While we may be comfortable with an allopathic approach to male infertility, we are also responsible for knowledge about lifestyle modifications and holistic, complementary, and alternative therapies that are used by ...While we may be comfortable with an allopathic approach to male infertility, we are also responsible for knowledge about lifestyle modifications and holistic, complementary, and alternative therapies that are used by many of our patients. This paper provides an evidence-based review separating fact from fiction for several of these therapies. There is sufficient literature to support weight reduction by diet and exercise, smoking cessation, and alcohol moderation. Supplements that have demonstrated positive effects on male fertility on small randomized controlled trial （RCT） include aescin, coenzyme Qlo, glutathione, Korean red ginseng, L-carnitine, nigella sativa, omega-3, selenium, a combination of zinc and folate, and the Menevit antioxidant. There is no support for the use of Vitamin C, Vitamin E, or saffron. The data for Chinese herbal medications, acupuncture, mind-body practice, scrotal cooling, and faith-based healing are sparse or inconclusive.展开更多
Varicocele repair is mainly indicated in young adult patients with clinical palpable varicocele and abnormal semen parameters. Varicocele treatment is associated with a significant improvement in sperm concentration, ...Varicocele repair is mainly indicated in young adult patients with clinical palpable varicocele and abnormal semen parameters. Varicocele treatment is associated with a significant improvement in sperm concentration, motility, morphology, and pregnancy rate. Antegrade scrotal sclerotherapy （ASS） represented one of the main alternatives to the traditional inguinal or suprainguinal surgical ligation. This article reviews the use of ASS for varicocele treatment. We provide a brief overview of the history of the procedure and present our methods used in ASS. In addition, we review complication and success of ASS, including our own retrospective data of treating 674 patients over the last 17 years. Herein, we analyzed step by step the ASS technique and described our results with an original modified technique with a long follow-up. Between December 1997 and December 2014, we performed 674 ASS. Mean operative time was 14 min （range 9 to 50 min）. No significant intraoperative complications were reported. Within 90 days from the procedure, postoperative complications were recorded in overall 49 （7.2%） patients. No major complications were recorded. A persistent/recurrent varicocele was detected in 40 （5.9%） cases. In 32/40 （80%） cases, patients showed preoperative grade III varicoceles. In patients with a low sperm number before surgery, sperm count improved from 13 x 106 to 21 x 106 m1-1 （P〈 0.001）. The median value of the percentage of progressive motile forms at 1 h improved from 25% to 45% （P 〈 0.001）. Percentage of normal forms increased from 17% before surgery to 35% 1 year after the procedure （P 〈 0.001）. In the subgroup of the 168 infertile patients, 52 （31%） fathered offspring at a 12-month-minimum follow-up. Therefore, ASS is an effective minimal invasive treatment for varicocele with low recurrence/persistence rate.展开更多
Background: Scrotal trauma is a rare injury, and can compromise reproductive function. If in closed trauma, a morphological assessment of the lesion is usually necessary before treatment, in open trauma otherwise, nam...Background: Scrotal trauma is a rare injury, and can compromise reproductive function. If in closed trauma, a morphological assessment of the lesion is usually necessary before treatment, in open trauma otherwise, namely in the case of testicular evisceration, surgical exploration is the rule. Objective: To present the management of open scrotal trauma. Case Presentation: These were two adults aged 42 and 63, admitted for post-traumatic testicular evisceration. One of the patients presented with signs of infection due to a diagnosis delay. Management consisted on surgical exploration, with scrotal debridement and testicular reintegration. The evolution was favourable. Conclusion: Open scrotal trauma is a rare lesion that can cause testicular evisceration. It requires surgical exploration, which should be systematic.展开更多
Poor spermatogenesis in patients with inflammation of the genital tract is associated with scrotal hyperthermia.These patients can benefit from acupuncture treatment.We conducted a study to verify whether the influenc...Poor spermatogenesis in patients with inflammation of the genital tract is associated with scrotal hyperthermia.These patients can benefit from acupuncture treatment.We conducted a study to verify whether the influence of acupuncture treatment on sperm output in patients with low sperm density is associated with a decrease in scrotal temperature.The experimental group included 39 men who were referred for acupuncture owing to low sperm output.The control group,which comprised 18 normal fertile men,was used to define a threshold(30.5℃)above which scrotal skin