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Indocyanine green (ICG)-GUIDED lymphatic sparing laparoscopic varicocelectomy in children and adolescents. Is intratesticular injection of the dye safe? A mid-term follow-up study. J Pediatr Urol 2024; 20:282.e1-282.e6. [PMID: 38061982 DOI: 10.1016/j.jpurol.2023.11.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 10/11/2023] [Accepted: 11/18/2023] [Indexed: 04/22/2024]
Abstract
BACKGROUND Laparoscopic Palomo varicocelectomy using indocyanine green (ICG) fluorescent lymphography (FL) is standardized technique to perform lymphatic sparing and avoid post-operative hydrocele. No data regarding the safety of intratesticular injection of ICG are currently available. OBJECTIVE The study aimed to assess the safety and efficacy of this procedure at mid-term follow-up. STUDY DESIGN Seventy-two patients (median age 14.5 years) undergoing laparoscopic Palomo varicocelectomy using ICG-FL from January 2019 to July 2022, were enrolled. Operative indication was high-grade varicocele in all patients, associated symptoms in 30/72 (41.7 %) and left testicular hypotrophy in 42/72 (58.3 %). Follow-up included clinical examination at 1, 6, 12 months and scrotal Doppler ultrasonography (US) at 12 months postoperatively to assess varicocele persistence, hydrocele, and injections-related complications. RESULTS Lymphatic sparing was achieved using ICG-FL in all cases. No intra-operative complications or adverse reactions secondary to ICG occurred. The median follow-up was 22.8 months (range 11-49). Self-limited scrotal hematoma at the injection site occurred in 1/72 (1.4 %). Intratesticular hypoechoic millimetric area was detected at the injection site in 3/72 (4.2 %) on US. This finding disappeared after 1-year observation in 2/3 cases (66.7 %) (Figure). Persistent grade II varicocele was observed in 4/72 (5.5 %), not requiring re-intervention. No hydrocele occurred and 14/22 (63.6 %) with pre-operative hypotrophy showed catch-up growth. DISCUSSION ICG-FL was clinically safe, with no allergy or systemic adverse reactions to the dye reported in this series. No injury directly related to the injection of the dye was clinically observed, except for self-limiting scrotal hematoma in one patient. A millimetric hypoechoic and avascular area in the body of the left testicle at the injection site was found on scrotal US at 1-year follow-up in 3 patients of our series. This finding does not seem to be clinically relevant as patients were asymptomatic and serum tumor markers were normal in all cases. Furthermore, the hypoechoic area with calcifications resolved 1 year later in 2/3 patients. The absence of evolution of this finding seems to exclude the heteroplastic nature. We hypothesized that this finding may be linked to elevated volume and/or pressure of intratesticular injection. Future prospective study with larger series and longer follow-up is needed to assess long-term testicular outcomes. CONCLUSION Laparoscopic Palomo varicocelectomy using ICG-FL reported excellent outcomes with low incidence of varicocele persistence and no post-operative hydrocele. These preliminary data also confirmed safety of intratesticular injection of ICG at mid-term follow-up, without specific risks for both testis and patient.
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A Review of Classification, Diagnosis, and Management of Hydrocele. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:599-607. [PMID: 38010662 DOI: 10.1002/jum.16380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/15/2023] [Indexed: 11/29/2023]
Abstract
This article summarizes and updates a number of issues related to hydrocele including anatomy, embryology, classification, etiology, clinical manifestations, imaging findings, and management. Hydrocele is an abnormal collection of serous fluid between the parietal and visceral layers arising from the mesothelial lining of the tunica vaginalis that surrounds the testis and spermatic cord directly. Hydroceles result from an imbalance of secretion and reabsorption of fluid from the tunica vaginalis. Hydroceles can be divided into two types as primary and secondary. The diagnosis should be based on medical history, clinical manifestations, and imaging studies. Understanding the causes and types of hydroceles is useful for accurately diagnosing and treatment strategy. Hydroceles can be managed by conservative treatment, fluid aspiration, or hydrocelectomy.
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Testicular mesothelioma disguised as hydrocele: a case report. J Med Case Rep 2024; 18:114. [PMID: 38409016 PMCID: PMC10898004 DOI: 10.1186/s13256-024-04348-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 12/29/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Testicular tumors have many different manifestations. The majority of these cases are presented as an incidental finding during hydrocelectomy. Malignant mesotheliomas are uncommon tumours that can arise from the coelomic epithelium of the pleura, peritoneum, pericardium, and tunica vaginalis. CASE PRESENTATION We present a 51-year-old South Asian (Indian) male patient with a rare case of mesothelioma, presenting with right hydrocele, to whom a right hydrocelectomy was performed. Any history of trauma or asbestos exposure was not present. Histopathological and immunohistochemistry reports revealed a malignant mesothelioma of tunica vaginalis. There was no invasion of the tumour to the epididymis and spermatic cord. Imaging studies showed no signs of metastasis. 1 month later, a high inguinal orchidectomy was performed. The patient underwent adjuvant chemotherapy thereafter and is still on follow-up. CONCLUSION Although hydrocele is common, detailed evaluation is mandatory to rule out certain rare tumours-testicular and paratesticular variants.
