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1.
Int. braz. j. urol ; 45(4): 847-850, July-Aug. 2019. graf
Article in English | LILACS | ID: biblio-1040058

ABSTRACT

ABSTRACT Testicular germ cell tumor is the most common cancer in 20-to 35-years-old men. There are known risk factors such as undescended testicle(s) and history of testicular cancer. Most lesions are germ cell tumors with two main subtypes: seminomas and non-seminomatous germ cell tumors.


Subject(s)
Humans , Male , Adult , Retroperitoneal Neoplasms/pathology , Retroperitoneal Neoplasms/diagnostic imaging , Testicular Neoplasms/pathology , Testicular Neoplasms/diagnostic imaging , Neoplasms, Germ Cell and Embryonal/pathology , Neoplasms, Germ Cell and Embryonal/diagnostic imaging , Retroperitoneal Neoplasms/surgery , Testicular Neoplasms/surgery , Biopsy , Orchiectomy/methods , Tomography, X-Ray Computed , Neoplasms, Germ Cell and Embryonal/surgery , Ultrasonography, Doppler, Color , Tumor Burden , Middle Aged
2.
Arq. bras. med. vet. zootec. (Online) ; 71(2): 658-666, mar.-abr. 2019. tab
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1011263

ABSTRACT

Objetivou-se avaliar as características de carcaça e carne de novilhos Aberdeen Angus castrados cirurgicamente em duas idades ou imunocastrados com dois protocolos. Foram utilizados 48 bezerros, monitorados a partir do nascimento e desmamados, com idade e peso médio inicial de seis meses e de 160±16,54kg, respectivamente. Os animais foram distribuídos aleatoriamente nos seguintes tratamentos: castração cirúrgica ao nascer; castração cirúrgica ao desmame; imunocastração com três doses da vacina Bopriva® e imunocastração com quatro doses da vacina Bopriva®. O delineamento experimental utilizado foi o inteiramente ao acaso. Novilhos imunocastrados com três doses apresentaram maior quebra ao resfriamento e menor espessura de gordura ajustada para 100kg de carcaça fria que castrados cirurgicamente ao nascer (P<0,05). A imunocastração com três doses proporcionou incremento na participação de músculo, em relação às castrações cirúrgicas, mas reduziu a gordura em relação à castração cirúrgica ao nascimento (P<0,05). A relação músculo:osso foi superior nos imunocastrados com três doses em relação a castrados cirurgicamente no desmame (P<0,05). Apesar de variações na participação tecidual na carcaça, a castração imunológica mostrou-se viável em substituição à castração cirúrgica, não alterando os padrões qualitativos da carne.(AU)


The objective of this study was to evaluate the carcass and meat characteristics of Aberdeen Angus steers surgically castrated at two ages or immunocastrated with two protocols. Forty-eight calves we used, monitored from birth and weaned, with age and initial mean weight of six months and 160±16.54kg, respectively. The animals were randomly assigned to the following treatments: surgical castration at birth; surgical castration at weaning; immunocastration with three doses of the Bopriva ® vaccine and immunocastration with four doses of the Bopriva ® vaccine. The experimental design was completely randomized. Immunocastrated steers with three doses had a greater cooling break and lower fat thickness adjusted for 100kg of cold carcass than surgically castrated at birth (P< 0.05). Immunocastration with three doses provided an increase in muscle participation in relation to surgical castration but reduced fat in relation to surgical castration at birth (P< 0.05). The muscle:bone ratio was higher in the immunocastrated with three doses compared to surgically castrated at weaning (P< 0.05). Despite variations in tissue involvement in the carcass, the immunological castration proved to be viable to replace surgical castration, not changing the quality of the meat standards.(AU)


Subject(s)
Animals , Male , Cattle , Orchiectomy/methods , Orchiectomy/veterinary , Meat/analysis
3.
Rev. cir. (Impr.) ; 71(2): 157-161, abr. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1058249