temperature was considered to be high.Accordingly,34 of the 39 participants in the experimental group initially had high scrotal skin temperature;the other five had normal values.Scrotal skin temperature and sperm concentration were measured before and after acupuncture treatment.The five patients with initially normal scrotal temperatures were not affected by the acupuncture treatment.Following treatment,17 of the 34 patients with hyperthermia,all of whom had genital tract inflammation,had normal scrotal skin temperature;in 15 of these 17 patients,sperm count was increased.In the remaining 17 men with scrotal hyperthermia,neither scrotal skin temperature nor sperm concentration was affected by the treatment.About 90%of the latter patients suffered from high gonadotropins or mixed etiological factors.Low sperm count in patients with inflammation of the genital tract seems to be associated with scrotal hyperthermia,and,consequently,acupuncture treatment is recommended for these men.展开更多
Aim: This paper aims to report the second case of mucinous carcinoma of the scrotum revealed by scrotal fistulas listed in the literature and highlight the difficulties in the search and difficulties encountered in th...Aim: This paper aims to report the second case of mucinous carcinoma of the scrotum revealed by scrotal fistulas listed in the literature and highlight the difficulties in the search and difficulties encountered in the management of urogenital cancers in developing countries. Case presentation: This was a 62-year-old patient who had consulted for fistulized lesions of the scrotum associated with urinary disorders. Physical examination found budding lesions in the scrotum from which mucus was leaking. The diagnostic assessment carried out consisted of a biopsy sample of the scrotal lesions, a blood analysis and medical imaging, which led to the diagnosis. The mutilating nature of the surgery proposed to the patient after multidisciplinary consultation meeting and the expensive cost of chemotherapy drugs constituted the limits of the patient’s therapeutic management. Conclusion: Mucinous carcinoma of the scrotum is rare and primary lesion should always be sought. The presence of budding lesions of the scrotum with discharge of mucus should suggest the diagnosis.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
Objective:To design and manufacture medical scrotal support shorts for patients with enlarged scrotum and observe its application and effect.Methods:40 patients with enlarged scrotum admitted to the basic surgery depa...Objective:To design and manufacture medical scrotal support shorts for patients with enlarged scrotum and observe its application and effect.Methods:40 patients with enlarged scrotum admitted to the basic surgery department from February 2021 to March 2023 were selected and divided into a test group and a control group according to their time of admission,with the test group using scrotal support shorts and the control group using ordinary shorts without scrotal support pockets or diapers.Results:The complication rate of skin injury in the scrotum and the surrounding inguinal area of the patients in the test group was significantly lower than that of the control group(P<0.01).The medical cost covered by patients in the test group was significantly lower than that of the control group(P<0.01)and the hospitalization satisfaction of the patients in the test group was significantly higher than that of the control group(P<0.01).The difference in the therapeutic effect of the test groups was statistically significant when compared with the control group(P<0.05).Conclusion:Homemade medical scrotal support shorts reduced the local enlargement of the scrotum and bleeding,but also protected the scrotum and the surrounding skin to prevent secondary injuries.The process of patient care was simple and promoted their recovery.The length of hospitalization was also decreased,the burden of health care costs was reduced,and the overall comfort and satisfaction of the patient was improved.展开更多
BACKGROUND The most common causes of scrotal enlargement in patients include primary tumor of the scrotum,inflammation,hydrocele of the tunica vaginalis,and indirect inguinal hernia;scrotal enlargement caused by exter...BACKGROUND The most common causes of scrotal enlargement in patients include primary tumor of the scrotum,inflammation,hydrocele of the tunica vaginalis,and indirect inguinal hernia;scrotal enlargement caused by external tumors of the scrotum is rare.The patient had both a greater omentum tumor and an inguinal hernia,and the tumor protruded into the scrotum through the hernia sac,which is even rarer.Moreover,omental tumors are mostly metastatic,and primary omental fibroma is rare.CASE SUMMARY Here,we report a rare case of a 25-year-old young man with scrotal enlargement and pain for 3 months.Preoperative examination and multidisciplinary discu-ssions considered intra-abdominal tumor displacement and inguinal hernia,and intraoperative exploration confirmed that the greater omentum tumor protruded into the scrotum.Therefore,tumor resection and tension-free inguinal hernia repair were performed.The final diagnosis was benign fibroma of the greater omentum accompanied by an indirect inguinal hernia.CONCLUSION This unusual presentation of a common inguinal hernia disease illustrates the necessity of performing detailed history taking,physical examination,and imaging before surgery.展开更多
