Magnetic resonance (MR) imaging of the scrotum represents an important supplemental diagnostic tool in the evaluation of scrotal diseases. Diffusion-weighted (DW) MR imaging is a developing technique, proved to im...Magnetic resonance (MR) imaging of the scrotum represents an important supplemental diagnostic tool in the evaluation of scrotal diseases. Diffusion-weighted (DW) MR imaging is a developing technique, proved to improve tissue characterization. We evaluated the feasibility and diagnostic performance of DW MR imaging in the detection and characterization of scrotal lesions. We retrospectively evaluated 31 scrotal lesions (23 intratesticular and 8 extratesticular) in 26 men. All MR examinations were performed on a 1.5-T unit, using a pelvic-phased array coil. DW sequences were obtained using a single shot, multislice spin echo planar diffusion pulse sequence and a b factor of 0 and 900 s mm-2. The DW MR characteristics and the apparent diffusion coefficient (ADC) values of normal scrotal contents and scrotal diseases were evaluated. Comparison between the ADC values of normal scrotum, benign lesions and scrotal malignancies was performed. The accuracy of conventional sequences, DW images alone and DW imaging combined with conventional images in differentiating benign from malignant scmtal lesions was calculated. The ADC values of testicular malignancies were different from those of normal testis and benign intratesticular lesions, and the ADC values of benign extratesticular lesions from those of normal epididymis (P〈0.05). The overall accuracy of conventional imaging, DW imaging alone and DW MR combined with conventional sequences in the characterization of intratesticular lesions was 91%, 87% and 100%, respectively. Our findings suggest that DW MR imaging and ADC values may provide valuable information in the diagnosis and characterization of scrotal diseases.展开更多
Aim: To investigate age-related inflammatory events in the male genital tract. Methods: In a total of 4 265 randomly collected patients attending the andrological outpatient clinic of the Center for Dermatology and ...Aim: To investigate age-related inflammatory events in the male genital tract. Methods: In a total of 4 265 randomly collected patients attending the andrological outpatient clinic of the Center for Dermatology and Andrology, University of Giessen, Germany, ejaculate volume, pH-value, sperm concentration, total and progressive sperm motility, concentration of polymorphonuclear (PMN) elastase, number of peroxidase-positive cells and fructose were measured and correlated with patient's age. Results: While ejaculate volume, motility and fructose all correlated negatively with age, sperm concentration, PMN elastase and the pH-value showed a positive correlation. The prevalence of male genital tract inflammation (as defined by PMN elastase 〉 250 ng/mL) and its severity increased significantly. PMN elastase did not correlate with sperm motility. Fructose as a marker of seminal vesicle function showed a significant negative relationship with the PMN elastase levels, the number of peroxidase-positive cells and sperm motility. Conclusion: The significant increases of PMN elastase levels as marker of male genital tract inflammation in older men appear to be indicative of age-related changes in local immunoregulatory mechanisms. Because there is no association of PMN elastase with sperm motility, a direct inhibitory effect of this enzyme can be excluded.展开更多
Background Genital prolapse affects 30% of middle-aged and older women and is becoming a major public health concern. Sacrospinous ligament fixation is an effective and safe procedure for vaginal vault prolaps with a ...Background Genital prolapse affects 30% of middle-aged and older women and is becoming a major public health concern. Sacrospinous ligament fixation is an effective and safe procedure for vaginal vault prolaps with a low recurrence and complication rate. This study aimed to investigate the efficacy and safety of unilateral sacrospinous ligament fixation (SSLF) for the management of pelvic organ prolapse (POP).Methods Forty patients with severe prolapse of pelvic organ undergoing unilateral SSLF were retrospectively studied.In this study, all patients were staged by the value of POP-Q. All procedures were performed by a senior physician. The characteristics of these patients and their immediate and short-term post-operative outcome were recorded. All patients were seen six weeks and six months after the surgery. The evaluation included standardized questionnaire and site-specific vaginal examination by one physician.Results The average operation time was 65-92 minutes. The average blood loss was 83-188 ml. The average hospitalization time was 6.1 days. The average cost was 5885 yuan. The average day of urethral catheter removal after the operation