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Metastatic Lung Adenocarcinoma Presenting as Hydrocele. Mayo Clin Proc 2023; 98:1894-1896. [PMID: 38044007 DOI: 10.1016/j.mayocp.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 12/05/2023]
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Misdiagnosis of scrotal and retroperitoneal lymphangioma in children. BMC Pediatr 2023; 23:551. [PMID: 37924010 PMCID: PMC10623770 DOI: 10.1186/s12887-023-04380-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 10/21/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Scrotal and retroperitoneal lymphangioma (SRL) in children is relatively rare and its clinical symptoms are usually difficult to distinguish from other conditions such as hydrocele and incarcerated inguinal oblique hernia. This study aimed to explore the clinical diagnosis and treatment of abdominal scrotal lymphangioma in children, and thus, to increase our understandings of this disease in clinical practice. METHOD This study enrolled nine boys, aged 1-10, who were admitted to Shanghai Children's Hospital from January 2019 to December 2020 and who were finally confirmed with lymphangioma in the inguinal area. The clinical manifestations, diagnosis, and treatment of these children were analyzed retrospectively. The length of diagnostic process ranged from 3 weeks to 20 months. We also reviewed other cases of initially misdiagnosed cases of SRL in English publications from 2000 to 2022. RESULTS The nine cases were misdiagnosed as hydrocele, hematoma, or inguinal hernia. Three patients received intracystic injection of bleomycin, three underwent laparoscopic mass resection, and three underwent resection of the inguinal lymphangioma under direct vision. Postoperative pathological analysis of the surgical specimens confirmed the diagnosis of benign cystic lesions and lymphangioma. Meanwhile, among the 14 cases of SRL in literature review, eight were misdiagnosed. Six were initially diagnosed as hydrocele, one as inguinal oblique hernia, and one as testicular tumor, all of which underwent ultrasonography scans. All cases were confirmed as lymphangioma after pathological examination. CONCLUSION The non-specific clinical manifestations may contribute to the misdiagnosis of scrotal masses in children. A detailed and accurate medical history, careful physical examination, and imaging findings are important factors contributing to the preoperative differential diagnosis of scrotal lumps in children, but the final diagnosis is based on pathological examination.
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Metachronous Contralateral Occurrence of Hydrocele After Unilateral Hydrocelectomy in Children Younger Than 8 Years. J Korean Med Sci 2023; 38:e79. [PMID: 36918032 PMCID: PMC10010910 DOI: 10.3346/jkms.2023.38.e79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 12/19/2022] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Hydrocele on the contralateral side after surgical repair is an uncommon condition compared to surgical site recurrence. Although there has been much research on metachronous contralateral inguinal hernia in children, metachronous contralateral hydrocele, which share a common pathology with inguinal hernias, has not yet been investigated. We have investigated the incidence and risk factors for metachronous contralateral occurrence of communicating and noncommunicating hydroceles in children younger than 8 years. METHODS From January 2017 to June 2020, 302 children younger than 8 who were diagnosed with unilateral hydroceles were treated in our hospital without surgical exploration of contralateral hydrocele. The disease was classified into communicating and noncommunicating hydroceles. We divided patients into two groups according to the presence of metachronous contralateral hydrocele and analyzed the differences between the two groups. RESULTS Among 302 patients, the mean age was 36.4 ± 20.9 months. Metachronous contralateral hydrocele occurred in 15 (4.9%) patients as communicating hydroceles. Comparison between the two groups showed statistically significant differences in type of hydrocele (P = 0.047) at first diagnosis. CONCLUSION Clinically evident risk of metachronous contralateral hydrocele after unilateral hydrocelectomy was 4.9%. Despite the relatively low incidence rate, the risk of metachronous contralateral occurrence should always be consulted with parents before surgical treatment of hydroceles.
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Clinical challenges of scrotal lymphangioma in an adult: a rare case of scrotal swelling. THE CANADIAN JOURNAL OF UROLOGY 2022; 29:11262-11265. [PMID: 35969731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Scrotal lymphangiomas represent an extremely rare cause of scrotal swelling. We report a case of scrotal lymphangioma in an 18-year-old male who presented with painful scrotal swelling. Scrotal ultrasound revealed a complex multicystic structure in the left hemiscrotum. The patient underwent successful surgical excision of the mass. Postoperatively, he developed a hydrocele which eventually spontaneously regressed. Histopathology confirmed the diagnosis. We outline the unusual presentation, characteristic imaging and histology findings, and surgical management of scrotal lymphangiomas. With this information, urologists may exercise a heightened level of awareness for this rare cause of scrotal swelling.
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Abdominoscrotal Haematocele in an Adult and Its Successful Treatment. Sultan Qaboos Univ Med J 2022; 22:144-148. [PMID: 35299808 PMCID: PMC8904109 DOI: 10.18295/squmj.4.2021.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/11/2021] [Accepted: 02/10/2021] [Indexed: 11/16/2022] Open
Abstract
Abdominoscrotal hydrocele (ASH) is a variant of hydrocele that rarely occurs in adults. ASH has two sacs, one in the scrotum and one in the abdomen connected through the inguinal canal. Abdominoscrotal haematocele is a rare complication of ASH. We report a 57-year-old male patient who presented to a tertiary care hospital in Puducherry, India, in 2019 with complaints of swelling in the scrotum for 15 years and abdominal pain for two months. Both the swellings were soft and cross fluctuation was present. Imaging confirmed the diagnosis of ASH. During a diagnostic laparoscopy, the abdominal sac was decompressed and found to have thick brownish fluid suggestive of haematocele. It was demonstrated that both sacs were connected. Due to difficulty in the dissection of the sac, the procedure was converted to an open procedure. Both the sacs were excised and Lytle’s repair was done for the dilated internal ring. The patient recovered and no recurrence of any swelling in the abdomen or scrotum was found at the end of a one-year follow-up.