Antegrade scrotal sclerotherapy is a simple and easy technique for the treatment of varicocele. The success rate varies between 87% and 95%. The initial reflux grade and the number of collateral vessels of the spermat...Antegrade scrotal sclerotherapy is a simple and easy technique for the treatment of varicocele. The success rate varies between 87% and 95%. The initial reflux grade and the number of collateral vessels of the spermatic vein are the most important factors to predict the outcome of the technique. The postoperative complication rate is about 7% and the common ones are scrotal hematoma and epididymo-orchitis of slight severity. Testicular athrophy is a rare event (0.6%). This technique offers a considerable cost reduction compared to other therapeutic options currently available for varicocele.展开更多
BACKGROUND Aggressive angiomyolipoma is an extremely rare benign mesenchymal tumor that was originally described as a locally recurrent mucinous spindle cell tumour.Agg-ressive angiomyolipoma originates from myofibrob...BACKGROUND Aggressive angiomyolipoma is an extremely rare benign mesenchymal tumor that was originally described as a locally recurrent mucinous spindle cell tumour.Agg-ressive angiomyolipoma originates from myofibroblasts,vascular smooth muscle cells,or fibroblasts,and displays various phenotypes of myofibroblasts and abnor-mal muscle arteries.Aggressive angiomyolipoma was first identified in 1983 and fewer than 50 male patients have been reported to date.It is an extremely rare mesenchymal tumour and often confused with other diseases.Patients with epididymal aggressive angiomyolipoma lack typical symptoms,most of which occur incidentally,although some patients may experience mild pain,discomfort,and swelling.Pain may be exacerbated by pressure from the mass.CASE SUMMARY A 66-year-old male was admitted to the hospital on January 14,2022 with chief complaint of swelling in the left scrotum for one year.There was no apparent cause for the swelling.The patient did not consult with any doctor or receive any treatment for the swelling.The enlarged scrotum increased in size gradually until it reached approximately the size of a goose egg,and was accompanied by discom-fort and swelling of the left cavity of the scrotum.The patient had no history of any testicular trauma,infection,or urinary tract infection.The patient urinated freely,1-2 times at night,without urgency,dysuria(painful urination),or haematuria.There was no significant family history of malignancy.The patient underwent excision of the enlarged tumour and the left epididymis under general anaes-thesia on January 18,2022.Twelve months of follow-up revealed no recurrence.The patient was satisfied with the treatment.CONCLUSION Aggressive angiomyolipoma is extremely rare clinically and often confused with other diseases.The pathogenesis of aggressive angiomyolipoma is unclear and the clinical presentation is mostly a painless enlarged mass.The diagnosis of aggressive angiomyolipoma requires a combination of medical history,preoperative imaging such as compute展开更多
Background: There were 800 individual case reports of urogenital foreign bodies in the English literature from 1755 to 1999. The use of urogenital foreign bodies for sexual pleasure is a common occurrence in today’s ...Background: There were 800 individual case reports of urogenital foreign bodies in the English literature from 1755 to 1999. The use of urogenital foreign bodies for sexual pleasure is a common occurrence in today’s population. The aim of this discussion is the management of scrotal injury caused by magnetic urogenital foreign bodies. Case Presentation: 56-year-old male with scrotal tissue entrapped between two opposed magnet rings. Self-reported attempts at removal were unsuccessful and caused for presentation to the emergency department. Additional attempts at removal by medical staff unsuccessful in emergency department and therefore the patient proceeded to the operating room. Intraoperatively the use of two cardiac magnets allowed for removal without a need for invasive surgical procedure. Conclusion: Cardiac magnets are preferred means of removal for entrapped skin between magnetic foreign bodies that could be utilized at the bedside.展开更多