was 2.1 days. The incidence of postoperative morbidity was 17.1%. One (2.4%) patient had hematoma in the right pelvic. The mean length of postoperative follow-up for 35 patients was 13.1 months. The rate of follow-up was 87.5%. One (2.9%) patient showed recurrent vaginal vault prolapse six months after the surgery. The objective success rate of pelvic organ prolapse was 85% (34/40). There was significant difference between the POP-Q of Aa, Ba, Ap, Bp,and D before and after operation (P 〈0.001 ). Five (14.3%) patients complained lower back pain, gluteal pain or right groin pain. Three (8.6%) patients developed de novo stress incontinence. Vaginal disabsorbable sutures were found in three (8.6%) patients. One (2.9%) patient had de novo urge incontinence.Conclusions Unilateral SSLF was both cost and treatment effective management fo展开更多
Male circumcision (MC) is reported to reduce human papillomavirus (HPV) prevalence in men. However, the efficacy remains imprecise. The aim of this study was to conduct a systematic review and meta-analysis to ass...Male circumcision (MC) is reported to reduce human papillomavirus (HPV) prevalence in men. However, the efficacy remains imprecise. The aim of this study was to conduct a systematic review and meta-analysis to assess the relationship between MC and genital HPV infection and genital warts. PUBMED, EMBASE, and Web of Science were searched from inception to March 22, 2015. We identified 30 papers, including a total of 12149 circumcised and 12252 uncircumcised men who were evaluated for the association of circumcision with genital HPV or genital warts. Compared with men who were not circumcised, circumcised men may have had significantly reduced odds of genital HPV prevalence (odds ratio [OR]: 0.68; 95% confidence interval [95% CI]: 0.56-0.82). There was no significant association between MC and genital HPV acquisition of new infections (OR: 0.99; 95% CI: 0.62-1.60), genital HPV clearance (OR: 1.38; 95% Ch 0.96-1.97), and prevalence of genital warts (OR: 1.17; 95% CI: 0.63-2.17). This meta-analysis suggests that circumcision reduces the prevalence of genital HPV infections. However, no clear evidence was found that circumcision was associated with decreased HPV acquisition, increased HPV clearance, or decreased the prevalence of genital warts. More studies are required to evaluate adequately the effect of MC on the acquisition and clearance of HPV infections and prevalence of genital warts.展开更多
To study the clinicopathologic features and immunoprofile of angiomyofibroblastoma (AMF) with emphasis on differential diagnosis Methods Seven vulvar, two vaginal and one perineal angiomyofibroblastomas were evaluat...To study the clinicopathologic features and immunoprofile of angiomyofibroblastoma (AMF) with emphasis on differential diagnosis Methods Seven vulvar, two vaginal and one perineal angiomyofibroblastomas were evaluated by light microscopy and immunohistochemistry The immunohistochemical studies were performed on paraffin embedded sections using the standard ABC method with a panel of antibodies Results Angiomyofibroblastoma predominantly occurred in middle aged women in the genital region, especially in the superficial area of the vulva Clinically, most of the tumors presented as slowly growing painless masses and were often diagnosed as Bartholin's gland cysts Histologically, the tumors were all well circumscribed and characterized by alternating hypocellular and hypercellular areas with abundant thin walled blood vessels The tumor cells were bland and spindle shaped or epithelioid and tended to concentrate around the vessels or cluster in small nests Immunohistochemically, the tumor cells expressed vimentin and estrogen receptor protein in all 10 cases and desmin in 9 cases Three cases showed weak or focal immunoreactivity to alpha smooth muscle actin and muscle specific actin All ten patients were treated by local excision Follow up showed a benign course with no signs of recurrence Conclusions Angiomyofibroblastoma is a distinctive neoplasm that has a propensity to occur in the female genital tract Recognition of this entity is important to avoid misdiagnosis with other vulvar angiomyxoid neoplasms展开更多
To evaluate the anesthetic effect of ultrasound-guided(USG)ilioinguinal/iliohypogastric nerve(Ⅱ/IHN)block combined with genital branch of genitofemoral nerve(GFN)block in the elderly undergoing inguinal hernia repair...To evaluate the anesthetic effect of ultrasound-guided(USG)ilioinguinal/iliohypogastric nerve(Ⅱ/IHN)block combined with genital branch of genitofemoral nerve(GFN)block in the elderly undergoing inguinal hernia repair,54 old patients(aged 60-96years,ASAⅠ-Ⅲ)with indirect hernia were enrolled and scheduled for unilateral tensiofree herniorrhaphy.Patients were grouped randomly to receive either USGⅡ/IHN plus GFN block(Group G)or USGⅡ/IHN block alone(GroupⅠ).The intraoperative visual analogue scale(VAS)scores were recorded at skin incision,at spermatic cord/round ligament traction and at sac ligation.The resting and dynamic VAS scores were recorded postoperatively.The requirements of extra sedatives and analgesics for intra-and postoperative analgesia were assessed.Occurrence of complications of the block,postoperative nausea and vomiting and femoral nerve palsy was also reported.Both groups showed similar sensory block.When stretching spermatic cord/round ligament,the patients in group G had significantly lower VAS scores than in group.And group G used much fewer adjuvant sedatives and analgesics to achieve adequate anaesthesia.In addition,group G was presented with better intraoperative anaesthesia and lower postoperative dynamic VAS scores at all time points tested.No significant difference was found in the postoperative requirement of rescue medication.Both groups showed no complications related to the block and group G reported no femoral nerve palsy.The addition of GFN block toⅡ/IHN block improves the quality of perioperative anesthesia and analgesia in the elderly and reduces the consumption of extra sedatives and analgesics during the surgery.展开更多
The male and female reproductive tracts are complex microenvironments that have diverse functional demands. The immune system in the reproductive tract has the demanding task of providing a protective environment for ...The male and female reproductive tracts are complex microenvironments that have diverse functional demands. The immune system in the reproductive tract has the demanding task of providing a protective environment for a fetal allograft while simultaneously conferring protection against potential pathogens. As such, it has evolved a unique set of adaptations, primarily under the influence of sex hormones, which make it distinct from other mucosal sites. Here, we discuss the various components of the immune system that are present in both the male and female reproductive tracts, including innate soluble factors and cells and humoral and cell-mediated adaptive immunity under homeostatic conditions. We review the evidence showing unique phenotypic and functional characteristics of immune cells and responses in the male and female reproductive tracts that exhibit compartmentalization from systemic immunity and discuss how these features are influenced by sex hormones. We also examine the interactions among the reproductive tract, sex hormones and immune responses following HIV-1 infection. An improved understanding of the unique characteristics of the male and female reproductive tracts will provide insights into improving clinical treatments of the immunological causes of infertility and the design of prophylactic interventions for the prevention of sexually transmitted infections.展开更多
The aims of this study were (a) to determine the prevalence of subjects with semen hyperviscosity (SHV) in a large population of male partners of subfertile couples; (b) to identify any correlation between SHV a...The aims of this study were (a) to determine the prevalence of subjects with semen hyperviscosity (SHV) in a large population of male partners of subfertile couples; (b) to identify any correlation between SHV and infections or inflammation of the genital tract; (c) to assess the effects of therapeutic approaches for treating SHV; and (d) to assess sperm kinetic parameters after successful treatment of SHV. A retrospective study of 1 833 male partners of subfertile couples was conducted. Next, clinical, seminal, bacteriological and ultrasound studies involving 52 subjects suffering from SHV were performed, and the SHV was classified as being mild (length of thread 〉 2 cm and ≤4 cm), moderate (〉 4 cm and ≤ 6 cm) or severe (〉 6 cm). The prevalence of SHV was observed in 26.2% (480) of the subjects, with 13.2% suffering from mild, 6.6% from moderate and 6.4% from severe SHV. Treatment was completely successful in only 27 subjects (52.0%), primarily in those who had mild basal SHV with a positive semen culture. In these subjects, progressive motility percentage, straight line velocity and linearity were significantly higher than pre-treatment levels. SHV is often found in subjects with subfertility. Pathogenesis was strictly related to infective/inflammatory factors in only 48.0% of cases; therefore, it is possible that biochemical, enzymatic or genetic factors have a role in this condition.展开更多
Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. Whe...Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. When present, these neoplasms often manifest with nonspecific signs and symptoms such as pain, itching, swelling, single-focus lesions, bleeding, and enlargement of inguinal lymph nodes, in addition to the presence of progressively enlarging vulvar nodules. Consequently, the diagnostic investigation involves histopathological examination and confirmation through immunohistochemistry. Objective: To present a comprehensive understanding of this rarely studied pathology. The primary objective is to provide valuable insights that could aid in the future development of universally applicable treatment guidelines. Case Presentation: A 57-year-old female, with no prior comorbidities, menopause at 36, who presented with a left vulvar nodule accompanied by intense pain and swelling, later diagnosed with small cell neuroendocrine carcinoma in the vulva. Conclusion: This case report highlights the importance of enhancing our knowledge regarding small cell neuroendocrine carcinoma in the vulva, given its scarcity in medical literature. The information presented here underscores the need for standardized diagnostic and treatment approaches, paving the way for future consensus on managing this uncommon but challenging neoplasm.展开更多
Background: In Africa, female genital mutilation (FGM) is a widespread and harmful practice, with Somalia having the highest incidence at 98%. This practice has severe and long-lasting physical and mental health conse...Background: In Africa, female genital mutilation (FGM) is a widespread and harmful practice, with Somalia having the highest incidence at 98%. This practice has severe and long-lasting physical and mental health consequences. The aim of the study was to evaluate the different types of FGM;immediate and long-term complications associated with the practice, and identify factors related to its prevalence. Method: In a one-year cross-sectional hospital-based study, data were collected from females aged 18 - 50 with a history of FGM. Face-to-face semi-structured questionnaires were used for data collection. Data analysis was performed using SPSS version 26, utilizing univariate and bivariate analyses to identify correlations between variables, which were presented in tables. Results: In a study involving 255 female participants, 65.5% were between 18 and 30 years old. The majority (82.7%) were married, while 47.1% were illiterate. FGM cases were more prevalent in rural areas (61.6%). Among the participants, 45.1% were employed. Type 3 FGM was the most common (44.3%), followed by Type 2 (32.2%) and Type 1 (23.9%). In terms of short-term complications experienced by circumcised women, the most common were bleeding, reported by 29.8% of participants, followed by infection (25.1%), and urinary retention (19.2%). Among the long-term complications observed, recurrent vaginal infections were the most prevalent, affecting 29.8% of the surveyed females. This was episiotomy during delivery (22.3%) and genital scarring (10.2%). Conclusion: The study reveals that Type 3 FGM is highly prevalent among the surveyed females, contributing to an increased risk of recurrent vaginal infections, prolonged second stage of labor, higher likelihood of episiotomy during delivery, and genital scarring. These findings emphasize the urgent need for effective preventive strategies and implementation from both international and local organizations to eliminate the harmful practice of FGM.展开更多
文摘Magnetic resonance (MR) imaging of the scrotum represents an important supplemental diagnostic tool in the evaluation of scrotal diseases. Diffusion-weighted (DW) MR imaging is a developing technique, proved to improve tissue characterization. We evaluated the feasibility and diagnostic performance of DW MR imaging in the detection and characterization of scrotal lesions. We retrospectively evaluated 31 scrotal lesions (23 intratesticular and 8 extratesticular) in 26 men. All MR examinations were performed on a 1.5-T unit, using a pelvic-phased array coil. DW sequences were obtained using a single shot, multislice spin echo planar diffusion pulse sequence and a b factor of 0 and 900 s mm-2. The DW MR characteristics and the apparent diffusion coefficient (ADC) values of normal scrotal contents and scrotal diseases were evaluated. Comparison between the ADC values of normal scrotum, benign lesions and scrotal malignancies was performed. The accuracy of conventional sequences, DW images alone and DW imaging combined with conventional images in differentiating benign from malignant scmtal lesions was calculated. The ADC values of testicular malignancies were different from those of normal testis and benign intratesticular lesions, and the ADC values of benign extratesticular lesions from those of normal epididymis (P〈0.05). The overall accuracy of conventional imaging, DW imaging alone and DW MR combined with conventional sequences in the characterization of intratesticular lesions was 91%, 87% and 100%, respectively. Our findings suggest that DW MR imaging and ADC values may provide valuable information in the diagnosis and characterization of scrotal diseases.
