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Erdem LO, Akduman BÜ. Intratesticular Varicocele Concomitant With Spermatocele. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2016. [DOI: 10.1177/8756479304270562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Varicocele is an abnormal dilatation of the veins of the pampiniform plexus. Intratesticular varicocele, characterized by dilated intratesticular veins, is an extremely rare disorder. This is the second reported case of intratesticular varicocele demonstrated by using power Doppler sonography. Spermatocele is a common benign retention cyst most often located in the caput epididymis. This is the first intratesticular varicocele case concomitant with spermatocele. The authors believe that power Doppler sonography and gray-scale sonography are effective, rapid methods in the diagnosis of intratesticular varicocele and spermatocele.
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Affiliation(s)
- L. Oktay Erdem
- Zonguldak Karaelmas University, Faculty of Medicine, Department of Radiology, 67600 Kozlu/Zonguldak, Turkey
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Yang JR, Wei YB, Yan B, Yin Z, Gao YL, Wang Z, Zhou KQ. Comparison between Open Epididymal Cystectomy and Minimal Resection of Epididymal Cysts Using a Scrotoscope: A Clinical Trial for the Evaluation of a New Surgical Technique. Urology 2015; 85:1510-4. [PMID: 25868737 DOI: 10.1016/j.urology.2015.03.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Revised: 03/02/2015] [Accepted: 03/03/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To provide a new surgical technique for epididymal cyst (EC) treatment and to assess its safety and efficiency. METHODS Forty-eight patients with symptomatic EC were randomized into 2 groups. One group (n = 23) received traditional open epididymal cystectomy (OEC) and the other group (n = 25) underwent minimal epididymal cystectomy with scrotoscope (MECS), which provided a clear vision of scrotal contents. Demographic information and perioperative and postoperative outcomes data were obtained and analyzed during a 2- to 6-month follow-up. RESULTS No significant differences between the OEC and MECS groups were found in demographic information. Compared with OEC group, the MECS group had a shorter operating time (18.6 ± 2.9 vs 54.5 ± 7.0 minutes; P <.05), shorter incision length (1.1 ± 0.2 vs 4.8 ± 0.6 cm; P <.05), and less blood loss (4.6 ± 1.6 vs 17.0 ± 3.1 g; P <.05). Except for the 8.0% rate (2 of 25) of scrotal edema after MECS and 17.4% rate (4 of 23) of scrotal hematoma after OEC, both groups resulted in 0% incidence of testis or epididymis injury, wound infection, and cyst recurrence based on postoperative outcome data. Significant differences were observed after MECS compared with those after OEC based on the rates of symptom relief (95.2% vs 61.1%; P <.05) and days of wound pain (12.1 ± 2.6 vs 17.7 ± 4.1 days; P <.05). CONCLUSION For the first time, our study applied scrotoscope as a new alternative technique for EC treatment. Scrotoscope provides a clear field of vision and makes tissues harvested available for pathologic examination when performing decortications of EC. The results suggest MECS may be a safe, effective, and encouraging new technique.
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Affiliation(s)
- Jin-rui Yang
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, P.R. China.