BACKGROUND Congenital scrotal agenesis(CSA)is very rare.There are 11 cases of congenital scrotal agenesis or absence reported in the literature,most of which are bilateral and accompanied by cryptorchidism.Only two ca...BACKGROUND Congenital scrotal agenesis(CSA)is very rare.There are 11 cases of congenital scrotal agenesis or absence reported in the literature,most of which are bilateral and accompanied by cryptorchidism.Only two cases of which are unilateral scrotal agenesis and not accompanied by cryptorchidism.This is the first reported case of unilateral scrotal agenesis with cryptorchidism and scrotoplasty.CASE SUMMARY A 2-year-old boy was admitted to our hospital with left cryptorchidism and ipsilateral CSA.An innovative method was used in the patient where a scrotal skin pedicle from the right part of scrotal skin was transplanted to the left side.At the same time,descent orchiopexy was performed.At the 4-mo follow-up,the left testicle was located in the scrotum and the size and shape were normal.CONCLUSION For unilateral CSA with ipsilateral cryptorchidism,contralateral scrotal pedicle transplantation and descent orchiopexy appear to be a successful surgical option.展开更多
Aim:To study whether additional measurements of motility characteristics of spermatozoa by computer assisted semen analysis(CASA)were more sensitive indicators of reduced semen quality than estimates of percentages of...Aim:To study whether additional measurements of motility characteristics of spermatozoa by computer assisted semen analysis(CASA)were more sensitive indicators of reduced semen quality than estimates of percentages of motile,rapid or progressive cells.Methods:Intermittent scrotal insulation was applied to 6 rams for 16 h per day for 21 days or to 2 of these for 12 h per day for 28 days in the following year.Semen was collected and evaluated by CASA immediately and either frozen or stored at 30℃ or 5℃ before re-evaluation.Results:Intermittent scrotal insulation caused falls in the percentage of motile,progressive and rapid sperm,as did freezing-thawing and storage at 30℃ or 5℃.Motility characteristics(amplitude of lateral head displacement,mean path velocity,mean progressive velocity and curvilinear velocity),as determined by CASA fell only when the percentage of motile sperm was already reduced.Freezing and thawing or liquid storage of the semen from insulated rams caused a greater fall in the percentage of motile and rapid sperm than control semen,but only affected the motility characteristics when the percentage of motile sperm was already reduced.Conclusion:Intermittent scrotal insulation affected not only the motility of the freshly collected sperm,but also theft ability to withstand the additional stress of storage.The additional data on motility characteristics obtained by CASA appeared to be no more a sensitive indicator than the percentage of motile cells of reductions in semen quality.(Asian J Andro12006 Jul;8:411-418)展开更多
Despite the low incidence, squamous cell carcinoma(SCC) remains the most common scrotal malignancy featuring a propensity for recurrence and metastasis. In recent years there has been a significant change in the epide...Despite the low incidence, squamous cell carcinoma(SCC) remains the most common scrotal malignancy featuring a propensity for recurrence and metastasis. In recent years there has been a significant change in the epidemiology of scrotal SCC. Surgery is the mainstay of treatment for resectable disease. Sentinel lymph node dissection similar to algorithm for patients with penile SCC can reduce the morbidity of routine lymph node dissection. Emerging treatments for advanced and metastatic SCC are at the cusp of significantly changing management of this disease. We have performed a comprehensive review of scrotal SCC with a focus on these topics.展开更多
Stress urinary incontinence （SUI） and end-stage erectile dysfunction （ED） after radical prostatectomy （RP） can decrease a patient＇s quality of life （QoL）. We describe a surgical technique involving scrotal in...Stress urinary incontinence （SUI） and end-stage erectile dysfunction （ED） after radical prostatectomy （RP） can decrease a patient＇s quality of life （QoL）. We describe a surgical technique involving scrotal incision for simultaneous dual implantation of an artificial urinary sphincter （AUS） and an inflatable penile prosthesis （IPP）. Patients with moderate to severe SUI （〉3 pads per day） and end-stage ED following RP were selected for dual implantation. An upper transverse scrotal incision was made, followed by bulbar urethra dissection and AUS cuff placement. Through the same incision, the corpora cavernosa was exposed, and an IPP positioned. Followed by extraperitoneal reservoirs placement and pumps introduced in the scrotum. Short-term, intra- and post-operative complications; continence status and erectile function; and patient satisfaction and QoL were recorded. A total of 32 patients underwent dual implantation. Early AUS-related complications were： AUS reservoir migration and urethral erosion. One case of distal corporal extrusion occurred. No prosthetic infection was reported. Over 96% of patients were socially the continent （≤1 pad per day） and 〉95% had sufficient erections for intercourse. Limitations of the study were the small number of patients, the lack of the control group using a perineal approach for AUS placement and only a 12 months follow-up. IPP and AUS dual implantation using a single scrotal incision technique is a safe and effective option in patients with SUI and ED after RP. Further studies on larger numbers of patients are warranted.展开更多
This study was performed to summarize our clinical experience with testicular descent and fixation through a scrotal stria incision for the treatment of palpable cryptorchidism in children.This study included 1034 chi...This study was performed to summarize our clinical experience with testicular descent and fixation through a scrotal stria incision for the treatment of palpable cryptorchidism in children.This study included 1034 children with palpable cryptorchidism from March 2009 to March 2019.A scrotal stria incision was used to perform testicular descent and fixation.Overall,1020 children successfully underwent surgical testicular descent and fixation through a scrotal stria incision,and 14 patients underwent conversion to inguinal incision surgery.All patients were discharged 1-2 days after the operation.During hospitalization and follow-up,55 patients developed complicationsy including 10 patients with testicular retraction,7 with poor healing of the incision,and 38 with a scrotal hematoma.No patients developed testicular atrophy,an in direct ingui nal hernia,or a hydrocoele.Testicular descent and fixation through a scrotal stria incision for the treatment of palpable cryptorchidism in children is safe and feasible in well-selected cases.This method has the advantages of no scarring and a good cosmetic effect.展开更多
文摘While we may be comfortable with an allopathic approach to male infertility, we are also responsible for knowledge about lifestyle modifications and holistic, complementary, and alternative therapies that are used by many of our patients. This paper provides an evidence-based review separating fact from fiction for several of these therapies. There is sufficient literature to support weight reduction by diet and exercise, smoking cessation, and alcohol moderation. Supplements that have demonstrated positive effects on male fertility on small randomized controlled trial （RCT） include aescin, coenzyme Qlo, glutathione, Korean red ginseng, L-carnitine, nigella sativa, omega-3, selenium, a combination of zinc and folate, and the Menevit antioxidant. There is no support for the use of Vitamin C, Vitamin E, or saffron. The data for Chinese herbal medications, acupuncture, mind-body practice, scrotal cooling, and faith-based healing are sparse or inconclusive.
文摘Varicocele repair is mainly indicated in young adult patients with clinical palpable varicocele and abnormal semen parameters. Varicocele treatment is associated with a significant improvement in sperm concentration, motility, morphology, and pregnancy rate. Antegrade scrotal sclerotherapy （ASS） represented one of the main alternatives to the traditional inguinal or suprainguinal surgical ligation. This article reviews the use of ASS for varicocele treatment. We provide a brief overview of the history of the procedure and present our methods used in ASS. In addition, we review complication and success of ASS, including our own retrospective data of treating 674 patients over the last 17 years. Herein, we analyzed step by step the ASS technique and described our results with an original modified technique with a long follow-up. Between December 1997 and December 2014, we performed 674 ASS. Mean operative time was 14 min （range 9 to 50 min）. No significant intraoperative complications were reported. Within 90 days from the procedure, postoperative complications were recorded in overall 49 （7.2%） patients. No major complications were recorded. A persistent/recurrent varicocele was detected in 40 （5.9%） cases. In 32/40 （80%） cases, patients showed preoperative grade III varicoceles. In patients with a low sperm number before surgery, sperm count improved from 13 x 106 to 21 x 106 m1-1 （P〈 0.001）. The median value of the percentage of progressive motile forms at 1 h improved from 25% to 45% （P 〈 0.001）. Percentage of normal forms increased from 17% before surgery to 35% 1 year after the procedure （P 〈 0.001）. In the subgroup of the 168 infertile patients, 52 （31%） fathered offspring at a 12-month-minimum follow-up. Therefore, ASS is an effective minimal invasive treatment for varicocele with low recurrence/persistence rate.
文摘Background: Scrotal trauma is a rare injury, and can compromise reproductive function. If in closed trauma, a morphological assessment of the lesion is usually necessary before treatment, in open trauma otherwise, namely in the case of testicular evisceration, surgical exploration is the rule. Objective: To present the management of open scrotal trauma. Case Presentation: These were two adults aged 42 and 63, admitted for post-traumatic testicular evisceration. One of the patients presented with signs of infection due to a diagnosis delay. Management consisted on surgical exploration, with scrotal debridement and testicular reintegration. The evolution was favourable. Conclusion: Open scrotal trauma is a rare lesion that can cause testicular evisceration. It requires surgical exploration, which should be systematic.
文摘Poor spermatogenesis in patients with inflammation of the genital tract is associated with scrotal hyperthermia.These patients can benefit from acupuncture treatment.We conducted a study to verify whether the influence of acupuncture treatment on sperm output in patients with low sperm density is associated with a decrease in scrotal temperature.The experimental group included 39 men who were referred for acupuncture owing to low sperm output.The control group,which comprised 18 normal fertile men,was used to define a threshold(30.5℃)above which scrotal skin temperature was considered to be high.Accordingly,34 of the 39 participants in the experimental group initially had high scrotal skin temperature;the other five had normal values.Scrotal skin temperature and sperm concentration were measured before and after acupuncture treatment.The five patients with initially normal scrotal temperatures were not affected by the acupuncture treatment.Following treatment,17 of the 34 patients with hyperthermia,all of whom had genital tract inflammation,had normal scrotal skin temperature;in 15 of these 17 patients,sperm count was increased.In the remaining 17 men with scrotal hyperthermia,neither scrotal skin temperature nor sperm concentration was affected by the treatment.About 90%of the latter patients suffered from high gonadotropins or mixed etiological factors.Low sperm count in patients with inflammation of the genital tract seems to be associated with scrotal hyperthermia,and,consequently,acupuncture treatment is recommended for these men.
文摘Aim: This paper aims to report the second case of mucinous carcinoma of the scrotum revealed by scrotal fistulas listed in the literature and highlight the difficulties in the search and difficulties encountered in the management of urogenital cancers in developing countries. Case presentation: This was a 62-year-old patient who had consulted for fistulized lesions of the scrotum associated with urinary disorders. Physical examination found budding lesions in the scrotum from which mucus was leaking. The diagnostic assessment carried out consisted of a biopsy sample of the scrotal lesions, a blood analysis and medical imaging, which led to the diagnosis. The mutilating nature of the surgery proposed to the patient after multidisciplinary consultation meeting and the expensive cost of chemotherapy drugs constituted the limits of the patient’s therapeutic management. Conclusion: Mucinous carcinoma of the scrotum is rare and primary lesion should always be sought. The presence of budding lesions of the scrotum with discharge of mucus should suggest the diagnosis.
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Objective:To design and manufacture medical scrotal support shorts for patients with enlarged scrotum and observe its application and effect.Methods:40 patients with enlarged scrotum admitted to the basic surgery department from February 2021 to March 2023 were selected and divided into a test group and a control group according to their time of admission,with the test group using scrotal support shorts and the control group using ordinary shorts without scrotal support pockets or diapers.Results:The complication rate of skin injury in the scrotum and the surrounding inguinal area of the patients in the test group was significantly lower than that of the control group(P<0.01).The medical cost covered by patients in the test group was significantly lower than that of the control group(P<0.01)and the hospitalization satisfaction of the patients in the test group was significantly higher than that of the control group(P<0.01).The difference in the therapeutic effect of the test groups was statistically significant when compared with the control group(P<0.05).Conclusion:Homemade medical scrotal support shorts reduced the local enlargement of the scrotum and bleeding,but also protected the scrotum and the surrounding skin to prevent secondary injuries.The process of patient care was simple and promoted their recovery.The length of hospitalization was also decreased,the burden of health care costs was reduced,and the overall comfort and satisfaction of the patient was improved.
文摘BACKGROUND The most common causes of scrotal enlargement in patients include primary tumor of the scrotum,inflammation,hydrocele of the tunica vaginalis,and indirect inguinal hernia;scrotal enlargement caused by external tumors of the scrotum is rare.The patient had both a greater omentum tumor and an inguinal hernia,and the tumor protruded into the scrotum through the hernia sac,which is even rarer.Moreover,omental tumors are mostly metastatic,and primary omental fibroma is rare.CASE SUMMARY Here,we report a rare case of a 25-year-old young man with scrotal enlargement and pain for 3 months.Preoperative examination and multidisciplinary discu-ssions considered intra-abdominal tumor displacement and inguinal hernia,and intraoperative exploration confirmed that the greater omentum tumor protruded into the scrotum.Therefore,tumor resection and tension-free inguinal hernia repair were performed.The final diagnosis was benign fibroma of the greater omentum accompanied by an indirect inguinal hernia.CONCLUSION This unusual presentation of a common inguinal hernia disease illustrates the necessity of performing detailed history taking,physical examination,and imaging before surgery.
文摘Antegrade scrotal sclerotherapy is a simple and easy technique for the treatment of varicocele. The success rate varies between 87% and 95%. The initial reflux grade and the number of collateral vessels of the spermatic vein are the most important factors to predict the outcome of the technique. The postoperative complication rate is about 7% and the common ones are scrotal hematoma and epididymo-orchitis of slight severity. Testicular athrophy is a rare event (0.6%). This technique offers a considerable cost reduction compared to other therapeutic options currently available for varicocele.
文摘BACKGROUND Aggressive angiomyolipoma is an extremely rare benign mesenchymal tumor that was originally described as a locally recurrent mucinous spindle cell tumour.Agg-ressive angiomyolipoma originates from myofibroblasts,vascular smooth muscle cells,or fibroblasts,and displays various phenotypes of myofibroblasts and abnor-mal muscle arteries.Aggressive angiomyolipoma was first identified in 1983 and fewer than 50 male patients have been reported to date.It is an extremely rare mesenchymal tumour and often confused with other diseases.Patients with epididymal aggressive angiomyolipoma lack typical symptoms,most of which occur incidentally,although some patients may experience mild pain,discomfort,and swelling.Pain may be exacerbated by pressure from the mass.CASE SUMMARY A 66-year-old male was admitted to the hospital on January 14,2022 with chief complaint of swelling in the left scrotum for one year.There was no apparent cause for the swelling.The patient did not consult with any doctor or receive any treatment for the swelling.The enlarged scrotum increased in size gradually until it reached approximately the size of a goose egg,and was accompanied by discom-fort and swelling of the left cavity of the scrotum.The patient had no history of any testicular trauma,infection,or urinary tract infection.The patient urinated freely,1-2 times at night,without urgency,dysuria(painful urination),or haematuria.There was no significant family history of malignancy.The patient underwent excision of the enlarged tumour and the left epididymis under general anaes-thesia on January 18,2022.Twelve months of follow-up revealed no recurrence.The patient was satisfied with the treatment.CONCLUSION Aggressive angiomyolipoma is extremely rare clinically and often confused with other diseases.The pathogenesis of aggressive angiomyolipoma is unclear and the clinical presentation is mostly a painless enlarged mass.The diagnosis of aggressive angiomyolipoma requires a combination of medical history,preoperative imaging such as compute
文摘Background: There were 800 individual case reports of urogenital foreign bodies in the English literature from 1755 to 1999. The use of urogenital foreign bodies for sexual pleasure is a common occurrence in today’s population. The aim of this discussion is the management of scrotal injury caused by magnetic urogenital foreign bodies. Case Presentation: 56-year-old male with scrotal tissue entrapped between two opposed magnet rings. Self-reported attempts at removal were unsuccessful and caused for presentation to the emergency department. Additional attempts at removal by medical staff unsuccessful in emergency department and therefore the patient proceeded to the operating room. Intraoperatively the use of two cardiac magnets allowed for removal without a need for invasive surgical procedure. Conclusion: Cardiac magnets are preferred means of removal for entrapped skin between magnetic foreign bodies that could be utilized at the bedside.
基金Supported by the National Natural Science Foundation of China,No.81602219
文摘BACKGROUND Congenital scrotal agenesis(CSA)is very rare.There are 11 cases of congenital scrotal agenesis or absence reported in the literature,most of which are bilateral and accompanied by cryptorchidism.Only two cases of which are unilateral scrotal agenesis and not accompanied by cryptorchidism.This is the first reported case of unilateral scrotal agenesis with cryptorchidism and scrotoplasty.CASE SUMMARY A 2-year-old boy was admitted to our hospital with left cryptorchidism and ipsilateral CSA.An innovative method was used in the patient where a scrotal skin pedicle from the right part of scrotal skin was transplanted to the left side.At the same time,descent orchiopexy was performed.At the 4-mo follow-up,the left testicle was located in the scrotum and the size and shape were normal.CONCLUSION For unilateral CSA with ipsilateral cryptorchidism,contralateral scrotal pedicle transplantation and descent orchiopexy appear to be a successful surgical option.
文摘Aim:To study whether additional measurements of motility characteristics of spermatozoa by computer assisted semen analysis(CASA)were more sensitive indicators of reduced semen quality than estimates of percentages of motile,rapid or progressive cells.Methods:Intermittent scrotal insulation was applied to 6 rams for 16 h per day for 21 days or to 2 of these for 12 h per day for 28 days in the following year.Semen was collected and evaluated by CASA immediately and either frozen or stored at 30℃ or 5℃ before re-evaluation.Results:Intermittent scrotal insulation caused falls in the percentage of motile,progressive and rapid sperm,as did freezing-thawing and storage at 30℃ or 5℃.Motility characteristics(amplitude of lateral head displacement,mean path velocity,mean progressive velocity and curvilinear velocity),as determined by CASA fell only when the percentage of motile sperm was already reduced.Freezing and thawing or liquid storage of the semen from insulated rams caused a greater fall in the percentage of motile and rapid sperm than control semen,but only affected the motility characteristics when the percentage of motile sperm was already reduced.Conclusion:Intermittent scrotal insulation affected not only the motility of the freshly collected sperm,but also theft ability to withstand the additional stress of storage.The additional data on motility characteristics obtained by CASA appeared to be no more a sensitive indicator than the percentage of motile cells of reductions in semen quality.(Asian J Andro12006 Jul;8:411-418)
文摘Despite the low incidence, squamous cell carcinoma(SCC) remains the most common scrotal malignancy featuring a propensity for recurrence and metastasis. In recent years there has been a significant change in the epidemiology of scrotal SCC. Surgery is the mainstay of treatment for resectable disease. Sentinel lymph node dissection similar to algorithm for patients with penile SCC can reduce the morbidity of routine lymph node dissection. Emerging treatments for advanced and metastatic SCC are at the cusp of significantly changing management of this disease. We have performed a comprehensive review of scrotal SCC with a focus on these topics.
文摘Stress urinary incontinence （SUI） and end-stage erectile dysfunction （ED） after radical prostatectomy （RP） can decrease a patient＇s quality of life （QoL）. We describe a surgical technique involving scrotal incision for simultaneous dual implantation of an artificial urinary sphincter （AUS） and an inflatable penile prosthesis （IPP）. Patients with moderate to severe SUI （〉3 pads per day） and end-stage ED following RP were selected for dual implantation. An upper transverse scrotal incision was made, followed by bulbar urethra dissection and AUS cuff placement. Through the same incision, the corpora cavernosa was exposed, and an IPP positioned. Followed by extraperitoneal reservoirs placement and pumps introduced in the scrotum. Short-term, intra- and post-operative complications; continence status and erectile function; and patient satisfaction and QoL were recorded. A total of 32 patients underwent dual implantation. Early AUS-related complications were： AUS reservoir migration and urethral erosion. One case of distal corporal extrusion occurred. No prosthetic infection was reported. Over 96% of patients were socially the continent （≤1 pad per day） and 〉95% had sufficient erections for intercourse. Limitations of the study were the small number of patients, the lack of the control group using a perineal approach for AUS placement and only a 12 months follow-up. IPP and AUS dual implantation using a single scrotal incision technique is a safe and effective option in patients with SUI and ED after RP. Further studies on larger numbers of patients are warranted.
文摘This study was performed to summarize our clinical experience with testicular descent and fixation through a scrotal stria incision for the treatment of palpable cryptorchidism in children.This study included 1034 children with palpable cryptorchidism from March 2009 to March 2019.A scrotal stria incision was used to perform testicular descent and fixation.Overall,1020 children successfully underwent surgical testicular descent and fixation through a scrotal stria incision,and 14 patients underwent conversion to inguinal incision surgery.All patients were discharged 1-2 days after the operation.During hospitalization and follow-up,55 patients developed complicationsy including 10 patients with testicular retraction,7 with poor healing of the incision,and 38 with a scrotal hematoma.No patients developed testicular atrophy,an in direct ingui nal hernia,or a hydrocoele.Testicular descent and fixation through a scrotal stria incision for the treatment of palpable cryptorchidism in children is safe and feasible in well-selected cases.This method has the advantages of no scarring and a good cosmetic effect.
