Context and Objective: Groin hernia is a common pathology in visceral surgery (2nd rank after appendicitis), which affects approximately 4.6% of the African population. Restoring the normal anatomy of the groin region...Context and Objective: Groin hernia is a common pathology in visceral surgery (2nd rank after appendicitis), which affects approximately 4.6% of the African population. Restoring the normal anatomy of the groin region is one of the most benign interventions. However, uro-andrological complications are possible. This study aimed to contribute to the improvement of the management of urogenital complications of groin hernia surgery. Patients and Method: We carried out a prospective study of descriptive type with a duration of 6 months from 1 August 2021 to 31 January 2022. The data were collected using a pre-established survey sheet. The study covered several sites (public hospitals and private clinics) in Guinea. Results: The urogenital complications of the surgery of the hernia of the groin represented 15.22% or 14 cases out of 92 patients. The average age was 37.00 years with extremes of 20-69 years. Polygamists occupied the first place. The reason for consultation was dominated by decreased testicular volume (42.86%), followed by a desire to conceive (21.43%). Unilateral testicular atrophy represented 63.64%, bilateral 27.27%. We performed a left orchidectomy in one patient and a cystorraphy in another simple operative follow-up. The other cases consisting of testicular atrophy, due to lack of a suitable technical platform, did not benefit from any specific therapeutic treatment. Conclusion: Urogenital complications of groin hernia surgery are relatively common. Testicular atrophy was the main clinical complication. The left orchidectomy and cystorraphy were the therapeutic procedures performed.展开更多
Background: Burkitt’s lymphoma of the testis (TBL) is a rare and extremely aggressive malignant usually diagnosed in front of a testicular mass. We describe an interesting single case of TBL managed by a combined mul...Background: Burkitt’s lymphoma of the testis (TBL) is a rare and extremely aggressive malignant usually diagnosed in front of a testicular mass. We describe an interesting single case of TBL managed by a combined multimodal approach with a review of the literature. Case Report: A patient aged 69-year-old male, newly hypertensive, who presented with a twelve-month history of right testis progressive painful scrotal swelling, which worsens following a motorbike accident. Clinical examination revealed a large tender mass in an erythematous right scrotal bursa. A scrotal ultrasound showed a right heterogenous intra-testicular mass. The patient underwent unilateral (right) radical orchiectomy. Histopathological examination revealed presence of monomorphic lymphoid cells, with moderate to increased size, dissociated inconstantly by macrophages consistent with a Burkitt’s-like non-Hodgkin Lymphoma. After surgery, the patient was transferred to oncologist for adjuvant chemotherapy. Conclusion: A testicular mass is a usual circumstance for the discovery of a primary tumour of the testicle. Burkitt’s testicular lymphoma is a rare tumour whose diagnosis is based on histological findings. There are non-consensual etiological or predisposing factors. The treatment depends imperatively on the stage of the disease. Therapeutic modalities relay on in surgical excision, chemotherapy and radiation therapy but the accurate procedures are not standardized.展开更多
Scrotal trauma in motorcycle accidents (STMA) is a rare entity in the literature. In general, trauma to the genitals is not life-threatening. However, STMA can cause rupture of the testis with consequences that can le...Scrotal trauma in motorcycle accidents (STMA) is a rare entity in the literature. In general, trauma to the genitals is not life-threatening. However, STMA can cause rupture of the testis with consequences that can lead to alteration of sexuality and reproduction. We present an STMA case managed in a rural hospital where various types of injuries arise from motorcycle accidents. A 20-year-old man without any previous pathology presented in our hospital with a swollen painful scrotum. One week prior to presentation, the patient with a speeding motorbike drove over a speed bump, and the frame of his motorcycle broke into two halves, violently striking his genitals and causing scrotal trauma. After examination and investigation, patient has consented to scrotal exploration which was carried out. A partial left orchidectomy was performed and the right testicle was healthy. The evolution was favorable and the patient was discharged on the 5th postoperative day. Prognosis at 6 months was good. It is possible that genital trauma related to motorcycle accidents will become more frequent in the future. This underscores the importance of educating motorcyclists to respect the Highway Code;and making practitioners aware of the risk of serious injury in the event of acute scrotal trauma.展开更多