Keywords: Testicular Hydrocele; Scrotal Hydrocele; Testicular Haematocele; Scrotal Haematocele; Laparoscopic Surgical Procedure; Laparoscopic Surgery; Case Report; India.
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Massive Scrotal Swelling. Am Fam Physician 2022; 105:77-78. [PMID: 35029938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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[Laparoscopic phelps approach in children with inguinal hernia: a retrospective comparative study]. Khirurgiia (Mosk) 2022:51-57. [PMID: 36223150 DOI: 10.17116/hirurgia202210151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of a new method of inguinal hernia repair in children (PHELPS) first proposed by the authors compared to another laparoscopic method (SEAL). MATERIAL AND METHODS The study demonstrated the results of laparoscopic treatment of 729 patients with inguinal hernias. Of these, 255 patients underwent PHELPS procedure. Other 474 patients underwent SEAL procedure. The difference between both methods is that hernial ligature is passed around the hernial sac in case of PHELPS. SEAL procedure implies capture of tissues of anterior abdominal wall (muscles and aponeurosis) into this knot. We analyzed whether this factor can lead to less incidence of recurrence and hydrocele. RESULTS Both groups were comparable by age, body weight and gender. Median of surgery time including correction of unilateral and bilateral hernia was similar (20.0 [10.0; 20.0] min versus 15.0 [15.0; 20.0] min; p=0.666). We found faster patient recovery after PHELPS procedure for inguinal hernia including much less doses of postoperative analgesia (1.0 [1.0; 1.0] versus 1.0 [1.0; 2.0]; p<0.001) and shorter hospital-stay (8.0 [8.0; 8.0] hours versus 8.0 [8.0; 9.0] hours; p=0.010). There were no significant differences in the incidence of postoperative hydrocele (0 versus 6; p=0.097). Nevertheless, recurrence rate differed significantly (0 versus 17; p=0.001). CONCLUSION PHELPS procedure is characterized by lower incidence of recurrence and accelerated postoperative recovery compared to SEAL technique.
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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] [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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[Mesothelioma of the tunica vaginalis of the testis-a histopathological finding with far-reaching consequences]. Urologe A 2021; 61:292-296. [PMID: 34652478 DOI: 10.1007/s00120-021-01689-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 11/25/2022]
Abstract
Mesotheliomas are very aggressive tumors, almost exclusively caused by asbestos. Four of the 5 mesotheliomas assessed in the years 2014-2020 were recognized as occupational diseases, the 5th case was discontinued due to lack of the patient's cooperation. Surgical exposure of the testis was performed under the suspected diagnoses of hydrocele (n = 3), spermatocele (n = 1) as well as "unknown" (n = 1). This proves that a histopathological examination of removed tissue is the gold standard in scrotal interventions. Every mesothelioma must always be reported as an occupational disease.
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An Emoji for a Tunica Vaginalis Hydrocele. Int J Surg Pathol 2020; 28:771. [PMID: 31870200 DOI: 10.1177/1066896919896628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abdominoscrotal Lymphangioma Masquerading as a Communicating Hydrocele: A Case Report. Gulf J Oncolog 2020; 1:63-65. [PMID: 32342921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2019] [Indexed: 06/11/2023]
Abstract
A 5-year old boy presented with a picture of communicating hydrocele and was discovered to have an abdominoscrotal lymphangioma after undergoing hydrocele surgery. Upon initial presentation the lymphangioma was missed and the child underwent inguinal approach surgery for hydrocele. The lymphangioma was then noticed as an abdominal lump due to a rapid increase in size within 1 week following the hydrocele surgery. The sudden enlargement of the lymphangioma was due to intra-cystic hemorrhage post-operatively. The lymphangioma was then completely excised with no recurrence noted after 1 year of follow up. This is a rare case of a retroperitoneal, abdominoscrotal lymphangioma masquerading as a communicating hydrocele. Keywords: Communicating Hydrocele, Abdominoscrotal lymphangioma, Scrotal Swelling.