文摘Aim: To investigate age-related inflammatory events in the male genital tract. Methods: In a total of 4 265 randomly collected patients attending the andrological outpatient clinic of the Center for Dermatology and Andrology, University of Giessen, Germany, ejaculate volume, pH-value, sperm concentration, total and progressive sperm motility, concentration of polymorphonuclear (PMN) elastase, number of peroxidase-positive cells and fructose were measured and correlated with patient's age. Results: While ejaculate volume, motility and fructose all correlated negatively with age, sperm concentration, PMN elastase and the pH-value showed a positive correlation. The prevalence of male genital tract inflammation (as defined by PMN elastase 〉 250 ng/mL) and its severity increased significantly. PMN elastase did not correlate with sperm motility. Fructose as a marker of seminal vesicle function showed a significant negative relationship with the PMN elastase levels, the number of peroxidase-positive cells and sperm motility. Conclusion: The significant increases of PMN elastase levels as marker of male genital tract inflammation in older men appear to be indicative of age-related changes in local immunoregulatory mechanisms. Because there is no association of PMN elastase with sperm motility, a direct inhibitory effect of this enzyme can be excluded.
文摘Background Genital prolapse affects 30% of middle-aged and older women and is becoming a major public health concern. Sacrospinous ligament fixation is an effective and safe procedure for vaginal vault prolaps with a low recurrence and complication rate. This study aimed to investigate the efficacy and safety of unilateral sacrospinous ligament fixation (SSLF) for the management of pelvic organ prolapse (POP).Methods Forty patients with severe prolapse of pelvic organ undergoing unilateral SSLF were retrospectively studied.In this study, all patients were staged by the value of POP-Q. All procedures were performed by a senior physician. The characteristics of these patients and their immediate and short-term post-operative outcome were recorded. All patients were seen six weeks and six months after the surgery. The evaluation included standardized questionnaire and site-specific vaginal examination by one physician.Results The average operation time was 65-92 minutes. The average blood loss was 83-188 ml. The average hospitalization time was 6.1 days. The average cost was 5885 yuan. The average day of urethral catheter removal after the operation was 2.1 days. The incidence of postoperative morbidity was 17.1%. One (2.4%) patient had hematoma in the right pelvic. The mean length of postoperative follow-up for 35 patients was 13.1 months. The rate of follow-up was 87.5%. One (2.9%) patient showed recurrent vaginal vault prolapse six months after the surgery. The objective success rate of pelvic organ prolapse was 85% (34/40). There was significant difference between the POP-Q of Aa, Ba, Ap, Bp,and D before and after operation (P 〈0.001 ). Five (14.3%) patients complained lower back pain, gluteal pain or right groin pain. Three (8.6%) patients developed de novo stress incontinence. Vaginal disabsorbable sutures were found in three (8.6%) patients. One (2.9%) patient had de novo urge incontinence.Conclusions Unilateral SSLF was both cost and treatment effective management fo
文摘Male circumcision (MC) is reported to reduce human papillomavirus (HPV) prevalence in men. However, the efficacy remains imprecise. The aim of this study was to conduct a systematic review and meta-analysis to assess the relationship between MC and genital HPV infection and genital warts. PUBMED, EMBASE, and Web of Science were searched from inception to March 22, 2015. We identified 30 papers, including a total of 12149 circumcised and 12252 uncircumcised men who were evaluated for the association of circumcision with genital HPV or genital warts. Compared with men who were not circumcised, circumcised men may have had significantly reduced odds of genital HPV prevalence (odds ratio [OR]: 0.68; 95% confidence interval [95% CI]: 0.56-0.82). There was no significant association between MC and genital HPV acquisition of new infections (OR: 0.99; 95% CI: 0.62-1.60), genital HPV clearance (OR: 1.38; 95% Ch 0.96-1.97), and prevalence of genital warts (OR: 1.17; 95% CI: 0.63-2.17). This meta-analysis suggests that circumcision reduces the prevalence of genital HPV infections. However, no clear evidence was found that circumcision was associated with decreased HPV acquisition, increased HPV clearance, or decreased the prevalence of genital warts. More studies are required to evaluate adequately the effect of MC on the acquisition and clearance of HPV infections and prevalence of genital warts.