The main objective of this study was to analyze the effects of sex, ovariectomy (Ovx) and orchidectomy (Orx) on antidepressant and anxiolytic effect of melatonin in forced swimming test, open field test and elevated p...The main objective of this study was to analyze the effects of sex, ovariectomy (Ovx) and orchidectomy (Orx) on antidepressant and anxiolytic effect of melatonin in forced swimming test, open field test and elevated plus maze test. Initially, 4 mg/kg of melatonin was daily administered, at 4:00 pm, to intact male and female rats during 8 weeks. Our results have shown that the effect of chronic injection of Mel is sex dependent in the three behaviors tests. Females rats have responded better than males in behavior test study after administration of melatonin, this difference between the sexes may be related to the action of sex hormones (androgens and estrogens) on behavior in males as well as in females. Secondly, to determine the possible interaction between Melatonin and steroid hormones, Ovx/sham female received Mel at dose of 4mg/kg alone or NaCl (0.9%) alone, and Orx/sham male received Mel at dose of 4 mg/kg alone or NaCl (0.9%) alone daily and during 8 weeks of treatment at 4:00 pm. All animals were tested in the open-field test, elevated plus maze test for anxiety behavior study, and forced swimming test for depression behavior study. Results revealed that Mel exerts an anxiolytic and antidepressant effects in the orchidectomized males and in intact females, confirming that the suppression of androgens by orchidectomy improved anxiolytic and antidepressant effects of melatonin in males. However in females, the suppression of estrogen by ovariectomy masked the antidepressant and anxiolytic effects of melatonin. Our results confirmed that the antidepressant and anxiolytic effects of melatonin are linked to sex hormones.展开更多
Background Epidemiological study showed that the use of angiotensin-converting enzyme inhibitors was associated with higher bone mineral density （BMD） in older people, especially male subjects, which suggested that ...Background Epidemiological study showed that the use of angiotensin-converting enzyme inhibitors was associated with higher bone mineral density （BMD） in older people, especially male subjects, which suggested that angiotensin II may have a detrimental effect on bone. Therefore, blocking its effect may have a beneficial effect on bone health. Methods Six-month-old male spontaneously hypertensive rats （SHR） and normotensive Wistar Kyoto rats （WKY） were used. Animals of each model were randomly assigned to the following four groups： Group 1, SHAM operated＋vehicle; Group 2, orchidectomy （ORX）＋vehicle; Group 3, ORX＋low-dose Iosartan （10 mg.kgl.dl）; and Group 4, ORX＋high-dose Iosartan （25 mg-kg-l.d-1）. Blood pressure was recorded weekly. SHAM and ORX operations were performed, followed by daily Iosartan and vehicle treatment from day 4 after operation for 16 weeks. Serum and 24-hour urine samples were collected for measurement of bone turnover markers before euthanasia and then the left femur was collected for measurements of BMD and microarchitecture before mechanical test. Results Urine deoxypyridinoline/urine creatinine （DPD/Cr） ratio was significantly higher in SHR than in WKY. BMD and microarchitecture parameters also showed bone deterioration in SHR. After ORX, serum osteocalcin concentration decreased and urine DPD/Cr ratio increased significantly accompanied by a significant decrease in cortical and trabecular BMD and cortical bone thickness in both WKY and SHR. High-dose Iosartan significantly increased DPD in urine in both SHR and WKY. Apart from marginal favorable changes in bone architecture in WKY treated with high-dose Iosartan, Iosartan did not show significant effect on BMD, bone area, bone microarchitecture, and mechanical properties in both SHR and WKY. Conclusion Angiotensin II type I receptor blocker Iosartan was not able to demonstrate significant effect on ORX-induced bone deterioration in both hypertensive and normotensive rats.展开更多
OBJECTIVE: To determine whether the central nervous system is involved in the effect of Chinese herbal medicine on sexual function recovery in orchidectomized rats.METHODS: Orchidectomized rats were administered intra...OBJECTIVE: To determine whether the central nervous system is involved in the effect of Chinese herbal medicine on sexual function recovery in orchidectomized rats.METHODS: Orchidectomized rats were administered intragastrically with a decoction of "kidneynourishing" Chinese herbal medicine once per day for 28 days. Accessory genital organ weight, plasma testosterone, and mating behavior were investigated. The expression of c-Fos and neuronal nitric oxide synthase(n NOS) in neuronal cells in the nucleus accumbens(NAc) was analyzed by immunohistochemistry.RESULTS: There was a decrease in accessory genital organ weight, plasma testosterone, and sexual behavior, as well as a low number of c-Fos-positive cells and a large n NOS-positive cell area in orchidectomized rats. Administration of the herbal medicine increased accessory genital organ weight, testosterone level, mating behavior, and c-Fos-positive cell number, while it decreased the n NOS-positive cell area in orchidectomized rats.CONCLUSION: An increase of plasma testosterone after administration of "kidney-nourishing" herbal medicine might contribute to the elevated sexual function and activity in orchidectomized rats. In addition, a central nervous system mechanism, such as the functional alteration of NAc, might be involved.展开更多
Introduction: Testicular torsion is a surgical emergency which requires early diagnosis and prompt surgical management to avoid testicular damage. The aim of this study is to survey the clinical findings and outcome o...Introduction: Testicular torsion is a surgical emergency which requires early diagnosis and prompt surgical management to avoid testicular damage. The aim of this study is to survey the clinical findings and outcome of the patients treated for testicular torsion in a university hospital in Babol, northern Iran. Methods: In this cross sectional study, a retrospective survey of all cases presenting with acute scrotum and primarily diagnosed as testicular torsion was conducted during 2001 and 2012 in Babol, northern Iran. All 103 cases were reviewed and several clinical data, including duration of symptoms and operative findings were collected. Findings: Of 103 patients who presented to the emergency department with acute scrotum, the median age of the cases was 16.0 years. Thirty four percent of the patients presented emergency unit less than 6 hours from symptom exposure. Pain (95.1%) was the major symptom in all patients. Surgery revealed that 72 (70.9%) cases were diagnosed firmly as testicular torsion that 23 patients underwent orchidectomy for a necrotic torsed testis. There were significant differences between orchiectomized versus non-orchiectomized torsion cases in affected side, symptom presentation to operation time. Conclusion: According to our results more than half of the cases presented more than in the golden time. Late presentation to hospital was the major cause of delay leading to orchidectomy in patients with testicular torsion. Greater effort in health education and direct or selfreferal to hospital may reduce this delay.展开更多
<strong>Background:</strong> The traumas of scrotum are often traumas caused by accidents on the public highway or in sport. However, fractures of the penis are secondary to a direct trauma to the penis wi...<strong>Background:</strong> The traumas of scrotum are often traumas caused by accidents on the public highway or in sport. However, fractures of the penis are secondary to a direct trauma to the penis with rupture of the albuginea causing hematoma, pain and deviation of the penis. Animal bites are rare. <strong>Purpose:</strong> To describe the management of traumatic emergencies of the external genital organs at the CHU Bouaké. <strong>Patients and Methods:</strong> Retrospective and descriptive study on the patients treated at Bouaké University Hospital for traumatic emergencies of the external genital organs during the period from January 01, 2012 to December 31, 2018. The parameters studied were epidemiological, clinical and therapeutic. <strong>Results:</strong> The study period registered 26 patients. The mean age was 34.5 years, Closed trauma to the scrotum was a frequent reason with 30.8%, the trauma sat on the scrotum in 53.8%, the penis in 42.3%, the vulva in 3.8% of cases. The circumstances of discovery of trauma to the penis were dominated by coitus missteps (45.5%), on the stock exchange and vulva by accidents on the public highway (60.8%). Scrotal swelling was the frequent clinical sign (26.9%). Treatment was dominated by surgery in 92.30%. Seven patients (29.16%) underwent exploratory scrototomy associated with hematoma evacuation, five patients (20.83%), a simple trimming, five patients (20.83%), an evacuation of the hematoma associated with a cavernous suture, one patient (4.16%), a trimming associated with a suture of the vulva, one patient (4.16%), a trimming associated with a right orchiectomy. The hospital stay was less than 5 days. The course was simple in 92.30% of the cases;two patients (7.7%) had complications such as testicular necrosis and atrophy which have been treated by orchidectomy. <strong>Conclusion:</strong> Traumatic emergencies of the external genitalia are rare but serious. Treatment is dominated by surgery.展开更多
Objective: To report our experience of a contemporary series of patients who underwent radical orchidectomy for non-palpable testicular masses, in order to comment on their malignant potential and identify any factors...Objective: To report our experience of a contemporary series of patients who underwent radical orchidectomy for non-palpable testicular masses, in order to comment on their malignant potential and identify any factors predictive of a malignant outcome. Materials and Methods: We reviewed the case-notes of patients who underwent radical inguinal orchidectomy over a 22-month period between January 2010 and October 2011. Results: A total of 71 patients were analysed, with a mean (range) age of 45 years (17 - 82). Overall, 41 (57.7%) orchidectomies were malignant and 30 (42.3%) were benign. There were 20 (28%) non-palpable testicular masses found incidentally on ultrasound, and of these 40% were malignant and 60% were benign. In total 6 of these non-palpable lesions were <1 cm in size, and of these 66.6% were malignant and 33.3% were benign. The majority of tumours were in patients under the age of 50, but there was no correlation between the lesion size and the risk of a malignant outcome. Conclusion: In view of the significant rate of malignancy in non-palpable testicular masses we recommend surgical intervention over surveillance alone. However, as the majority of these lesions may eventually turn out to be benign, we suggest that testis-sparing surgery is the optimal approach, and should be performed in centres where the required radiological, histopathological, and surgical expertise exists.展开更多
文摘Context and Objective: Groin hernia is a common pathology in visceral surgery (2nd rank after appendicitis), which affects approximately 4.6% of the African population. Restoring the normal anatomy of the groin region is one of the most benign interventions. However, uro-andrological complications are possible. This study aimed to contribute to the improvement of the management of urogenital complications of groin hernia surgery. Patients and Method: We carried out a prospective study of descriptive type with a duration of 6 months from 1 August 2021 to 31 January 2022. The data were collected using a pre-established survey sheet. The study covered several sites (public hospitals and private clinics) in Guinea. Results: The urogenital complications of the surgery of the hernia of the groin represented 15.22% or 14 cases out of 92 patients. The average age was 37.00 years with extremes of 20-69 years. Polygamists occupied the first place. The reason for consultation was dominated by decreased testicular volume (42.86%), followed by a desire to conceive (21.43%). Unilateral testicular atrophy represented 63.64%, bilateral 27.27%. We performed a left orchidectomy in one patient and a cystorraphy in another simple operative follow-up. The other cases consisting of testicular atrophy, due to lack of a suitable technical platform, did not benefit from any specific therapeutic treatment. Conclusion: Urogenital complications of groin hernia surgery are relatively common. Testicular atrophy was the main clinical complication. The left orchidectomy and cystorraphy were the therapeutic procedures performed.
文摘Background: Burkitt’s lymphoma of the testis (TBL) is a rare and extremely aggressive malignant usually diagnosed in front of a testicular mass. We describe an interesting single case of TBL managed by a combined multimodal approach with a review of the literature. Case Report: A patient aged 69-year-old male, newly hypertensive, who presented with a twelve-month history of right testis progressive painful scrotal swelling, which worsens following a motorbike accident. Clinical examination revealed a large tender mass in an erythematous right scrotal bursa. A scrotal ultrasound showed a right heterogenous intra-testicular mass. The patient underwent unilateral (right) radical orchiectomy. Histopathological examination revealed presence of monomorphic lymphoid cells, with moderate to increased size, dissociated inconstantly by macrophages consistent with a Burkitt’s-like non-Hodgkin Lymphoma. After surgery, the patient was transferred to oncologist for adjuvant chemotherapy. Conclusion: A testicular mass is a usual circumstance for the discovery of a primary tumour of the testicle. Burkitt’s testicular lymphoma is a rare tumour whose diagnosis is based on histological findings. There are non-consensual etiological or predisposing factors. The treatment depends imperatively on the stage of the disease. Therapeutic modalities relay on in surgical excision, chemotherapy and radiation therapy but the accurate procedures are not standardized.
文摘Scrotal trauma in motorcycle accidents (STMA) is a rare entity in the literature. In general, trauma to the genitals is not life-threatening. However, STMA can cause rupture of the testis with consequences that can lead to alteration of sexuality and reproduction. We present an STMA case managed in a rural hospital where various types of injuries arise from motorcycle accidents. A 20-year-old man without any previous pathology presented in our hospital with a swollen painful scrotum. One week prior to presentation, the patient with a speeding motorbike drove over a speed bump, and the frame of his motorcycle broke into two halves, violently striking his genitals and causing scrotal trauma. After examination and investigation, patient has consented to scrotal exploration which was carried out. A partial left orchidectomy was performed and the right testicle was healthy. The evolution was favorable and the patient was discharged on the 5th postoperative day. Prognosis at 6 months was good. It is possible that genital trauma related to motorcycle accidents will become more frequent in the future. This underscores the importance of educating motorcyclists to respect the Highway Code;and making practitioners aware of the risk of serious injury in the event of acute scrotal trauma.
文摘The main objective of this study was to analyze the effects of sex, ovariectomy (Ovx) and orchidectomy (Orx) on antidepressant and anxiolytic effect of melatonin in forced swimming test, open field test and elevated plus maze test. Initially, 4 mg/kg of melatonin was daily administered, at 4:00 pm, to intact male and female rats during 8 weeks. Our results have shown that the effect of chronic injection of Mel is sex dependent in the three behaviors tests. Females rats have responded better than males in behavior test study after administration of melatonin, this difference between the sexes may be related to the action of sex hormones (androgens and estrogens) on behavior in males as well as in females. Secondly, to determine the possible interaction between Melatonin and steroid hormones, Ovx/sham female received Mel at dose of 4mg/kg alone or NaCl (0.9%) alone, and Orx/sham male received Mel at dose of 4 mg/kg alone or NaCl (0.9%) alone daily and during 8 weeks of treatment at 4:00 pm. All animals were tested in the open-field test, elevated plus maze test for anxiety behavior study, and forced swimming test for depression behavior study. Results revealed that Mel exerts an anxiolytic and antidepressant effects in the orchidectomized males and in intact females, confirming that the suppression of androgens by orchidectomy improved anxiolytic and antidepressant effects of melatonin in males. However in females, the suppression of estrogen by ovariectomy masked the antidepressant and anxiolytic effects of melatonin. Our results confirmed that the antidepressant and anxiolytic effects of melatonin are linked to sex hormones.
基金This study was partially supported by a direct research grant from The Chinese University of Hong Kong （No. 2006.2.017）, the Natural Science Foundation of Jiangsu Province, China （No. BK2010285）, and the Collegiate Natural Science Fund of Jiangsu Province, China （No. 10KJB320015）.
文摘Background Epidemiological study showed that the use of angiotensin-converting enzyme inhibitors was associated with higher bone mineral density （BMD） in older people, especially male subjects, which suggested that angiotensin II may have a detrimental effect on bone. Therefore, blocking its effect may have a beneficial effect on bone health. Methods Six-month-old male spontaneously hypertensive rats （SHR） and normotensive Wistar Kyoto rats （WKY） were used. Animals of each model were randomly assigned to the following four groups： Group 1, SHAM operated＋vehicle; Group 2, orchidectomy （ORX）＋vehicle; Group 3, ORX＋low-dose Iosartan （10 mg.kgl.dl）; and Group 4, ORX＋high-dose Iosartan （25 mg-kg-l.d-1）. Blood pressure was recorded weekly. SHAM and ORX operations were performed, followed by daily Iosartan and vehicle treatment from day 4 after operation for 16 weeks. Serum and 24-hour urine samples were collected for measurement of bone turnover markers before euthanasia and then the left femur was collected for measurements of BMD and microarchitecture before mechanical test. Results Urine deoxypyridinoline/urine creatinine （DPD/Cr） ratio was significantly higher in SHR than in WKY. BMD and microarchitecture parameters also showed bone deterioration in SHR. After ORX, serum osteocalcin concentration decreased and urine DPD/Cr ratio increased significantly accompanied by a significant decrease in cortical and trabecular BMD and cortical bone thickness in both WKY and SHR. High-dose Iosartan significantly increased DPD in urine in both SHR and WKY. Apart from marginal favorable changes in bone architecture in WKY treated with high-dose Iosartan, Iosartan did not show significant effect on BMD, bone area, bone microarchitecture, and mechanical properties in both SHR and WKY. Conclusion Angiotensin II type I receptor blocker Iosartan was not able to demonstrate significant effect on ORX-induced bone deterioration in both hypertensive and normotensive rats.
基金the Natural Science Foundation of Shanxi Province(Effects and Mechanism of Electrical Stimulation of Mesolimbic Dopaminergic Pathway on Apioid Addiction,No.2012011042-1Study on Element and Properties of Common Herb Medication Administrated Through the Skin Iontophoresis,No.2008011077-4)
文摘OBJECTIVE: To determine whether the central nervous system is involved in the effect of Chinese herbal medicine on sexual function recovery in orchidectomized rats.METHODS: Orchidectomized rats were administered intragastrically with a decoction of "kidneynourishing" Chinese herbal medicine once per day for 28 days. Accessory genital organ weight, plasma testosterone, and mating behavior were investigated. The expression of c-Fos and neuronal nitric oxide synthase(n NOS) in neuronal cells in the nucleus accumbens(NAc) was analyzed by immunohistochemistry.RESULTS: There was a decrease in accessory genital organ weight, plasma testosterone, and sexual behavior, as well as a low number of c-Fos-positive cells and a large n NOS-positive cell area in orchidectomized rats. Administration of the herbal medicine increased accessory genital organ weight, testosterone level, mating behavior, and c-Fos-positive cell number, while it decreased the n NOS-positive cell area in orchidectomized rats.CONCLUSION: An increase of plasma testosterone after administration of "kidney-nourishing" herbal medicine might contribute to the elevated sexual function and activity in orchidectomized rats. In addition, a central nervous system mechanism, such as the functional alteration of NAc, might be involved.
文摘Introduction: Testicular torsion is a surgical emergency which requires early diagnosis and prompt surgical management to avoid testicular damage. The aim of this study is to survey the clinical findings and outcome of the patients treated for testicular torsion in a university hospital in Babol, northern Iran. Methods: In this cross sectional study, a retrospective survey of all cases presenting with acute scrotum and primarily diagnosed as testicular torsion was conducted during 2001 and 2012 in Babol, northern Iran. All 103 cases were reviewed and several clinical data, including duration of symptoms and operative findings were collected. Findings: Of 103 patients who presented to the emergency department with acute scrotum, the median age of the cases was 16.0 years. Thirty four percent of the patients presented emergency unit less than 6 hours from symptom exposure. Pain (95.1%) was the major symptom in all patients. Surgery revealed that 72 (70.9%) cases were diagnosed firmly as testicular torsion that 23 patients underwent orchidectomy for a necrotic torsed testis. There were significant differences between orchiectomized versus non-orchiectomized torsion cases in affected side, symptom presentation to operation time. Conclusion: According to our results more than half of the cases presented more than in the golden time. Late presentation to hospital was the major cause of delay leading to orchidectomy in patients with testicular torsion. Greater effort in health education and direct or selfreferal to hospital may reduce this delay.
文摘<strong>Background:</strong> The traumas of scrotum are often traumas caused by accidents on the public highway or in sport. However, fractures of the penis are secondary to a direct trauma to the penis with rupture of the albuginea causing hematoma, pain and deviation of the penis. Animal bites are rare. <strong>Purpose:</strong> To describe the management of traumatic emergencies of the external genital organs at the CHU Bouaké. <strong>Patients and Methods:</strong> Retrospective and descriptive study on the patients treated at Bouaké University Hospital for traumatic emergencies of the external genital organs during the period from January 01, 2012 to December 31, 2018. The parameters studied were epidemiological, clinical and therapeutic. <strong>Results:</strong> The study period registered 26 patients. The mean age was 34.5 years, Closed trauma to the scrotum was a frequent reason with 30.8%, the trauma sat on the scrotum in 53.8%, the penis in 42.3%, the vulva in 3.8% of cases. The circumstances of discovery of trauma to the penis were dominated by coitus missteps (45.5%), on the stock exchange and vulva by accidents on the public highway (60.8%). Scrotal swelling was the frequent clinical sign (26.9%). Treatment was dominated by surgery in 92.30%. Seven patients (29.16%) underwent exploratory scrototomy associated with hematoma evacuation, five patients (20.83%), a simple trimming, five patients (20.83%), an evacuation of the hematoma associated with a cavernous suture, one patient (4.16%), a trimming associated with a suture of the vulva, one patient (4.16%), a trimming associated with a right orchiectomy. The hospital stay was less than 5 days. The course was simple in 92.30% of the cases;two patients (7.7%) had complications such as testicular necrosis and atrophy which have been treated by orchidectomy. <strong>Conclusion:</strong> Traumatic emergencies of the external genitalia are rare but serious. Treatment is dominated by surgery.
文摘Objective: To report our experience of a contemporary series of patients who underwent radical orchidectomy for non-palpable testicular masses, in order to comment on their malignant potential and identify any factors predictive of a malignant outcome. Materials and Methods: We reviewed the case-notes of patients who underwent radical inguinal orchidectomy over a 22-month period between January 2010 and October 2011. Results: A total of 71 patients were analysed, with a mean (range) age of 45 years (17 - 82). Overall, 41 (57.7%) orchidectomies were malignant and 30 (42.3%) were benign. There were 20 (28%) non-palpable testicular masses found incidentally on ultrasound, and of these 40% were malignant and 60% were benign. In total 6 of these non-palpable lesions were <1 cm in size, and of these 66.6% were malignant and 33.3% were benign. The majority of tumours were in patients under the age of 50, but there was no correlation between the lesion size and the risk of a malignant outcome. Conclusion: In view of the significant rate of malignancy in non-palpable testicular masses we recommend surgical intervention over surveillance alone. However, as the majority of these lesions may eventually turn out to be benign, we suggest that testis-sparing surgery is the optimal approach, and should be performed in centres where the required radiological, histopathological, and surgical expertise exists.