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Ascending testis after repair of pediatric inguinal hernia and hydrocele: A misunderstood operative complication. J Pediatr Urol 2017; 13:53.e1-53.e5. [PMID: 27727095 DOI: 10.1016/j.jpurol.2016.08.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 08/11/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Ascending testis (AT) is a rare complication after repair of an inguinal hernia/hydrocele. However, there has been some controversy concerning the AT following laparoscopic and open procedures. OBJECTIVE To review the experience of, and discuss the associated mechanisms with, testicular ascent after pediatric inguinal hernia/hydrocele surgery. STUDY DESIGN A retrospective review of the medical records of male children who underwent inguinal hernia/hydrocele repair at the present hospital between January 2000 and December 2014. Those who underwent subsequent orchiopexies due to ipsilateral cryptorchidism were identified. The ATs that were misdiagnosed, caused by improper operation, and retractile testes were excluded. The Poisson distribution evaluated the incidences of subgroups. RESULTS A total of 17,295 inguinal hernias and hydroceles were repaired on 12,849 males; of whom, 10 testes (0.058%) developed ATs on nine individuals postoperatively (Summary Table). The difference of AT incidences between subgroups was insignificant (P > 0.05), except for that grouped by the age at initial operation (cutoff = 1 year, P = 0.008; cutoff = 2 years, P = 0.012). During orchiopexy, extensive adhesions were found in the inguinal canal only in the two cases following open repair. The hernia sac/processus vaginalis remained intact in the canal of AT after laparoscopic repair, and partial after open herniotomy. DISCUSSION It was generally assumed that testicular ascent after repair of an inguinal hernia/hydrocele was caused by adhesion of the spermatic cord. However, the cord was not dissected during laparoscopic procedure, so adhesion was not the major reason for AT following laparoscopic surgery. The sac/processus were partially excised during open repair, but kept intact in laparoscopic procedure. Therefore, remnants of the sac/processus might play a greater role in postoperative testicular ascent than adhesions. Furthermore, it was found that AT incidence after the repair was not higher than that in 'normal' males. Ascending testis was probably not an operative complication, but a natural descent process of testis independent of the operation. Moreover, the testis descended further due to dissection of the cord and excision of the sac/processus, so the AT incidence was extremely low following open operation. From this point of view, open repair of an inguinal hernia/hydrocele was probably a protective factor for preventing testicular ascent. CONCLUSION Ascending testis is rare in male pediatric patients who have had repair of an inguinal hernia/hydrocele. Currently, the mechanism of testicular ascent is still unclear, and should be further investigated in the future.
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Malignant mesothelioma of the tunica vaginalis: a rare case report and description of multimodal treatment. THE CANADIAN JOURNAL OF UROLOGY 2016; 23:8585-8589. [PMID: 27995857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Malignant mesothelioma is an uncommon neoplasm that develops from serous surfaces, and rarely from the tunica vaginalis. Although atypical in any location, paratesticular presentation is exceedingly infrequent as only 0.3% to 1.4% of mesothelioma cases arise from the tunica vaginalis. Fewer than 300 cases have been reported with very few descriptions of long term follow up and multimodal therapy. Here we describe a patient with 2 years of follow up for metastatic mesothelioma treated with orchiectomy, chemotherapy and robot-assisted laparoscopic retroperitoneal lymph node dissection.
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Paratesticular Rhabdomyosarcoma Presenting With a Giant Abdominoscrotal Hydrocele in a Toddler. Urology 2015; 87:200-1. [PMID: 26435457 DOI: 10.1016/j.urology.2015.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 08/31/2015] [Accepted: 09/01/2015] [Indexed: 11/17/2022]
Abstract
Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in infants and children. Paratesticular RMS accounts for approximately 7% of all RMSs. It commonly presents as a painless scrotal mass, which is usually distinct from the testis. We report an unusual case of paratesticular RMS presenting with a giant abdominoscrotal hydrocele in a toddler. To the best of our knowledge, this is the first case of paratesticular RMS presenting with an abdominoscrotal hydrocele.
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[Traumatic Testicular Rupture Complicated with Hydrocele: A Case Report]. HINYOKIKA KIYO. ACTA UROLOGICA JAPONICA 2015; 61:411-413. [PMID: 26563625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 17-year-old man presented with right hydrocele because of an athletic injury. His scrotum was hit with a ball 2 months ago while playing baseball. He was diagnosed with post-traumatic hydrocele and underwent needle puncture at another hospital 1 month after the trauma. However, the hydrocele did not improve. Therefore, he was referred to our hospital for surgical treatment. For diagnosis of the traumatic hydrocele testis, a hydrocelectomy was scheduled. When we opened the tunica vaginalis, we realized that the tunica albuginea had been ruptured and the testicular parenchyma had gushed out. We tried to replace all the escaped testicular parenchyma into the tunica albuginea, but it was impossible. Therefore were moved some of the redundant testicular parenchyma, and replaced the remnants into the tunica albuginea. After the operation, right hydrocele and testicular atrophy did not occur. Traumatic testicular rupture complicated with hydrocele is rare.
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Isolated tuberculosis of tunica albuginea and tunica vaginalis presenting as acute hydrocoele: a diagnostic dilemma. BMJ Case Rep 2015; 2015:bcr-2014-207744. [PMID: 26347242 DOI: 10.1136/bcr-2014-207744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
We report the first case of genital tuberculosis (TB) occurring in tunica albuginea (TA) and tunica vaginalis (TV) presenting as acute hydrocoele. A 35-year-old man presented with acute onset left scrotal swelling. Physical examination revealed left hemiscrotal swelling with overlying skin erythema and tenderness. Surgical exploration was carried out due to increasing pain and per operatively found thickened TA and TV with a single small nodule on TA. Histopathology revealed typical granuloma formation, however, no Mycobacterium was seen. Subsequent Ziehl-Neelsen stain on separate tissue specimen confirmed the presence of acid-fast bacilli. Based on these findings, antituberculous treatment was started involving daily isoniazid (INH), rifampicin, ethambutol and pyrazinamide for 2 months and further INH and rifampicin for further 4 months.
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Pregnancy, parturition, parity and position in the family. Any influence on the development of paediatric inguinal hernia/hydrocele? NIGERIAN JOURNAL OF MEDICINE 2014; 23:311-314. [PMID: 25470857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
AIM To see if pre-partum factors have a relationship to the development of inguinal hernia in children. METHOD A prospective study on children with hernia. On first contact, the affected child was examined and data like the age, sex, weight, blood group, the diagnosis, side of the lesion and other co-morbid conditions was recorded. The mother filled a questionnaire about her age, parity, illness during pregnancy, her mode of delivery and the patient's position in the family. RESULTS There were 104 patients from 103 mothers, their ages ranged from 13 days to 14 years with the highest incidence in the 1-4 age group. The sex ratio was overwhelmingly male (M:F ratio was 38:1). Right sided hernias were predominant. Only 7% had a family history. The peak age group of the mothers was 26-32 years and about 33% of the mothers had some illness during pregnancy. The birth positions of the patients showed that majority of them were either 1st or 2nd born children. CONCLUSION Women of ages 26-32 likelyto have children with inguinal hernia. Malaria during pregnancy is unlikely to have a role to play. 1st and 2nd born male children have a higher chance of having inguinal hernia.
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[Diagnosis and treatment of yolk sac tumor of the testis with hydrocele in children: report of 7 cases]. ZHONGHUA NAN KE XUE = NATIONAL JOURNAL OF ANDROLOGY 2013; 19:1007-1010. [PMID: 24341096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To study the clinical characteristics of yolk sac tumor of the testis with concomitant testicular hydrocele in children and the association between the two conditions in order to improve the diagnosis and treatment of the disease. METHODS We retrospectively analyzed the clinical data of 7 cases of stage-I yolk sac tumor of the testis with concomitant testicular hydrocele. The patients ranged in age from 6 to 14 (mean 11) months. As treatment, we performed radical high spermatic cord orchiectomy after diagnosis established on intraoperative frozen sections, and conducted follow-up visits by medical examination, serum alpha-fetoprotein (AFP) detection, chest X-ray, ultrasonography and CT for 3-41 (mean 17) months, every month in the first year, every 3 months in the second year and every 6 months in the third year after surgery. RESULTS Postoperative pathology confirmed yolk sac tumor in all the cases, with negative incisal margin. The level of serum AFP were decreased to normal in 6 cases within 1 month after surgery, all diagnosed as at stage I, and cured without chemotherapy. The other 1 case, with the serum AFP level of 116 microg/L at 1 month after operation, was diagnosed as at stage II and received PVC chemotherapy, but lost to follow-up at 3 months post-operatively. CONCLUSION Yolk sac tumor of the testis with concomitant testicular hydrocele is easily misdiagnosed in children. Ultrasonography is necessitated as routine examination in its diagnosis. Radical high spermatic cord orchiectomy can be performed for patients in stage I, and chemotherapy should follow for those in stage II. Its prognosis is similar to that of other yolk sac tumors. Hitherto, there has been no evidence for a definitive correlation between yolk sac tumor of the testis and hydrocele in children.
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Hydrocele camouflaging cryptorchidism. Am Surg 2012; 78:E354-E355. [PMID: 22856474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Bilateral abdominoscrotal hydrocele in a 5–month-old infant presented with a left leg edema and cyanosis. Hernia 2012; 17:533-5. [PMID: 22760160 DOI: 10.1007/s10029-012-0953-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 06/22/2012] [Indexed: 11/30/2022]
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The role of laparoscopic evaluation to detect a contralateral defect at initial presentation for inguinal hernia repair. Am Surg 2011; 77:1463-1466. [PMID: 22196658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Our objective was to determine the accuracy of laparoscopic evaluation to detect a contralateral patent processus vaginalis (CPPV) at initial presentation for inguinal hernia (IH) repair and the rate of CPPV relative to age, sex, and initial hernia side. We performed a 5-year retrospective review of 1580 pediatric patients with unilateral IH in which surgeons selectively used laparoscopy to evaluate for a CPPV. There were 1205 boys and 303 girls; 980 (65%) presented with right IH (RIH) and 528 (35%) with left IH (LIH). Laparoscopic evaluation was performed in 459 (47%) patients presenting with RIH and 225 (43%) patients presenting with LIH. Laparoscopic evaluation was positive for CPPV in 32 per cent of patients with RIH and 42 per cent of patients with LIH (P = 0.0168). CPPV was associated with prematurity (P = 0.0003) and age younger than 6 months (P = 0.0001) but not with sex (P = 0.55). The future contralateral occurrence rate was 1.6 per cent and recurrence rate 0.2 per cent. This study supports the accuracy of CPPV evaluation by laparoscopy. Although the rate of CPPV decreases after 6 months of age, girls older than 2 years of age have a significantly higher rate of CPPV than boys, supporting laparoscopic evaluation in older girls.
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Reactive pseudo-glandular mesothelial hyperplasia in testis tunica vaginalis: a case report. Pathologica 2011; 103:304-306. [PMID: 22393687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
A case of benign reactive pseudo-glandular mesothelial hyperplasia arising in the context of chronic vaginitis in presented: morphological and immunohistochemical investigations and differential diagnoses are described.
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Hydrocele: an atypical presentation of metastatic sarcomatoid renal cell carcinoma. THE CANADIAN JOURNAL OF UROLOGY 2011; 18:5742-5744. [PMID: 21703053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Herein is a case of a 55-year-old man who presented with epididymitis. He subsequently failed medical management for the suspected infection and progressed to develop an acute scrotum and sonographic findings consistent with a pyocele. Concurrent computed tomography (CT), obtained for persistent abdominal pain, revealed a large enhancing upper pole renal mass suspicious for malignancy. He was taken for emergent scrotal exploration to drain the presumptive pyocele. However, during scrotal exploration, no purulence or evidence of infection was seen. Although, seemingly unrelated to the renal mass, the thickened hydrocele sac was excised and sent as a specimen. Pathology of the sac revealed a diagnosis of metastatic sarcomatoid renal cell carcinoma. Appropriate chemotherapy was initiated based on the scrotal pathology, circumventing the need for a CT directed retroperitoneal lymph node biopsy or nephrectomy.
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Image of the month. Abdominoscrotal hydrocele. ARCHIVES OF SURGERY (CHICAGO, ILL. : 1960) 2011; 146:757-758. [PMID: 21690456 DOI: 10.1001/archsurg.2011.137-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Prevalence of endemic Bancroftian filariasis in the high altitude region of south-eastern Nigeria. J Vector Borne Dis 2011; 48:78-84. [PMID: 21715729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND & OBJECTIVES The study was aimed at determining the prevalence and intensity of Wuchereria bancrofti microfilaraemia in a high altitude region of south-eastern Nigeria, and ascertaining the prevalence of clinical signs and symptoms associated with the filarial infections. METHODS Thick smear of 50 μl finger-prick blood collected at night between 2200 and 0200 hrs from consenting persons were stained with Giemsa and examined microscopically in a cross-sectional study. Consenting individuals were examined for various gradations of hydrocele, limb and scrotal elephantiasis by qualified medical personnel. RESULTS The prevalence of W. bancrofti microfilaraemia was 4.3%, highest in the older people but comparable in both sexes. The overall micro filarial (mf) geometric mean intensity (GMI) among mf positive individuals was 123 mf/ml of blood (138 mf/ml for males and 110 mf/ml of blood for females); and rose significantly with increasing age (one-way analysis of variance; p <0.001). Prevalence of clinical manifestations was: hydrocele (7.1%), scrotal elephantiasis (4%), and limb elephantiasis (6%). The mf GMI was significantly higher among those without hydrocele or limb elephantiasis than among those with the clinical manifestations (t-test; p <0.05 for both tests); the opposite was the case for scrotal elephantiasis, (t-test; p <0.01). CONCLUSION Filariasis is endemic in the high altitude region of south-eastern Nigeria. The chronic clinical manifestations observed there underscore the need for urgent combination therapy interventions.
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[A clinical guideline for diagnosis and treatment of hydrocele in childhood]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2011; 49:101-108. [PMID: 21513669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To develop a guideline available to the medical staff of the first and second level of care, which includes recommendations based on the best available evidence about diagnosis and management of hydrocele in the pediatric patient. METHODS Clinical questions were formulated and structured. Standardized sequence was established to search for practice guidelines from the clinical questions raised on diagnosis and treatment of hydrocele in children. The working group searched clinical practice guidelines and found only one. For recommendations not included in the reference guide the search process was conducted in PubMed and Cochrane Library. The results were expressed as levels of evidence and grade of recommendation. CONCLUSIONS The most of the infant hydroceles are communicating and do resolve without treatment, however recognize those to need surgery is necessary to treat opportunely.
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Hydrocele with surprise. Case report and review of literature. Arch Ital Urol Androl 2010; 82:287-290. [PMID: 21341584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
INTRODUCTION Hydrocele is a fluid collection between tunica vaginalis and testis. Approximately 10% of testicular cancers occurs with a reactive hydrocele. CASE REPORT A 64 year old male presented with a 30 year history of left hydrocele, progressively increasing. Physical examination demonstrated a left large hydrocele, transilluminable, not under pressure. Ultrasonography showed a "corpusculated hydrocele with vaginal hypertrophy jutting out near the head of the epididymis, perhaps caused by an inflammatory reaction [...]" As the patient showed only a minimal discomfort due to the groin swelling, without pain, surgical excision was planned without priority (Class C < 180 days). RESULTS The surgical exploration showed a paratesticular papillary neoplasm of 3 cm. Intraoperative pathologic examination of a frozen sample demonstrated a "borderline papillary cystadenoma". The Left orchifunicolectomy was performed. The definitive histological examination showed a "left paratesticular Papillary Serous Tumor of Low Malignant Potential (PSTLMP) with morfoimmunoistochemical features of Mullerian origin of neoplasm". Computed tomography (CT) was negative for lymph nodes and metastasis. In agreement with the oncologist we decide for atchful waiting. DISCUSSION Despite of rich personal experience of resections and eversions of the vaginal tunic, an urologist rarely observes a case of paratesticular cancer. A PubMed search found 28 citations between 1985 and 2010 with 42 reported cases of paratesticolar neoplasm, including 27 with malignancy features. Rhabdomyosarcoma is the most common, followed by mesothelioma, adenocarcinoma and neuroblastoma. This case report consists of a "borderline" neoplasm for which in the literature, after orchiectomy, it is reported no case of recurrence or metastasis (with a follow up of up to 18 years). CONCLUSION The banality of the disease never must underestimate the possibility of an undetected cancer.
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Letter to the editor regarding patency of processus vaginalis in abdominoscrotal hydrocele. J Pediatr Surg 2010; 45:667; author reply 667. [PMID: 20223340 DOI: 10.1016/j.jpedsurg.2009.10.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Accepted: 10/26/2009] [Indexed: 11/16/2022]
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Abdominoscrotal hydrocele: a plea for a scrotal repair. J Pediatr Surg 2010; 45:668; author reply 668-9. [PMID: 20223342 DOI: 10.1016/j.jpedsurg.2009.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Accepted: 12/30/2009] [Indexed: 11/19/2022]
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[Diagnostic image; a neonate with a blueish, swollen scrotum]. NEDERLANDS TIJDSCHRIFT VOOR GENEESKUNDE 2009; 153:B369. [PMID: 19785835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A blueish, swollen scrotum in a neonate appeared to be caused by a hydrocele, as shown by the typical transillumination.
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[Penile and scrotale abnormalities in children and adult]. LA REVUE DU PRATICIEN 2008; 58:2289-2297. [PMID: 19209663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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[Hydrocele with massive scrotal calcification]. ARCH ESP UROL 2008; 61:749-750. [PMID: 18705201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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[Bilateral giant scrotal hydrocele in an adult]. HINYOKIKA KIYO. ACTA UROLOGICA JAPONICA 2008; 54:509-511. [PMID: 18697499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Bilateral giant hydrocele in an adult is a rare clinical entity. A 31-year-old man presented with painless bilateral scrotal swelling that had appeared at age 13 years and had increased very slowly since. Computed tomography and ultrasonography revealed collection of fluid on both sides of the scrotum. Giant scrotal hydrocele were diagnosed, and surgical excision was performed. The fluid volume was 1,050 ml in right, 645 ml in left. No inguinal hernia was found. Pathologic examination of the resected portion of the tunica vaginalis testis revealed inflammatory changes, and fluid cytology was negative. Eight months has passed, and there has been no evidence of recurrence.
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Bilateral spermatocele concurrent with bilateral scrotal hydrocele presenting huge scrotal swelling. HINYOKIKA KIYO. ACTA UROLOGICA JAPONICA 2007; 53:729-731. [PMID: 18018592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We report the very rare case of bilateral spermatoceles concurrent with bilateral scrotal hydrocele presenting huge scrotal swelling. A 52-year-old man came to our hospital because of large scrotal swelling. Ultrasonography and magnetic resonance imaging showed bilateral large scrotal hydroceles concurrent with bilateral multicystic spermatoceles above the hydrocele. He had no history of vasectomy or scrotal injury, and the semen examination was normal. The contents of the hydroceles and spermatoceles were first aspirated, but hydrocelectomy and spermatocelectomy were eventually done because after the aspiration the fluid increased more rapidly. Bilateral spermatocele is very rare; moreover, this is the first report of bilateral spermatocele concurrent with bilateral hydrocele.
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Abstract
Abdominoscrotal hydrocele (ASH) is reported with increasing frequency and is recognized to be responsible for complications not only related to the pressure effect on the contiguous structures, but a wide a variety of conditions, including hemorrhage and malignant transformation. Although there are only two reports in the literature of spontaneous resolution, the actual accepted consensus for treatment is complete excision. The surgical approaches are abdominal, scrotal or combined. There is no report in the literature of a laparoscopic excision of ASH. In this paper, we report on the first case to be treated with this approach and highlight the new advantages and simplicity in using this recommended technique.
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Abstract
PURPOSE The FG syndrome, also known as Opitz-Kaveggia syndrome, is an X-linked disorder characterized by developmental delay, congenital hypotonia, characteristic facial appearance, relative macrocephaly and anomalies affecting the genitourinary, gastrointestinal and musculoskeletal systems. Genitourinary abnormalities in the FG syndrome include cryptorchidism, hypospadias, inguinal hernia, hydrocele and occasional anomalies of renal or ureteral development. To our knowledge no previous study has systematically evaluated the genitourinary aspects of the disorder. We describe the genitourinary anomalies seen in children with the FG syndrome. This report may help elucidate the pathogenic mechanisms responsible for the disorder. Also, we provide a simple checklist for urologists that will help guide referrals for genetics and other specialty consultations. MATERIALS AND METHODS We retrospectively reviewed 228 patients with the FG syndrome to identify the frequency of characteristic historical and physical findings. These patients were diagnosed on the basis of a firsthand history and physical examination, or by a careful outside evaluation including detailed records and photographs. RESULTS Of the patients 90% were male. The overall incidence of any genitourinary anomaly was 48.5% in boys, 13.6% in girls and 44.7% overall. In boys the most common abnormalities were cryptorchidism (24%), hypospadias (14%) and hernia or hydrocele (13%). CONCLUSIONS The FG syndrome is a disorder with a greater prevalence than previously thought, yet is rarely suspected by urologists. The manifestations may be complex. Identification of patients with syndromal genitourinary anomalies by urologists will enhance the quality of care based on referral of patients for additional evaluation.