ABSTRACT

INTRODUCCIÓN: Los tumores paratesticulares representan del 7%-10% de las masas intraescrotales. Los sarcomas abarcan el 90% de las lesiones malignas del cordón espermático y de éstas, aproximadamente, el 3%-7% son liposarcomas. CASO CLÍNICO: Presentamos el caso de un varón de 45 años, que consultó en urgencias por una masa inguinoescrotal derecha no reductible, diagnosticándose de hernia inguinal incarcerada. Se realizó cirugía urgente evidenciando una gran tumoración de aspecto lipomatoso, dependiente de cordón espermático. Se realizó orquiectomía y hernioplastía inguinal. La anatomía patológica, reveló un liposarcoma bien diferenciado de cordón espermático. Posteriormente, se realizó estudio de extensión, sin afectación a distancia y no precisó tratamiento adyuvante. Actualmente, tras dos años de seguimiento no ha presentado recidiva. DISCUSIÓN: Sólo alrededor de 200 casos han sido comunicados previamente en la literatura y sólo 61 de éstos se presentaron simulando una hernia inguinal incarcerada. Debido a la baja incidencia de esta patología es difícil de conocer la historia natural y llegar a conclusiones sobre los resultados del tratamiento, el cual hasta el momento sigue siendo la orquiectomía radical, con escisión amplia de los tejidos locales. El papel de la radio y quimioterapia aun es controvertido. CONCLUSIONES: Los sarcomas del cordón espermático son neoplasias raras con alta tasa de recurrencia local. Su manejo inicial es quirúrgico. Se requiere de un alto índice de sospecha clínica para el diagnóstico ya que las implicaciones oncológicas varían en función del tratamiento que, en ocasiones, es llevado a cabo por cirujanos generales al simular una hernia inguinal.


INTRODUCTION: Paratesticular tumors represent 7%-10% of intraescrotal masses. Sarcomas account for 90% of malignant lesions of the spermatic cord and of these approximately 3%-7% are liposarcomas. CLINICAL CASE: This is the case of a 45 year old male who consulted in the emergency department for a non-reducible right inguino-scrotal mass and was diagnosed with an incarcerated inguinal hernia. Emergency surgery was performed which revealed a large lipomatous tumor, originating from the spermatic cord. Orchiectomy and hernioplasty were performed. Histopathology revealed a well-differentiated liposarcoma of the spermatic cord. Later extension study was conducted, without distant affectation, and did not require adjuvant treatment. Today, after two years of monitoring has been no recurrence. DISCUSSION: Only about 200 cases have been previously reported in the literature and only 61 of these were presented mimicking an incarcerated inguinal hernia. Due to the low incidence of this disease it is difficult to know the natural history and draw conclusions on the results of treatment, which so far remains the radical orchiectomy with wide local excision of the tissue. The role of radiotherapy and chemotherapy is still controversial


Subject(s)
Humans , Male , Middle Aged , Testicular Neoplasms/surgery , Liposarcoma/surgery , Spermatic Cord , Spermatic Cord/pathology , Testicular Neoplasms/diagnosis , Orchiectomy/methods , Tomography, X-Ray Computed , Diagnosis, Differential , Hernia, Inguinal/surgery , Hernia, Inguinal/diagnosis , Liposarcoma/diagnosis
4.
Int. braz. j. urol ; 42(6): 1210-1219, Nov.-Dec. 2016. tab, graf
Article in English | LILACS | ID: biblio-828923

ABSTRACT

Abstract Purpose To investigate the roles of age, testicular rotation and time in the surgical outcome of intravaginal testicular torsion (iTT). Patients and Methods We retrieved the records of all iTT patients treated in our unit from January 2012 to January 2014. Explanatory variables were: age (years); presentation delay (PrD, time between symptoms and hospitalization); surgical delay (SurgD, time between hospitalization and surgery) and testicular rotation (rotation), with surgical outcome (orchidopexy, orchidectomy) as response variable. Differences in PrD, SurgD, age and rotation by surgical outcome were evaluated non-parametrically. Step-down logistic regression included age, PrD, SurgD and rotation as predictors. Statistical significance and confidence intervals (CI) were set at p<0.05 and 0.95. Odds ratios (OR) were computed from the model's coefficients. Results Complete variable information was available for 117 patients, and most (61, 52.1%) underwent orchidectomy. Ages were similar between orchidectomy and orchidopexy patients (median 15.8 vs. 16.0 years, p=0.78). In contrast, PrD (85.0 vs. 8.4 hours, p<0.001), SurgD (3.0 vs. 16.0 hours, p<0.001) were different between orchidectomy and orchidopexy patients. SurgD was similar with PrD<24 hours (4.0 vs. 2.8, p=0.1). Orchidectomy patients had greater rotation (3.0π vs. 2.0π radians, p<0.001). Logistic regression revealed that PrD (OR 0.94; 0.92–0.97; p<0.001) and rotation (OR 0.43; 0.27–0.70; p<0.001) were inversely associated with orchidopexy. Conclusion Testicular rotation exerts a multiplicative effect on PrD, so time should not be regarded as the sole predictor of surgical outcome in iTT.


Subject(s)
Humans , Male , Child , Adolescent , Spermatic Cord Torsion/surgery , Testis/surgery , Orchiectomy/methods , Prognosis , Testis/blood supply , Time Factors , Treatment Outcome , Statistics, Nonparametric
5.
Rev. cuba. med. mil ; 45(3): 391-396, jul.-set. 2016. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-960555

ABSTRACT

El fibroma paratesticular es un proceso proliferativo benigno de origen incierto, probablemente inflamatorio reactivo no tumoral. El objetivo del trabajo es presentar un caso de fibroma paratesticular, así como la secuencia diagnóstica y terapéutica adoptada. Se presenta un paciente de 55 años de edad con antecedentes de hipertensión arterial. Acude a la consulta externa de Urología por presentar aumento de volumen del testículo derecho, de un año de evolución, que en los últimos tres meses le había ocasionado molestias leves. Al interrogatorio no se recogieron antecedentes de traumatismos o inflamaciones en ese testículo. En el examen físico presentó, hacia el polo inferior del testículo y cola del epidídimo derechos, una masa de consistencia pétrea, irregular, de 3 a 4 cm de diámetro, fija e indolora. El ultrasonido testicular reportó la presencia de una imagen compleja, hacia polo inferior, heterogénea hipo e hiperecoica calcificada en su interior, que medía 33 x 18 x 34 mm para 11cm³ de volumen, y con ligero hidrocele asociado. El paciente fue sometido a orquiectomia radical derecha, proceder que transcurrió sin complicaciones. El resultado histopatológico fue proliferación fibrosa nodular e hialinizante que afecta la túnica albugínea, fibroma calcificado del testículo derecho. La evolución posoperatoria fue satisfactoria. Aunque el diagnóstico definitivo de fibroma paratesticular es histopatológico, sus características clínicas y ecográficas lo hacen ser uno de los diagnósticos diferenciales a tener en cuenta, con los tumores malignos del testículo(AU)


Paratesticular fibroma is a benign proliferative process of uncertain origin, probably non-tumor reactive inflammatory. The aim of the study is to present a case of paratesticular fibroma, as well as the diagnostic and therapeutic sequence implemented. We present a 55 year old patient with a history of hypertension. This patient visits the Urology outpatient clinic because of an increase in volume of the right testicle, a year of evolution, which in the last three months had caused slight discomfort. No history of trauma or inflammation was recorded in the testicle. On the physical examination he presented, to the lower pole of the testis and tail of the right epididymis, a mass of irregular stony consistency, 3 to 4 cm in diameter, fixed and painless. The testicular ultrasound reported the presence of a complex image, towards the lower pole, heterogeneous hypo and hyperechoic calcified inside, which measured 33 x 18 x 34 mm for 11 cm3 volume, and with associated light hydrocele. The patient underwent right radical orchiectomy with no complications. The histopathological result was nodular and hyalinizing fibrous proliferation affecting the tunica albuginea, calcified fibroma of the right testicle. Postoperative evolution was satisfactory. Although the definitive diagnosis of paratesticular fibroma is histopathological, its clinical and ultrasound characteristics make it one of the differential diagnoses to be considered with malignant tumors of the testis(AU)


Subject(s)
Humans , Male , Middle Aged , Testicular Neoplasms/surgery , Fibroma/diagnostic imaging , Orchiectomy/methods
6.
Rev. cientif. cienc. med ; 18(2): 32-37, 2015. ilus
Article in Spanish | LILACS | ID: lil-785621

ABSTRACT

Los tumores genitourinarios tienen presentaciòn testicular (98%) o paratesticular (2%). La incidencia de los tumores paratesticulares es mínima, ya que son más comunes los tumores del tejido testicular como tal y no tanto así los originados en tejidos mesenquimales como el leiomioma, el cual es considerado una neoplasia rara en su presentación para esta localización. Al ser una entidad de presentación poco común, su diagnóstico es un reto ya que la mayoría de estos son referidos como tumores testiculares, se debe tener en cuenta que hoy en día hay nuevas alternativas para su adecuado diagnóstico pre-operatorio como por ejemplo uso de Resonancia magnética ya que es de elección en tumores de partes blandas. Es por esta razón que se presenta este caso, para poder dar a conocer su incidencia en nuestro medio, su presentación clínica, las técnicas de abordaje diagnóstico además de los diagnósticos diferenciales y su terapéutica.


The tumors genitourinarios have presentaciòn testicular (98 %) or paratesticular (2 %).The incident of the tumors paratesticulares is minimal, since the tumors of the fabric are more common testicular as such and not so much this way the originated ones in fabrics mesenquimales as the leiomioma, which is considered to be a rare neoplasia in his presentation for this location.To the being an entity of slightly common presentation, his diagnosis is a challenge since the majority of these they are recounted as tumors testiculares, it is necessary to to bear in mind that nowadays there are new alternatives for his suitable pre-operative diagnosis as for example use of magnetic Resonance since it is of choice in tumors of soft parts. It is for this reason that appears this case, to be able to announce his incident in our way, his clinical presentation, the technologies of diagnostic boarding besides the differential diagnoses and his therapeutics.


Subject(s)
Humans , Male , Middle Aged , Testicular Neoplasms , Orchiectomy/methods , Leiomyoma
7.
Acta cir. bras ; 29(5): 292-298, 05/2014. tab, graf
Article in English | LILACS | ID: lil-709237

ABSTRACT

PURPOSE: To investigate the effects of human chorionic gonadotropin (hCG) on the testicular tissue of young male rats. METHODS: Male Wistar rats were assigned to groups (10 rats/group).Control Group received subcutaneous saline solution; Group 1 received hCG 50UI/Kg/dose; and Group 2 received hCG 100UI/Kg/dose, daily for 15 days. Half was submitted to bilateral orchiectomy on the 16th day and the other half 45 days after the beginning of the hormone application. Testicles were weighed, measured and has their volumes determined. The diameter of the tubules and the thickness of the seminiferous epithelium were measured. RESULTS: Control Group presented the highest values of testicles volume and weight. Rats in the Control presented normal histology. In G1 and G2 atrophy of the seminiferous tubules, apoptosis of germ cells and multinucleated giant cells were observed. Comparing groups, in the first operation Control rats had higher diameter values. In the second operation, the Control was only different from G1. As for thickness, Control had higher values in both operations. Comparing the time of operation, the diameter values were higher in G1 and G2 in the second operation. For all groups, the thickness of the epithelium was higher in the second operation. CONCLUSIONS: Human chorionic gonadotropin is gonadotoxic in rats. This effect was temporary and can affect reproductive potential. The total recovery of testicular damage in the studied range could not be proved, and the effects were not dose-dependent. .


Subject(s)
Animals , Male , Chorionic Gonadotropin/administration & dosage , Reproductive Control Agents/administration & dosage , Testis/anatomy & histology , Testis/drug effects , Dose-Response Relationship, Drug , Models, Animal , Orchiectomy/methods , Random Allocation , Rats, Wistar , Reference Values , Seminiferous Tubules/anatomy & histology , Seminiferous Tubules/drug effects , Testis/surgery
8.
Einstein (Säo Paulo) ; 12(1): 109-111, Jan-Mar/2014. graf
Article in English | LILACS | ID: lil-705808

ABSTRACT

A 23-year-old male with a history of bone marrow transplant for acute myeloid leukemia. He presented a large mass in the right inguinal region 5 years ago. Upon physical examination, right-sided cryptorchidism was observed. The tumor markers alpha-fetoprotein and beta-HCG were within normalcy range and lactate dehydrogenase was raised. Computed tomography of the abdomen and pelvis revealed right testicular mass in contiguity with the inguinal canal to the ipsilateral retroperitoneum, associated with right hydronephrosis. Due to the risk of germ-cell tumor in undescended testicle, the patient underwent radical right orchiectomy. The pathological examination showed recurrence of acute myeloid leukemia in the testis. He was referred to oncology for adjuvant therapy. Our literature review found no similar cases described.


Paciente de 23 anos, masculino, com antecedente de transplante de medula óssea por leucemia mieloide aguda. Há 5 anos, apresentou volumosa massa em região inguinal direita. No exame físico, foi constatada criptorquidia à direita. Os marcadores tumorais alfa-fetoproteína e beta-HCG encontravam-se dentro da normalidade, e a desidrogenase láctica estava aumentada. A tomografia computadorizada de abdomen e pelve revelou massa testicular direita com contiguidade pelo canal inguinal, até o retroperitônio ipsilateral, associada a hidronefrose direita. Devido ao alto risco de neoplasia germinativa em testículo criptorquídico, o paciente foi submetido à orquiectomia radical direita, cujo anatomopatológico revelou recidiva de leucemia mieloide aguda em testículo. Foi encaminhado para oncologia para terapia adjuvante. Nossa revisão não revelou nenhum caso semelhante na literatura.


Subject(s)
Humans , Male , Young Adult , Cryptorchidism/surgery , Leukemia, Myeloid, Acute/surgery , Neoplasm Recurrence, Local/surgery , Orchiectomy/methods , Testicular Neoplasms/surgery , Biopsy , Bone Marrow Transplantation , Cryptorchidism/pathology , Leukemia, Myeloid, Acute/pathology , Neoplasm Recurrence, Local/pathology , Tomography, X-Ray Computed , Treatment Outcome , Testicular Neoplasms/pathology
9.
Arq. bras. med. vet. zootec ; 65(3): 681-686, June 2013. tab
Article in English | LILACS | ID: lil-679098

ABSTRACT

After a serious injury or sudden death, epididymis cauda sperm recovery and cryopreservation may present as the last opportunity to obtain genetic material from a valuable stallion. This study evaluated the viability of cooled equine sperm collected by three different methods: sperm of ejaculated (G1), sperm recovered from the epididymal cauda immediately after orchiectomy (G2) and sperm recovered from the epididymal cauda after storage for 24 hours at 5°C (G3). To obtain G1 sperm, two ejaculates were collected. After 1 week, all stallions underwent a bilateral orchiectomy, and one of the removed epididymides was flushed to obtain G2 sperm. The contralateral epididymis was stored at 5°C for 24 hours before being flushed to obtain G3 sperm. The sperm samples were evaluated immediately after the addition of the refrigeration extender, and after 24 and 48 hours of storage at 5°C. After 24 and 48 hours of storage, the epididymal sperm demonstrated higher motility traits when compared to the ejaculated sperm (P<0.05). These results indicate that sperm recovered from the epididymal cauda of stallions are more resistant to the cooling process, with higher kinetic parameters and plasma membrane integrity when compared to the ejaculated sperm.


A recuperação de espermatozoides da cauda do epidídimo pode ser a última chance para preservação do germoplasma quando ocorre morte súbita ou lesão grave em garanhões de alto valor genético. O presente trabalho comparou a viabilidade após refrigeração dos espermatozoides do ejaculado (G1), recuperados da cauda do epidídimo imediatamente após a orquiectomia (G2) e recuperados após armazenamento do epidídimo por 24 horas a 5ºC (G3). No G1 foram colhidos dois ejaculados. Uma semana após a colheita dos ejaculados os garanhões foram submetidos à orquiectomia bilateral e realizada a colheita dos espermatozoides da cauda do epidídimo de um testículo de cada garanhão (G2). O testículo contralateral permaneceu a 5°C por 24 horas, antes da recuperação espermática (G3). A análise das amostras foi realizada imediatamente após a adição do meio de refrigeração, e após 24 e 48 horas de armazenamento a 5°C. Após 24 e 48 horas de armazenamento, os espermatozoides do epidídimo demonstraram características de cinética maiores que os do ejaculado (P<0.05). Estes resultados indicam que espermatozoides recuperados da cauda do epidídimo foram mais resistentes ao processo de refrigeração, com maiores parâmetros de cinética espermática e integridade da membrana plasmática quando comparados aos espermatozoides do ejaculado.


Subject(s)
Animals , Cryopreservation/instrumentation , Epididymis/anatomy & histology , Semen Preservation/methods , Spermatozoa , Horses/classification , Orchiectomy/methods
10.
Rev. chil. urol ; 78(1): 8-13, 2013.
Article in Spanish | LILACS | ID: lil-773999

ABSTRACT

Los tumores testiculares de células germinales (TCG) son poco frecuentes, corresponden al 2 por ciento de todos los cánceres masculinos. La incidencia de cáncer contralateral oscila entre 1por ciento a 5 por ciento, siendo los tumores metacrónicos mucho más comunes que los sincrónicos bilaterales. El tratamiento estándar en estos casos es la orquidectomía bilateral. Se han propuesto diferentes enfoques que buscan preservar la función testicular. Dentro de estas alternativas se describen en la literatura la Orquidectomía Parcial (OP), el Ultrasonido Focalizado de Alta Intensidad (HIFU por su sigla en inglés) y la radioterapia primaria. Nuestro objetivo es realizar una revisión de este tema y describir las alternativas de tratamiento a la orquidectomía radical, con la idea de preservar la función androgénica. Para esto nos enfocaremos en el manejo del paciente con masa testicular palpable, no palpable y sus alternativas terapéuticas.


Testicular germ cell tumors (GCT) are rare, corresponding to 2 percent of all male cancers. Contralateral cancer incidence ranges from 1 percent to 5 percent, metachronous tumors being more common than bilateral synchronous. