ABSTRACT
Revisar et reflujo uretrodeferente como causa de orquioepidimitis recurrente en pacientes con antecedentes manipulación instrumental en uretra prostática, y su manejo diagnóstico y terapéutico. Descripción del caso de un paciente con antecedentes de resección trasuretral prostática (RTU) y con orquioepidimitis de repetición, que muestra en uno de los episodios una colección escrotal cuyo contenido es puncionado y se obtiene orina, planteando así la posibilidad diagnóstica de reflujo uretrodeferente. Se obtiene el diagnóstico mediante cistouretrografia miccional seriada (CUMS), observando opacificación con el contraste yodado del conducto deferente hasta el epidídimo. El tratamiento fue quirúrgico, con ligadura del conducto deferente a nivel inguinal. No hubo recurrencias posteriores. Es importante sospechar esta patología en pacientes con antecedentes de RTU, pues su diagnóstico y el tratamiento es diferente del resto de orquioepididimitis...
To review the uretro-deferent duct reflux as a cause of recurrent orquiepidemitis in patients with a history of instrumental manipulation in the prostatic urethra, its diagnostic and therapeutic management. Method: Description of a patient with a history of transurethral resection of prostate (TURP) and repeat orquiepidimitis, presenting in one of the episodes a scrotal collection whose content is punctured and urine is obtained; thus raising the diagnosis of uretro-deferent duct reflux. Diagnosis is confirmed by voiding cystourethrogram (VCUG), observing iodinated contrast opacification of the deferent duct up to the epididymis. The treatment was surgical, with inguinal ligation of the vas deferens. There was no subsequent recurrence.lt is important of suspect this condition in patients with a history of TURP, because lts diagnosis and treatment is different from usual orquiepididimitis...
Subject(s)
Humans , Male , Aged, 80 and over , Vas Deferens , Urethral Diseases/complications , Epididymitis/etiology , Orchitis/etiologyABSTRACT
Presentación de un caso poco frecuente de tuberculosis genital aislada, en un hombre de 28 años, no fumador, sin antecedentes clínicos significativos...
Subject(s)
Humans , Male , Adult , Orchitis/diagnosis , Orchitis/etiology , Orchitis/therapy , Tuberculosis, Male Genital/diagnosis , Tuberculosis, Male Genital/etiology , Tuberculosis, Male Genital/therapyABSTRACT
In sexually active males, the commonest organisms causing acute epididymo-orchitis are Chlamydia trachomatis and Neisseria gonnorhoae. The peak incidence is seen during 20's. The aim of our study was to prove that in majority of cases of acute epididymo-orchitis, the bacterial pathogens cannot be isolated. The reason being that the pathogen responsible in majority of cases is Chlamydia trachomitis which cannot be isolated by routine bacteriological techniques. We reviewed the cases of acute epididymo-orchitis and studied the percentage of patients in which bacterial pathogens were isolated. The clinical and microbiological data of patients from Aug. 2003 to Sep. 2005 was reviewed. The clinical diagnosis of acute epididymo-orchitis was confirmed by scrotal ultrasonography. Midstream urine sample were processed by using standard culture techniques. Patients were followed for a period of three months. There were total 97 patients, with median and interquartile range of 20 and 17-25 years respectively. At the time of presentation the median duration of symptoms was 4.5 days, while median hospital stay was 5 days. Scrotal pain was the main presenting symptom. Pyuria was noticed in 41 [43%] patients and in only 12 [14%] of these the bacterial pathogens were isolated. Main organisms being Escherichia coli and Klebsiella pneumoniae. We have concluded that Chlamydia trachomatis can not be isolated by routine bacteriological techniques. Currently available diagnostic methods are cumbersome and expensive. Therefore there is a need to develop simpler techniques, which can be made available in moderately equipped laboratories; in order to facilitate the detection of Chlamydia trachomatis. Presently the patients in whom the causative organisms can not be isolated can safely be treated for Chlamydia trachomatis
Subject(s)
Humans , Male , Orchitis/drug therapy , Chlamydia trachomatis/pathogenicity , Epididymitis/etiology , Orchitis/etiology , Acute DiseaseABSTRACT
As atividades testiculares, hormonal e espermiogênica säo de extrema importância para o homem e para a manutençäo e o aprimoramento da humanidade. Trauma, tumores, varicocle, criptorquidia, anorquia, atrofias, torçäo de cordäo espermático, estäo entre as diversas causas da infertilidade masculina. A integridade da barreira testículo - sangüínea parece ter um papel fundamental na patôgenese da orquite auto-imune. A orquite auto-imune é um processo inflamatório testicular mediado por formaçäo de anticorpos, contra os próprios antígenos testiculares do indivíduo, causando lesöes no epitélio germinativo. Neste estudo foram utilizados oitenta (80) ratos Wistar, singênicos, machos, adultos, separados em dez grupos, submetidos à torçäo unilateral do testículo, sob anestesia, por um período de duas à doze horas, seguido, entäo, de destorçäo e exame anatomopatológico das gônadas contralateral e ipsilateral, em períodos que variaram de duas à dez semanas. Estes testículos foram analisados através das técnicas de histologia e de imunofluorescência com a utilizaçäo de anticorpos monoclonais para as imunoglobulinas IgA, IgG e IgM de coelho e cabra, contra os antígenos testiculares do rato, para que se estudasse as possíveis alteraçöes no tecido testicular do animal, objetivando a comprovaçäo da existência de complexos auto-imunes no epitélio germinal. O estudo demonstrou a presença de imunoglobulinas, principalmente das classes IgG e IgM na luza e no interstício dos túbulos semíferos. Alteraçöes estruturais do testículo contralateral, näo torcido, foram demonstradas. Os resultados deste experimento indicam que o sistema inume de animais sadios contém linfócitos com receptores para os próprios antígenos, capazes de, na torçäo unilateral do cordäo espermático, promoverem uma doença auto-imune. A utilizaçäo de substâncias imuno-supressoras, neste estudo, o corticóide, foi feita para tentar minimizar ou mesmo coibir o processo auto-agressivo. Existiu uma proteçäo testicular contralateral efetiva, com o uso precoce da referida droga. É sugerido que a permanência de um testículo necrótico na bolsa escrotal, após torçäo prolongada, pode levar à subfertilidade ou infertilidade.
Subject(s)
Animals , Rats , Adrenal Cortex Hormones/pharmacokinetics , Antibody-Producing Cells , Blood-Testis Barrier/drug effects , Disease Models, Animal , Immunoglobulins , Orchitis/etiology , Orchitis/immunology , Rats, Wistar , Testis/ultrastructure , Spermatic Cord Torsion/complications , Spermatic Cord Torsion/immunology , Seminiferous Tubules/ultrastructure , Antibody Formation , Infertility, Male/etiologyABSTRACT
Cremster muscle excision in repair of inguinal hernias is controversial. Its excision intrrupts an important collateral to the testicle naemly the cremaster artery. If the cremasteric artery is a major contributer to the testicular blood supply, its ligation may result in ischemic orchitis. In this study we compared incidence of ischemnic orchitis with cremasteric artery preservation in 66 patients underwent. Marcy repair for groin hernia and the incidence of this complication when the artery is sacrified with the cremater muscle. We found a lower incidence of ischemic architis when the lower lateral flap of the cremster muscle was preserved. It was also found that the incidence of groin pain is less in this group of patients
Subject(s)
Humans , Male , Postoperative Complications , Orchitis/etiologySubject(s)
Adult , Humans , Male , Orchitis , Infertility, Male , Ureteral Calculi , Orchitis/etiology , Infertility, Male/etiology , Ureteral Calculi/complications , Testicular DiseasesSubject(s)
Adult , Animals , Humans , Malaria/complications , Male , Orchitis/etiology , Pain/etiology , Plasmodium falciparum/isolation & purificationSubject(s)
Adult , Brucellosis/diagnosis , Humans , Male , Middle Aged , Orchitis/etiology , Urethritis/etiologyABSTRACT
En trabajpos previos (1) demostramos la presencia de anticuerpos citofilicos antiespermáticos (ACA) en suero de cobayos con orquitis inmunológica experimental, encontrándose una estrecha relación entre lesión testicular y ACA. Dichos ACA fueron asilados mediante elución de la superficie de macrófagos, demosntrando su naturaleza de IgG2 (12). Este trabajo tiene por objeto estudiar la capacidad citotóxica tanto in vitro, como in vitro, de ACA extraídos (HE) de sueros provenientes de cobayos con alto título de ACA (HS). Asimismo, en dichos sueros se investigó la presencia de complejos inmunes circulantes (CIC). Se demostró citotoxicidad in citro sobre: a) células germinales aisladas de tésticulo normal (Tabla 1) incubadas con HS (1/32) y con el anticuerpo aislado HE (1/128); b) espermatozoides (Tabla 1) incubados con HE (1/64). Se demostro citotoxicidad in vivo (Tabla 2) mediante el estudio histológico de testículos de cobayos normales a los cuales se inyecto HS y HE en el espacio subalbugineo. Con HS se hallo intensa orquitis desde el primer día post-inyección. Con HE las lesiones testiculares se observaron a partir del día 7. La incubación in vitro o la inyección en el espacio subalbugíneo utilizando suero normal o fracción citofgílica aislada de suero normal no demostratron citotoxicidad en ningún caso. La presencia de CIC se investigó ne HS mediante: 1) la técnica de combinación 125I-C1q(19), con la cual no se obtuvieron datos significativos en relación al suero normal (Tabla 3); 2) el test de precipitación de polietilenglicol (4) el cual permitió detectar nivelles elevados de CIC en HS (Tabla 4). Estos hallazgos sugieren que los ACA poseen actividad citotóxica sobre el tejido testicular. Esta citotoxicidad podría estar relacionada con los CIC precipitables con polietilenglicol