基金This study was supparted in paut by the Shanghai Medi cal Leading Speciality(No 993025).
文摘To study the clinicopathologic features and immunoprofile of angiomyofibroblastoma (AMF) with emphasis on differential diagnosis Methods Seven vulvar, two vaginal and one perineal angiomyofibroblastomas were evaluated by light microscopy and immunohistochemistry The immunohistochemical studies were performed on paraffin embedded sections using the standard ABC method with a panel of antibodies Results Angiomyofibroblastoma predominantly occurred in middle aged women in the genital region, especially in the superficial area of the vulva Clinically, most of the tumors presented as slowly growing painless masses and were often diagnosed as Bartholin's gland cysts Histologically, the tumors were all well circumscribed and characterized by alternating hypocellular and hypercellular areas with abundant thin walled blood vessels The tumor cells were bland and spindle shaped or epithelioid and tended to concentrate around the vessels or cluster in small nests Immunohistochemically, the tumor cells expressed vimentin and estrogen receptor protein in all 10 cases and desmin in 9 cases Three cases showed weak or focal immunoreactivity to alpha smooth muscle actin and muscle specific actin All ten patients were treated by local excision Follow up showed a benign course with no signs of recurrence Conclusions Angiomyofibroblastoma is a distinctive neoplasm that has a propensity to occur in the female genital tract Recognition of this entity is important to avoid misdiagnosis with other vulvar angiomyxoid neoplasms
文摘To evaluate the anesthetic effect of ultrasound-guided(USG)ilioinguinal/iliohypogastric nerve(Ⅱ/IHN)block combined with genital branch of genitofemoral nerve(GFN)block in the elderly undergoing inguinal hernia repair,54 old patients(aged 60-96years,ASAⅠ-Ⅲ)with indirect hernia were enrolled and scheduled for unilateral tensiofree herniorrhaphy.Patients were grouped randomly to receive either USGⅡ/IHN plus GFN block(Group G)or USGⅡ/IHN block alone(GroupⅠ).The intraoperative visual analogue scale(VAS)scores were recorded at skin incision,at spermatic cord/round ligament traction and at sac ligation.The resting and dynamic VAS scores were recorded postoperatively.The requirements of extra sedatives and analgesics for intra-and postoperative analgesia were assessed.Occurrence of complications of the block,postoperative nausea and vomiting and femoral nerve palsy was also reported.Both groups showed similar sensory block.When stretching spermatic cord/round ligament,the patients in group G had significantly lower VAS scores than in group.And group G used much fewer adjuvant sedatives and analgesics to achieve adequate anaesthesia.In addition,group G was presented with better intraoperative anaesthesia and lower postoperative dynamic VAS scores at all time points tested.No significant difference was found in the postoperative requirement of rescue medication.Both groups showed no complications related to the block and group G reported no femoral nerve palsy.The addition of GFN block toⅡ/IHN block improves the quality of perioperative anesthesia and analgesia in the elderly and reduces the consumption of extra sedatives and analgesics during the surgery.
文摘The male and female reproductive tracts are complex microenvironments that have diverse functional demands. The immune system in the reproductive tract has the demanding task of providing a protective environment for a fetal allograft while simultaneously conferring protection against potential pathogens. As such, it has evolved a unique set of adaptations, primarily under the influence of sex hormones, which make it distinct from other mucosal sites. Here, we discuss the various components of the immune system that are present in both the male and female reproductive tracts, including innate soluble factors and cells and humoral and cell-mediated adaptive immunity under homeostatic conditions. We review the evidence showing unique phenotypic and functional characteristics of immune cells and responses in the male and female reproductive tracts that exhibit compartmentalization from systemic immunity and discuss how these features are influenced by sex hormones. We also examine the interactions among the reproductive tract, sex hormones and immune responses following HIV-1 infection. An improved understanding of the unique characteristics of the male and female reproductive tracts will provide insights into improving clinical treatments of the immunological causes of infertility and the design of prophylactic interventions for the prevention of sexually transmitted infections.
