week postoperatively. Fifteen hematospermia and 12 spermatocystitis patients were cured. Postoperative follow-up found 20 cases of water-like semen and 3 cases of orchiepididymitis, but no such complications as retrograde ejaculation, incontinence, or rectourethral fistula. CONCLUSIONS Transejaculatory duct and transprostatic utricle pathways are two common approaches to SVS, while TRUS-SVS may achieve a higher success rate and avoid injury of both the prostate and the rectum.
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Affiliation(s)
- Guang-Feng Shao
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong 250033, China
| | - Tian-Jia Ma
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong 250033, China
| | - Yu-Qiang Liu
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong 250033, China
| | - Jun-Jia Li
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong 250033, China
| | - Wen-Zhen Wang
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong 250033, China
| | - Ming-Zhen Yuan
- Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong 250033, China
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Lü J, Chen JN, Wen HD, Shen W, Liu J, Xiao YS, Zhang XM, Nie HB, Hu WL. [Ejaculatory duct dilation combined with seminal vesicle clysis for refractory hematospermia: A report of 32 cases]. Zhonghua Nan Ke Xue 2016; 22:511-515. [PMID: 28963839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To evaluate the effect of ejaculatory duct dilation combined with seminal vesicle clysis in the treatment of refractory hematospermia. METHODS Using ureteroscopy, we treated 32 patients with refractory hematospermia by transurethral dilation of the ejaculatory duct combined with clysis of the seminal vesicle with diluent gentamicin. RESULTS The operation was successfully accomplished in 31 cases, with the mean operation time of 32 (26-47) minutes. The patients were followed up for 6-39 (mean 23.6) months. No complications, such as urinary incontinence and retrograde ejaculation, were found after operation. Hematospermia completely disappeared in 27 cases, was relieved in 1, and recurred in 3 after 3 months postoperatively. Those with erectile dysfunction or mental anxiety symptoms showed significantly decreased scores of IIEF-Erectile Function (IIEF-EF) and Self-Rating Anxiety Scale (SAS). CONCLUSIONS Ejaculatory duct dilation combined with seminal vesicle clysis under the ureteroscope, with its the advantages of high effectiveness and safety, minimal invasiveness, few complications, and easy operation, deserves general clinical application in the treatment of refractory hematospermia.
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Affiliation(s)
- Jun Lü
- Department of Urology, Guangzhou General Hospital of Guangzhou Military Region, Guangzhou, Guangdong 510010, China
| | - Jie-Neng Chen
- Department of Urology, Guangzhou General Hospital of Guangzhou Military Region, Guangzhou, Guangdong 510010, China
| | - Hai-Dong Wen
- Department of Urology, Guangzhou General Hospital of Guangzhou Military Region, Guangzhou, Guangdong 510010, China
| | - Wen Shen
- Department of Urology, Guangzhou General Hospital of Guangzhou Military Region, Guangzhou, Guangdong 510010, China
| | - Jun Liu
- Department of Urology, Guangzhou General Hospital of Guangzhou Military Region, Guangzhou, Guangdong 510010, China
| | - Yuan-Song Xiao
- Department of Urology, Guangzhou General Hospital of Guangzhou Military Region, Guangzhou, Guangdong 510010, China
| | - Xiao-Ming Zhang
- Department of Urology, Guangzhou General Hospital of Guangzhou Military Region, Guangzhou, Guangdong 510010, China
| | - Hai-Bo Nie
- Department of Urology, Guangzhou General Hospital of Guangzhou Military Region, Guangzhou, Guangdong 510010, China
| | - Wei-Lie Hu
- Department of Urology, Guangzhou General Hospital of Guangzhou Military Region, Guangzhou, Guangdong 510010, China
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Dong Q, Ren ZJ, Yang B, Fang K, Liao J. [Minimally invasive surgery for ejaculatory duct obstruction in infertile men]. Zhonghua Nan Ke Xue 2016; 22:291-293. [PMID: 30088394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Ejaculatory duct obstruction(EDO) accounts for 1- 5% of the causes of male infertility and can be corrected by various surgical methods,among which transurethral resection of the ejaculatory ducts(TURED) is considered as the gold standard for its treatment and has been well established in clinical practice. Transutricular seminal vesiculoscopy has been gaining more and more attention for its cost-effectiveness and few complications in the treatment of EDO. The clinical evidence for treating EDO by balloon dilatation and seminal vesicle lavage is limited and its application value needs to be further investigated. This paper presents an overview on the treatment of EDO in infertile men by minimally invasive surgery.
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Gupta N, Zinn KM, Bansal I, Weinstein R. Fournier's gangrene: ultrasound or computed tomography? Med Ultrason 2014; 16:389-390. [PMID: 25463897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Nishant Gupta
- Ultrasound Division, Department of Radiology and Imaging, St. Vincent's Medical Center, Bridgeport, Connecticut, USA.
| | - Kenneth M Zinn
- Ultrasound Division, Department of Radiology and Imaging, St. Vincent's Medical Center, Bridgeport, Connecticut, USA
| | - Itisha Bansal
- Department of Internal Medicine,St. Vincent's Medical Center, Bridgeport, Connecticut, USA
| | - Robert Weinstein
- Department of Urology, St. Vincent's Medical Center, Bridgeport, Connecticut, USA
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Gupta R, Sharma SB. Pneumoscrotum. Indian Pediatr 2014; 51:942. [PMID: 25432240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Rahul Gupta
- Department of Paediatric Surgery, NIMS University Medical College, Jaipur, Rajasthan, India.
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Zhang N, Shen WB, Cai HC, Yan XM, Liu SL, Wu D, Sun G, Qian JM, Dun ZN, Zhao YQ. [Hennekam syndrome: a case report and review of literature]. Zhonghua Nei Ke Za Zhi 2013; 52:192-196. [PMID: 23856108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To study the clinical characteristics of Hennekam syndrome. METHODS We described a case of long-term iron deficiency anemia, characteristic facial anomalies, growth retardation, and intestinal lymphangiectasia. To our knowledge, this is the first case of Hennekam syndrome reported in China. Meanwhile, relevant literature was also reviewed. RESULTS A total of 35 cases of Hennekam syndrome were identified, consisting of 18 males and 17 females (age ranging 0 - 40 years old). Lymphangiectasia, lymphedema, facial anomalies (hypertelorism, flat nasal bridge and flat face) and developmental retardation were the major clinical manifestations of the syndrome. CCBE1 mutation may have played an important role in the pathogenesis of the syndrome. Long-term moderate-to-severe iron deficiency anemia was a distinctive feature of our case. Lymphangiography revealed lymphangiectasia of small intestine and lower limb, as well as thoracic outlet obstruction. Complete elimination of anemia and significant increase of serum albumin level were observed several months after the adhesiolysis procedure of the distal end of thoracic duct. However, anemia and severe hypoalbuminemia relapsed after taking greasy food. CONCLUSIONS Hennekam syndrome is a rare autosomal recessive syndrome characterized by defective lymphatic development. Congenital lymphangiectasia should be considered in the patients with unexplained developmental retardation and hypoalbuminemia. Moreover, intestinal lymphangiectasia can be a rare cause of gastrointestinal bleeding.
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Affiliation(s)
- Ning Zhang
- Department of Hematology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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Abstract
Penile reconstruction still represents a formidable challenge for the urologist. In this review, the most recent advances in penile reconstruction after trauma, excision of benign and malignant disease and in patients with micropenis, aphallia or female to male gender dysphoria are reported.
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Affiliation(s)
- Giulio Garaffa
- St Peter’s Andrology and the Institute of Urology, W1G 6BJ London, UK.
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Psychosomatic and biological perspectives on clinical controversies. Abstracts of the First World Congress of Obstetrics, Gynaecology and Andrology. March 21-23, 2011. London, United Kingdom. J OBSTET GYNAECOL 2011; 31 Suppl 1:1-50. [PMID: 21381987 DOI: 10.3109/01443615.2011.552340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstracts from the 6th European Congress of Andrology. September 29-October 1, 2010. Athens, Greece. Int J Androl 2010; 33 Suppl 1:21-98. [PMID: 20842794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Abstracts of the 20th Ljudevit Jurak International Symposium on Comparative Pathology. Pathology of the male genital tract. June 5-6 2009, Zagreb, Croatia. Acta Clin Croat 2009; 48:195-219. [PMID: 20037933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
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Greer DM, Friday RP, Romero J, Auluck PK. Case records of the Massachusetts General Hospital. Case 17-2009. A 30-year-old man with progressive neurologic deficits. N Engl J Med 2009; 360:2341-51. [PMID: 19474432 DOI: 10.1056/nejmcpc0810842] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- David M Greer
- Department of Neurology, Massachusetts General Hospital, USA
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Casey RW, Barkin J. Office based non-oncology urology trials. Can J Urol 2008; 15:4279-4283. [PMID: 18814821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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