| | - Yong-bao Wei
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, P.R. China; Department of Urology, Fujian Provincial Hospital, The Teaching Hospital of Fujian Medical University, Fuzhou, P.R. China
| | - Bin Yan
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Zhuo Yin
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Yun-Liang Gao
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Zhao Wang
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Ke-qin Zhou
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, P.R. China
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Nakhal RS, Hall-Craggs M, Freeman A, Kirkham A, Conway GS, Arora R, Woodhouse CRJ, Wood DN, Creighton SM. Evaluation of Retained Testes in Adolescent Girls and Women with Complete Androgen Insensitivity Syndrome. Radiology 2013; 268:153-60. [DOI: 10.1148/radiol.13121068] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Mukherjee S, Maheshwari V, Khan R, Rizvi SAA, Alam K, Harris SH, Sharma R. Clinico-radiological and pathological evaluation of extra testicular scrotal lesions. J Cytol 2013; 30:27-32. [PMID: 23661937 PMCID: PMC3643358 DOI: 10.4103/0970-9371.107509] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Scrotal ultrasound, though reliable in distinguishing between intratesticular and extratesticular lesions and characterizing them as cystic and solid, cannot distinguish benign from malignant pathology. Although fine needle aspiration cytology (FNAC) has proved to be of great diagnostic importance in testicular lesions, its scope in extratesticular lesions is largely unexplored. Aim: To evaluate extratesticular scrotal lesions cytologically and compare it with their clinical, radiological, and histological findings. Materials and Methods: Sixty five patients with extratesticular scrotal lesions were assessed clinically, radiologically, and cytologically. Histopathology was done in 45 cases where surgical exploration was undertaken. All the data were then analyzed and correlated. Results: Extratesticular lesions accounted for 72.2% of the scrotal swellings. Of these, the epididymis is most commonly involved (61.5% cases) with the commonest type of lesion being cystic (49.3% cases). Ultrasonography preferably with color doppler is highly useful for the evaluation of the scrotum. Apart from distinguishing extratesticular from testicular and cystic from solid lesions, it has an important role in identifying individual lesions, thus reducing the list of differential diagnosis. Fine needle aspiration cytology contributed to a definitive diagnosis in 47.7% cases. It helps classify cystic masses on the basis of their contents and defines the etiology of chronic inflammatory lesions, apart from corroborating with the clinico-radiological diagnosis. Histological evaluation was possible only in cases where surgery was performed and helps further define the diagnosis. Conclusion: Fine needle aspiration cytology is essentially non-traumatic and easy to carry out and should be a technique of choice for the study of scrotal pathology, main advantage being avoidance of delays in diagnosis.
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Affiliation(s)
- Suparna Mukherjee
- Department of Pathology, Army College of Medical Sciences, Delhi Cantt, New Delhi, India
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Kletzenbauer SP, Goodfellow T. Bizarre Scrotal Sonogram. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2012. [DOI: 10.1177/8756479312455861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 48-year-old male who had undergone left inguinal orchidectomy for testicular tumor 10 days previously presented with left inguinal and scrotal swelling. The scrotal sonogram showed what appeared to be two testes, with a mass within the left testicular area. Real-time scanning revealed that the left “testis” was thick fluid/hematoma with a more organized hematoma within.
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Chronic Tuberculous Epididymo-orchitis Manifesting as a Non-Tender Scrotal Swelling: Magnetic Resonance Imaging–Histological Correlation. Urology 2008; 71:755.e5-7. [DOI: 10.1016/j.urology.2007.11.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Revised: 10/19/2007] [Accepted: 11/08/2007] [Indexed: 11/23/2022]
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Abduljaleel PM, Al-Mulhim F, Nouman A, Kharouby A, Das SC. Intratesticular varicocele and extratesticular varicocele in a patient with nephrotic syndrome complicated by left renal vein thrombosis. Ann Saudi Med 2006; 26:228-30. [PMID: 16861853 PMCID: PMC6074448 DOI: 10.5144/0256-4947.2006.228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Vasilios S, Charalampos L, Elias P, Agelos K, Koutoulidis V, Lampros V. Ultrasound findings of an intratesticular varicocele. Report of a new case and review of the literature. Int Urol Nephrol 2006; 38:115-8. [PMID: 16502064 DOI: 10.1007/s11255-005-0915-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The authors present a new case of intratesticular varicocele(ITV). The ultrasound findings on gray-scale and color Doppler imaging as well as the pertinent clinical manifestations are discussed. A review of the literature is also presented. According to our knowledge only 34 cases of ITV have been reported in the literature and the clinical significance of this lesion is not yet well established. This is the first reported case of infertility caused by a solely ITV, showing that the clinical implications of this entity may be more significant than previously thought.
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Affiliation(s)
- Skiadas Vasilios
- Radiologic Department of Aretaieion Hospital, University of Athens, Athens, Greece.
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Turgut AT, Kosar U, Kosar P, Karabulut A. Scrotal sonographic findings in equestrians. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2005; 24:911-7; quiz 919. [PMID: 15972705 DOI: 10.7863/jum.2005.24.7.911] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Sports-related injuries are among the major causes of testicular trauma. In this study, we aimed to determine sonographically whether chronic urogenital trauma during horse riding increases the prevalence of scrotal sonographic abnormalities. To our knowledge, there are no studies in the literature that have focused on this topic. METHODS Group 1 included 26 male riders with a mean age +/- SD of 31 +/- 2.9 (range, 26-38) years and with a mean riding experience of 5 +/- 2.6 (range, 1-10) years, whereas group 2 included 26 healthy nonriding men with a mean age of 31 +/- 3.2 (range, 26-41) years. After the clinical evaluation, all patients underwent scrotal sonographic examination. RESULTS The prevalence of overall scrotal sonographic abnormalities in group 1 was significantly higher than that in group 2 (77% versus 38%; P < .05). The detected sonographic findings in group 1 were varicocele (46%), hydrocele (19%), testicular cyst (4%), epididymal cyst (35%), testicular calcification (19%), epididymal calcification (8%), scrotal calculus (8%), and inhomogeneity of parenchymal echo texture (4%). However, only varicocele (19%), epididymal cyst (19%), testicular calcification (12%), and scrotal calculus (4%) were detected in group 2. Between the 2 groups, the difference was significant for varicocele prevalence (P < .05) and marginally significant for hydrocele prevalence (P = .051). CONCLUSIONS We recommend scrotal sonographic examination of equestrians when they have a palpable mass or related symptoms, the etiology of which was found in our study to be closely related to horse riding.
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Affiliation(s)
- Ahmet Tuncay Turgut
- Department of Radiology, Ankara Research and Trainign Hospital, The Ministry of Health, Ankara, Turkey.
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Abstract
Intratesticular varicocele is a rare entity and describes dilated intratesticular veins radiating from the mediastinum testis into the testicular parenchyma. Scrotal ultrasonography of two patients who presented to our urology clinic due to left scrotal pain revealed multiple tubular structures in the testes with diameters of more than 2 mm. Duplex spectral analysis showed a reversed flow response to Valsalva's maneuver. Apropos of two cases, intratesticular varicocele is reviewed.
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Affiliation(s)
- Mir Ali Pourbagher
- Department of Radiology, Baskent University, School of Medicine, Adana Research and Teaching Center, 01250 Adana, Turkey
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Kocakoc E, Kiris A, Orhan I, Bozgeyik Z, Kanbay M, Ogur E. Incidence and importance of reflux in testicular veins of healthy men evaluated with color duplex sonography. JOURNAL OF CLINICAL ULTRASOUND : JCU 2002; 30:282-287. [PMID: 12116108 DOI: 10.1002/jcu.10068] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE Reflux in the testicular veins plays a crucial role in the diagnosis of a varicocele. The aim of this study was to evaluate the incidence and the sonographic features-duration and velocity-of reflux in testicular veins of healthy men using color duplex sonography (CDS). METHODS Healthy male volunteers, 18-45 years old, whose physical examinations and semen analyses were normal, were recruited for this study. The maximum diameters of testicular veins during both normal respiration and Valsalva's maneuver were measured by CDS using a 7.5-MHz linear-array transducer. Veins greater than 2 mm in diameter were considered to be a varicocele, and the subjects in these cases were excluded from the analysis. In cases in which reflux was present, the velocity and duration of reflux in the testicular veins during Valsalva's maneuver were measured. RESULTS Seventy men, whose mean (+/- standard deviation) age was 27 +/- 7 years, were enrolled in this study. Fourteen of the 70 patients had a left varicocele and thus were excluded from the analysis. Of the 112 hemiscrotums in the remaining 56 patients, 61 (54%) had reflux induced by Valsalva's maneuver and 51 (46%) did not. Twenty-two (39%) of refluxes were on the right side, with a mean duration of 1.1 +/- 0.5 seconds, and a mean velocity of 4.2 +/- 2.1 cm/second; 39 (70%) of the refluxes were on the left side, with a mean duration of 1.1 +/- 0.5 seconds and a mean velocity of 4.9 +/- 2.3 cm/second. The incidence of reflux was significantly higher on the left side (p = 0.003). The duration and velocity of the reflux did not differ significantly between the right and left sides. The difference in the testicular vein diameters between the right (1.3 +/- 0.2 mm; n = 56) and left (1.6 +/- 0.2 mm; n = 56) sides was statistically significant (p < 0.001). CONCLUSIONS Normal-sized testicular veins in healthy subjects had a remarkably high incidence of reflux induced by Valsalva's maneuver. The presence of reflux in subfertile men with normal testicular vein diameters is a diagnostic criterion, but it is necessary to quantify the reflux to prevent misdiagnosis of a varicocele and unnecessary surgery. The measurement of the duration and velocity limits of reflux in a large series of subjects may provide a reliable indicator for the diagnosis of varicocele.
