ABSTRACT
PURPOSE: To evaluate the prevalence of testicular microlithiasis among pediatric patients with inguinoscrotal affections. METHODS: Between January 2005 and January 2010, we evaluated, prospectively 1504 children ranging from 1 to 15 years with inguinoscrotal affections with a high-frequency ultrasound system, which employs a 10-MHz transducer. RESULTS: Testicular microlithiasis was identified in 20 testes of eleven children (0.71 percent of 1504 patients evaluated), through an ultrasound scan. Testicular microlithiasis was found in 5 children with cryptorchidism (3.93 percent of 127 patients), 4 children with retractile testes (14.8 percent of 27 patients), 1 child with a hypotrophic testis (100 percent of 1 patient), and 1 child with inguinal hernia (0.07 percent of 1349 patients). The children with testicular microlithiasis were submitted to annual physical examinations and ultrasound evaluations. CONCLUSIONS: Testicular microlithiasis was a rare condition and occurred in 0.7 percent of the subjects studied. The association with cryptorchidism, retractile and hypotrophic testis was significant.
OBJETIVO: Avaliar a prevalência de microlitíase testicular entre pacientes pediátricos com afecções inguinoescrotais. MÉTODOS: Estudo prospectivo entre janeiro de 2005 a janeiro de 2010, utilizando ultrasonografia escrotal em 1504 crianças (de 1 a 15 anos) com afecções inguinoescrotais. RESULTADOS: Microlitíase testicular foi identificada em 20 testículos de 11 crianças (0,71 por cento dos 1504 pacientes). 5 crianças com criptorquidia (3,93 por cento de 127 pacientes), 4 com testículo retrátil (14,8 por cento de 27 pacientes), 1 com hipotrofia testicular e 1 com hérnia inguinal (0,07 por cento de 1349 crianças). As crianças foram avaliadas anualmente com exame físico e ultrassonografia inguinoescrotal. CONCLUSÕES: A microlitíase testicular é uma entidade rara, ocorrendo em 0,7 por cento dos pacientes pediátricos com afecções inguinoescrotais. A associação com a criptorquidia, testículo retrátil e a hipotrofia testicular foi significativa.
Subject(s)
Adolescent , Child , Child, Preschool , Humans , Infant , Male , Lithiasis/epidemiology , Testicular Diseases/epidemiology , Brazil/epidemiology , Cryptorchidism/complications , Follow-Up Studies , Hernia, Inguinal/complications , Lithiasis/complications , Lithiasis , Prevalence , Prospective Studies , Risk Factors , Testicular Diseases/complications , Testicular Diseases , Testis/pathology , TestisABSTRACT
El presente estudio presenta a la fluxión funiculotesticular (FFT) como la complicación más frecuente de la herniorrafia inguinal, destacando que es poco mencionada en publicaciones sobre el tema a nivel internacional. El objetivo del presente estudio es dar a conocer la frecuencia de esta complicación en los pacientes intervenidos en el Centro de Referencia de Salud (CRS) Cordillera, analizar sus manifestaciones clínicas y su etiopatogenia. El estudio observacional, descriptivo, prospectivo se realizó en 304 varones portadores de hernia inguinal derivados desde los consultorios de las comunas de Peñalolén y Macul al CRS Cordillera Oriente. Los pacientes fueron intervenidos consecutivamente con anestesia local y técnicas quirúrgicas estándar y en forma ambulatoria. El control postoperatorio lo realizó un miembro del equipo quirúrgico a la semana y al mes de la intervención buscando dirigidamente signos de FFT. Ésta se encontró en 22 por ciento siendo severa en el 2,5 por ciento de los casos. Esta frecuencia fue similar para hernias directas e indirectas. La FFT fue significativamente mayor en las hernias recidivadas, las inguinoescrotales y en los casos en los que se instaló una malla. Esta complicación pone en evidencia una cadena de hechos que se inician con el trauma quirúrgico producto de la disección necesaria en una herniorrafia inguinal que produce inflamación, congestión venosa y linfática. En casos más graves puede producirse trombosis venosa y eventualmente daño isquémico del testículo.
Background: A complication of inguinal hernia repair that is seldom mentioned is spermatic cord and testicular swelling. Aim: To study the frequency of this complication, its clinical manifestations and to analyze its pathogenesis. Material and Methods: A descriptive observational, prospective study in 304 men (aged 15 to 89 years), subjected to an inguinal hernia repair. Operation was performed under local anesthesia in an ambulatory basis, with standard surgical techniques. The postoperative assessment was done by a member of the surgical staff one week and one month after surgery. Results: A mild or moderate swelling occurred in 19.5 percent of patients and a large, severe spermatic cord and testicular swelling developed in 2.5 percent of the cases. The frequency was similar in patients with direct or indirect hernias. Those with recurrent hernias, with hernias growing into the scrotum or that required a mesh for hernia repair, had a significantly higher frequency of spermatic cord and testicular swelling. No patient developed testicular ischemia. Conclusions: Spermatic cord and testicular swelling is the consequence of the dissection required for hernia repair, that is followed by a variable grade of damage to the tissues, inflammation, venous and lymphatic congestion and edema. In seldom occasions venous thrombosis and testicular damage may take place.
Subject(s)
Humans , Male , Adolescent , Adult , Middle Aged , Aged, 80 and over , Postoperative Complications/etiology , Testicular Diseases/epidemiology , Testicular Diseases/etiology , Hernia, Inguinal/surgery , Chile/epidemiology , Diagnosis, Differential , Testicular Diseases/diagnosis , Prospective StudiesABSTRACT
OBJECTIVE: To prospectively determine the prevalence of testicular microlithiasis in symptomatic patients who were referred for scrotal ultrasound examination and to evaluate the possible association of testicular microlithiasis with testicular cancer and other conditions such as cryptorchidism or history of ascending testis. MATERIALS AND METHODS: 391 men who were referred to our institutions between July 2002 and May 2005 for any type of symptoms from the testicles, underwent physical and scrotal ultrasound examination. The presence of testicular microlithiasis, the number of lesions and the involvement of both testicles in relation to the symptoms as well as the coexistence of other lesions were studied. RESULTS: Eighteen (4.6 percent) of 391 men enrolled into the study had testicular microlithiasis. Two out of the eighteen patients (11 percent) had concomitant testicular cancer, which was confirmed by pathological evaluation of the orchidectomy specimen. One of the patients with testicular microlithiasis presented a rising in biochemical tumor markers (LDH, and HCG) and underwent orchidectomy one year later. Five of the remaining 373 (1.3 percent) patients without microlithiasis were diagnosed with testicular cancer. Thirty six men reported having a history of ascending testis, but none of them was found with testicular cancer. Two cases of testicular torsion in a cryptorchid position had testicular microlithiasis, but the orchidectomy specimen (after surgery) was negative for testicular cancer. The correlation between testicular cancer and testicular microlithiasis found in our study was statistically significant (p < 0.05). CONCLUSION: There seems to be an association between testicular microlithiasis and testicular cancer.