RESUMO
OBJECTIVES: To assess the incidence of anatomical anomalies in patients with retractile testis. MATERIALS AND METHODS: We studied prospectively 20 patients (28 testes) with truly retractile testis and compared them with 25 human fetuses (50 testes) with testis in scrotal position. We analyzed the relations among the testis, epididymis and patency of the processus vaginalis (PV). To analyze the relations between the testis and epididymis, we used a previous classification according to epididymis attachment to the testis and the presence of epididymis atresia. To analyze the structure of the PV, we considered two situations: obliteration of the PV and patency of the PV. We used the Chi-square test for contingency analysis of the populations under study (p<0.05). RESULTS: The fetuses ranged in age from 26 to 35 weeks post-conception (WPC) and the 20 patients with retractile testis ranged in ages from 1 to 12 years (average of 5.8). Of the 50 fetal testes, we observed complete patency of the PV in 2 cases (4%) and epididymal anomalies (EAs) in 1 testis (2%). Of the 28 retractile testes, we observed patency of the PV in 6 cases (21.4%) and EA in 4 (14.28%). When we compared the incidence of EAs and PV patency we observed a significantly higher prevalence of these anomalies in retractile testes (p=0.0116). CONCLUSIONS: Retractile testis is not a normal variant with a significant risk of patent processos vaginalis and epididymal anomalies.
Assuntos
Criptorquidismo/complicações , Epididimo/anormalidades , Feto/embriologia , Hidrocele Testicular/complicações , Testículo/anormalidades , Criança , Pré-Escolar , Criptorquidismo/embriologia , Criptorquidismo/cirurgia , Epididimo/cirurgia , Idade Gestacional , Humanos , Lactente , Masculino , Estudos Prospectivos , Hidrocele Testicular/cirurgia , Testículo/embriologiaRESUMO
ABSTRACT Objectives: To assess the incidence of anatomical anomalies in patients with retractile testis. Materials and Methods: We studied prospectively 20 patients (28 testes) with truly retractile testis and compared them with 25 human fetuses (50 testes) with testis in scrotal position. We analyzed the relations among the testis, epididymis and patency of the processus vaginalis (PV). To analyze the relations between the testis and epididymis, we used a previous classification according to epididymis attachment to the testis and the presence of epididymis atresia. To analyze the structure of the PV, we considered two situations: obliteration of the PV and patency of the PV. We used the Chi-square test for contingency analysis of the populations under study (p <0.05). Results: The fetuses ranged in age from 26 to 35 weeks post-conception (WPC) and the 20 patients with retractile testis ranged in ages from 1 to 12 years (average of 5.8). Of the 50 fetal testes, we observed complete patency of the PV in 2 cases (4%) and epididymal anomalies (EAs) in 1 testis (2%). Of the 28 retractile testes, we observed patency of the PV in 6 cases (21.4%) and EA in 4 (14.28%). When we compared the incidence of EAs and PV patency we observed a significantly higher prevalence of these anomalies in retractile testes (p=0.0116). Conclusions: Retractile testis is not a normal variant with a significant risk of patent processus vaginalis and epididymal anomalies.
Assuntos
Humanos , Masculino , Lactente , Pré-Escolar , Criança , Testículo/anormalidades , Criptorquidismo/complicações , Epididimo/anormalidades , Feto/embriologia , Hidrocele Testicular/complicações , Testículo/embriologia , Estudos Prospectivos , Idade Gestacional , Criptorquidismo/cirurgia , Criptorquidismo/embriologia , Epididimo/cirurgia , Hidrocele Testicular/cirurgiaRESUMO
Operating time for idiopathic hydroceles and epididymal cysts is scarce as these conditions compete with an increasing caseload of more consequential surgical disease. Therapy is often relegated to repeated aspiration. Sclerotherapy appears to be effective in a majority of published trials, but comparative effectiveness, efficacy and safety of most agents, including phenol versus tetracycline, has not been established A deliberate strategy of re-treatment until cure is not universally practised, with surgery still being offered after single-treatment failures. Two trials, the first consisting of 53 scrotal cysts treated with 5% phenol-in-water and the second, 42 cysts treated with tetracycline, are compared for effectiveness, efficacy and safety of sclerotherapy per se and of re-treatment. Intention-to-treat analysis yields similar cure rates (no re-accumulation three months after last injection) for phenol and tetracycline (83% and 81% respectively, p = 0.8). Per-protocol analysis also yields similar cure rates (100% and 97% respectively, p = 0.26) and mean number of injections to cure (1.34 and 1.12 respectively, p = 0.069), with range 1-4 and 1-3 respectively. Severe pain following tetracycline injection required administration of pre-injection cord block. Other complications occurred equally (25% and 25.7% respectively, p = 0.94) and were trivial except for one case of chronic haematocele treated by orchiectomy in the tetracycline group. Phenol (5%) and tetracycline are equally efficacious sclerosants for idiopathic scrotal cysts, achieving almost 100% cure with re-treatment and matching the efficacy of surgery. Concern about post-treatment fertility applies equally to surgery and demands informed consent for both modalities.
El tiempo de operación para los hidroceles y los quistes epididimales es escaso, ya que estas condiciones triviales compiten con una creciente carga de casos de enfermedades quirúrgicas de mayores consecuencias. La terapia es a menudo relegada a una aspiración repetida. La escleroterapiaparece ser efectiva en la mayoría de los ensayos publicados, pero no se han establecido la seguridad, eficacia y efectividad comparativa de la mayor parte de los agentes, incluyendo el fenol, frente a la tetraciclina. No se practica universalmente una estrategia deliberada de re-tratamiento hasta la cura, ofreciéndose todavía la cirugía, luego de fracasos con tratamientos individuales. Dos ensayos, el primero consistente en 53 quistes escrotales tratados con fenol acuoso al 5%, y el segundo, en 42 quistes tratados con tetraciclina, se comparan en cuanto a efectividad, eficacia y seguridad para laescleroterapia per se y para el re-tratamiento. El análisis de intención de tratamiento produce tasas de curación similares (no hay re-acumulación 3 meses después de la última inyección) para el fenol y la tetraciclina (83% y 81% respectivamente, p = 0.8). El análisis por protocolo también produce tasas de curación similares (100% y 97% respectivamente, p = 0.26) y el número medio de inyecciones paracurar (1.34 y 1.12 respectivamente, p = 0.069), con rangos de 14 y 13 respectivamente. El dolor severo tras la inyección de tetraciclina requirió hacer un bloqueo espinal de pre-inyec-ción. Asimismo ocurrieron otras complicaciones (25% y 25.7% respectivamente, p = 0.94) y fueron triviales, con excepción de un caso de hematoceles crónicos tratado mediante orquiectomía en el grupo de tetraciclina. El fenol (5%) y la tetraciclina poseen igual eficacia como esclerosantes de los quistes escrotales idiopáticos, ya que logran una curación de casi 100% con el re-tratamiento, e igualan la eficacia de la cirugía...