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Affiliation(s)
- Ercan Kocakoc
- Department of Radiology, Faculty of Medicine, Firat University, 23119 Elazig, Turkey
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Frauscher F, Klauser A, Stenzl A, Helweg G, Amort B, zur Nedden D. US findings in the scrotum of extreme mountain bikers. Radiology 2001; 219:427-31. [PMID: 11323467 DOI: 10.1148/radiology.219.2.r01ma42427] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To sonographically investigate whether mountain bikers have a higher prevalence of scrotal abnormalities compared with that in nonbikers. MATERIALS AND METHODS Eighty-five male mountain bikers (mean age, 25 years; age range, 17-45 years) and 31 healthy nonbikers (mean age, 24 years; age range, 15-37 years) were examined for scrotal findings at ultrasonography (US). Only male subjects with a history of extensive off-road biking (> or =2 h/d 6 d/wk; covered distance, >5,000 km/y) were assigned to the group of mountain bikers, whereas the control group did not engage in bicycling. In addition to clinical evaluation, US examination of the scrotum was performed by using a linear-array transducer operating at a frequency of 8.0 MHZ: RESULTS Eighty (94%) mountain bikers had abnormal findings at scrotal US. Thirty-nine (46%) had a history of intermittent scrotal tenderness or discomfort but no severe scrotal trauma. Abnormal findings at US included scrotal calculi in 69 (81%), epididymal cysts in 39 (46%), epididymal calcifications in 34 (40%), testicular calcifications in 27 (32%), hydroceles in 24 (28%), varicoceles in nine (11%), and testicular microlithiasis in one (1%). In the control group, abnormal findings were noted in five (16%), all of whom had epididymal cysts. The overall difference in the number of scrotal abnormalities in bikers compared with the number in nonbikers was significant (P <.0001, chi2 test). CONCLUSION US shows a significantly higher prevalence of extratesticular and testicular disorders in these mountain bikers compared with nonbikers.
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Affiliation(s)
- F Frauscher
- Department of Radiology II, University Hospital Innsbruck, Austria.
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Herrero Riquelme S, Molinero Casares MM, García Serrano J. [Ultrasonographic diagnosis of massive bladder hernia at the inguinoscrotal level: report of a case]. Actas Urol Esp 2000; 24:825-8. [PMID: 11199301 DOI: 10.1016/s0210-4806(00)72555-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We present a case of massive inguinoscrotal bladder hernia in a 58 years-old man with a left inguinal hernia. It was diagnosed by ultrasound during evaluation of a mass in the left inguinal region extending to the scrotum. Cystography later confirmed the ultrasound findings but provided no new information. Although filling cystography is considered to be the gold-standard radiological diagnostic procedure for this entity I the use of ultrasound should not be discarded. Firstly I because direct and indirect ultrasonographics signs characterising inguinal bladder hernias have been reported, and secondly I to help in the differential diagnosis of a scrotal mass.
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Ozcan H, Aytaç S, Yağci C, Türkölmez K, Koşar A, Erden I. Color Doppler ultrasonographic findings in intratesticular varicocele. JOURNAL OF CLINICAL ULTRASOUND : JCU 1997; 25:325-329. [PMID: 9142628 DOI: 10.1002/(sici)1097-0096(199707)25:6<325::aid-jcu6>3.0.co;2-e] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- H Ozcan
- Department of Radiology, Ankara University Faculty of Medicine, Ibn-i Sina Hospital, Sihhiye, Turkey
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Abstract
Although US is the method of choice in the evaluation of scrotal abnormalities, the literature is extremely poor regarding sonographic demonstration of scrotal hernias, especially bladder-containing ones. We report three cases of inguinoscrotal vesical herniation in which US was employed, proving to be satisfactory. We highlight the practical value of US, since a preoperative identification of the hernial content can avoid surgical bladder injuries and modify operative management of the herniation.
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Affiliation(s)
- O Catalano
- Department of Radiology, University of Naples Federico II, Italy
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Abstract
Ultrasound is being used with increasing frequency in the evaluation of the male reproductive tract. To detect abnormalities, it is important to have a comprehensive understanding of the normal anatomy and normal variations. In this article, the ultrasound anatomy of the scrotum, penis, prostate, and seminal vesicles is presented. Because ultrasound is a very visual process, the anatomy is presented not only with text, but also through the liberal use of ultrasound images and associated diagrams. Ultrasound is both an operator- and equipment-dependent procedure and, where appropriate, we have included technical discussions regarding ultrasound equipment and settings.
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Affiliation(s)
- R A Older
- Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908, USA
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