文摘The aims of this study were (a) to determine the prevalence of subjects with semen hyperviscosity (SHV) in a large population of male partners of subfertile couples; (b) to identify any correlation between SHV and infections or inflammation of the genital tract; (c) to assess the effects of therapeutic approaches for treating SHV; and (d) to assess sperm kinetic parameters after successful treatment of SHV. A retrospective study of 1 833 male partners of subfertile couples was conducted. Next, clinical, seminal, bacteriological and ultrasound studies involving 52 subjects suffering from SHV were performed, and the SHV was classified as being mild (length of thread 〉 2 cm and ≤4 cm), moderate (〉 4 cm and ≤ 6 cm) or severe (〉 6 cm). The prevalence of SHV was observed in 26.2% (480) of the subjects, with 13.2% suffering from mild, 6.6% from moderate and 6.4% from severe SHV. Treatment was completely successful in only 27 subjects (52.0%), primarily in those who had mild basal SHV with a positive semen culture. In these subjects, progressive motility percentage, straight line velocity and linearity were significantly higher than pre-treatment levels. SHV is often found in subjects with subfertility. Pathogenesis was strictly related to infective/inflammatory factors in only 48.0% of cases; therefore, it is possible that biochemical, enzymatic or genetic factors have a role in this condition.
文摘Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. When present, these neoplasms often manifest with nonspecific signs and symptoms such as pain, itching, swelling, single-focus lesions, bleeding, and enlargement of inguinal lymph nodes, in addition to the presence of progressively enlarging vulvar nodules. Consequently, the diagnostic investigation involves histopathological examination and confirmation through immunohistochemistry. Objective: To present a comprehensive understanding of this rarely studied pathology. The primary objective is to provide valuable insights that could aid in the future development of universally applicable treatment guidelines. Case Presentation: A 57-year-old female, with no prior comorbidities, menopause at 36, who presented with a left vulvar nodule accompanied by intense pain and swelling, later diagnosed with small cell neuroendocrine carcinoma in the vulva. Conclusion: This case report highlights the importance of enhancing our knowledge regarding small cell neuroendocrine carcinoma in the vulva, given its scarcity in medical literature. The information presented here underscores the need for standardized diagnostic and treatment approaches, paving the way for future consensus on managing this uncommon but challenging neoplasm.
文摘Background: In Africa, female genital mutilation (FGM) is a widespread and harmful practice, with Somalia having the highest incidence at 98%. This practice has severe and long-lasting physical and mental health consequences. The aim of the study was to evaluate the different types of FGM;immediate and long-term complications associated with the practice, and identify factors related to its prevalence. Method: In a one-year cross-sectional hospital-based study, data were collected from females aged 18 - 50 with a history of FGM. Face-to-face semi-structured questionnaires were used for data collection. Data analysis was performed using SPSS version 26, utilizing univariate and bivariate analyses to identify correlations between variables, which were presented in tables. Results: In a study involving 255 female participants, 65.5% were between 18 and 30 years old. The majority (82.7%) were married, while 47.1% were illiterate. FGM cases were more prevalent in rural areas (61.6%). Among the participants, 45.1% were employed. Type 3 FGM was the most common (44.3%), followed by Type 2 (32.2%) and Type 1 (23.9%). In terms of short-term complications experienced by circumcised women, the most common were bleeding, reported by 29.8% of participants, followed by infection (25.1%), and urinary retention (19.2%). Among the long-term complications observed, recurrent vaginal infections were the most prevalent, affecting 29.8% of the surveyed females. This was episiotomy during delivery (22.3%) and genital scarring (10.2%). Conclusion: The study reveals that Type 3 FGM is highly prevalent among the surveyed females, contributing to an increased risk of recurrent vaginal infections, prolonged second stage of labor, higher likelihood of episiotomy during delivery, and genital scarring. These findings emphasize the urgent need for effective preventive strategies and implementation from both international and local organizations to eliminate the harmful practice of FGM.