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MESH Headings
- Abnormalities, Multiple/diagnosis
- Abnormalities, Multiple/genetics
- Abnormalities, Multiple/surgery
- Child
- Child, Preschool
- Chromosomes, Human, X/genetics
- Craniofacial Abnormalities/diagnosis
- Craniofacial Abnormalities/genetics
- Cryptorchidism/diagnosis
- Cryptorchidism/genetics
- Cryptorchidism/surgery
- Developmental Disabilities/diagnosis
- Developmental Disabilities/genetics
- Diagnosis, Differential
- Facies
- Female
- Follow-Up Studies
- Hernia, Inguinal/diagnosis
- Hernia, Inguinal/genetics
- Hernia, Inguinal/surgery
- Humans
- Hypospadias/diagnosis
- Hypospadias/genetics
- Hypospadias/surgery
- Infant
- Male
- Mediator Complex
- Muscle Hypotonia/diagnosis
- Muscle Hypotonia/genetics
- Mutation
- Phenotype
- Receptors, Thyroid Hormone/genetics
- Referral and Consultation
- Sex Chromosome Aberrations
- Syndrome
- Testicular Hydrocele/diagnosis
- Testicular Hydrocele/genetics
- Testicular Hydrocele/surgery
- Urogenital Abnormalities/diagnosis
- Urogenital Abnormalities/genetics
- Urogenital Abnormalities/surgery
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Abstract
Spermatoceles are usually asymptomatic and often found incidentally during physical examination. We report a case of giant spermatocele that mimicked a hydrocele. A 55-year-old man suffered from right scrotal enlargement for several years. As the heavy sensation and scrotal soreness worsened in recent months, he came to our outpatient clinic for help. Hydrocele was suspected due to transilluminating appearance of the scrotal content. Surgical exploration was arranged and a giant spermatocele was found. Total excision of the spermatocele was performed and the patient recovered well. The specimen was sent for pathology and spermatocele with spermatozoa was noted.
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Abstract
PURPOSE OF REVIEW Adolescent varicocele is a common lesion which remains poorly understood. Recent research in pathophysiology and surgical management has shed new light on this increasingly diagnosed clinical entity. RECENT FINDINGS Recent research demonstrates the potential importance of heat and oxidative stress patterns on testicular dysfunction with varicocele. The importance of testicular volume differentials as a surgical indication have been demonstrated. Surgical innovations have included artery sparing, often with microscopic magnification, and enhanced identification of lymphatics to reduce hydrocele with a laparoscopic approach. SUMMARY Optimal management of adolescent varicocele is being clarified. A conservative, selective approach based on testicular volume differentials and semen analysis findings seems appropriate. Techniques affording artery and lymphatic sparing should be employed.
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Abstract
Computed tomography scout view is a mode of operating a CT system. It is generally used to prescribe CT slices and to display slice locations rather than for direct diagnosis. However, we found that a careful study of CT scout view can contribute significantly to the diagnosis. We show seven abdominal, two chest and two head CT, where the study of CT scout view allowed diagnoses to be made that were not readily apparent from the axial slices.
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Abdomino-scrotal hydrocele in 35 years old: a case report. Kathmandu Univ Med J (KUMJ) 2007; 5:237-239. [PMID: 18604027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Abdomino-scrotal hydrocele is a condition usually affecting children. It is unusual to find an abdomino-scrotal hydrocele in middle aged adult. Most of the patients are asymptomatic except cystic abdominal mass and discomfort occasionally. We hereby report an unusual presentation of abdomino-scrotal hydrocele at age of 35 years and presenting as large cystic abdominal mass extending into scrotum.
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Paratesticular myxoid liposarcoma: a case report. INDIAN J PATHOL MICR 2007; 50:387-8. [PMID: 17883085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
Liposarcoma of the paratesticular region is a rare malignant soft tissue neoplasm. Out of all the possible sites of liposarcoma, the incidence in spermatic cord is rare, accounting for only 5% of these neoplasms. Among the various subtypes of liposarcoma described in the paratesticular region, myxoid variant of liposarcoma is seen very rarely. One such case is we ported here for its rarity and also to draw attention to the fact that, early diagnosis and complete excision carry better prognostic value.
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Abstract
The repair of inguinal hernia and hydrocele is one of the most common operations in a pediatric surgery practice. This work reviews current concepts in the management of the inguinal hernia and hydrocele. The authors describe current concepts of anesthetic management of children undergoing repair of inguinal hernia. The authors also discuss current management of the contralateral hernia, hernias in premature infants, and the management of an incarcerated hernia. In addition, the authors discuss the role of laparoscopy in the surgical treatment of an inguinal hernia and its application for investigation of the contralateral inguinal canal.
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A rare case of pancreatic pseudocyst masquerading as hydrocele. Acta Gastroenterol Belg 2006; 69:424. [PMID: 17343088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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