Assuntos
Humanos , Masculino , Escleroterapia/métodos , Espermatocele/terapia , Fenol/farmacologia , Hidrocele Testicular/terapia , Tetraciclina/farmacologia , Dor/induzido quimicamente , Escleroterapia/efeitos adversos , Espermatocele/complicações , Fenol/administração & dosagem , Hidrocele Testicular/complicações , Soluções Esclerosantes , Tetraciclina/administração & dosagem , Tetraciclina/efeitos adversosRESUMO
Operating time for idiopathic hydroceles and epididymal cysts is scarce as these conditions compete with an increasing caseload of more consequential surgical disease. Therapy is often relegated to repeated aspiration. Sclerotherapy appears to be effective in a majority of published trials, but comparative effectiveness, efficacy and safety of most agents, including phenol versus tetracycline, has not been established A deliberate strategy of re-treatment until cure is not universally practised, with surgery still being offered after single-treatment failures. Two trials, the first consisting of 53 scrotal cysts treated with 5% phenol-in-water and the second, 42 cysts treated with tetracycline, are compared for effectiveness, efficacy and safety of sclerotherapy per se and of re-treatment. Intention-to-treat analysis yields similar cure rates (no re-accumulation three months after last injection) for phenol and tetracycline (83% and 81% respectively, p = 0.8). Per-protocol analysis also yields similar cure rates (100% and 97% respectively, p = 0.26) and mean number of injections to cure (1.34 and 1.12 respectively, p = 0.069), with range 1-4 and 1-3 respectively. Severe pain following tetracycline injection required administration of pre-injection cord block. Other complications occurred equally (25% and 25.7% respectively, p = 0.94) and were trivial except for one case of chronic haematocele treated by orchiectomy in the tetracycline group. Phenol (5%) and tetracycline are equally efficacious sclerosants for idiopathic scrotal cysts, achieving almost 100% cure with re-treatment and matching the efficacy of surgery. Concern about post-treatment fertility applies equally to surgery and demands informed consent for both modalities.
Assuntos
Fenol/farmacologia , Escleroterapia/métodos , Espermatocele/terapia , Hidrocele Testicular/terapia , Tetraciclina/farmacologia , Humanos , Masculino , Dor/induzido quimicamente , Fenol/administração & dosagem , Soluções Esclerosantes , Escleroterapia/efeitos adversos , Espermatocele/complicações , Hidrocele Testicular/complicações , Tetraciclina/administração & dosagem , Tetraciclina/efeitos adversosRESUMO
Se revisaron los expedientes de 34 pacientes con 38 hidroceles testiculares, con edades comprendidas entre los 20 y 70 años, que se trataron en el servicio en que trabajan los autores por cirugía abierta y seguimiento durante un periodo promedio de 10 meses. Se produjeron 23.5 por ciento de complicaciones en total, la más frecuente la orquiepididimitis (11.7 por ciento); le siguieron recaídas en 8.8 por ciento y hematomas en 2.9 por ciento
Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Reoperação , Hidrocele Testicular/complicações , Hidrocele Testicular/cirurgiaAssuntos
Mesotelioma/diagnóstico por imagem , Neoplasias Testiculares/diagnóstico por imagem , Criança , Humanos , Masculino , Mesotelioma/complicações , Mesotelioma/patologia , Hidrocele Testicular/complicações , Neoplasias Testiculares/complicações , Neoplasias Testiculares/patologia , Testículo/patologia , UltrassonografiaRESUMO
Fueron revisadas 201 historias clínicas con diagnóstico de espina bífida de las cuales, 25 ameritaron evaluación aftalmológica. De ellas, 19 presentaron transtornos en la motilidad ocular como complicación de la hidrocefalia (endotropias 52%, exotropias 8%, nistagmus 8%) presentó algún grado de atrofia óptica
Assuntos
Humanos , Disrafismo Espinal/complicações , Hidrocele Testicular/complicaçõesRESUMO
Hydrocoele, a common problem in Guyana, is regarded as mainly of nuisance value. We therefore investigated the effects of hydrocoele on seminal fluid analyses of patients (20-48 yrs) who had bilateral hydrocoele for 6 months to eight years. Three separate preoperative masturbation specimens were collected into glass jars and analysed within one hour from eight patients. Similar specimens were analysed within 3 months and after 3 months of Lord's repair of their hydrocoeles. The quantity of fluid at operation was measured. In five patients where each sac contained more than 100 ml (125-825 ml), the sperm count was consistently less than 20 million/ml and motility was less than 50 percent. The lowest counts and motility were seen in patients with long-standing hydrocoeles. In three patients, one of the two sacs contained less than 25 ml. The sperm count averaged 70 million/ml and motility was approximately 60 percent. Cross seminal fluid volume was similar in the two groups. Seminal analysis returned to preoperative or improved levels within 3 months. These findings suggest that hydrocoele is a potential cause of infertility and that early operation may preserve spermatogenesis (AU)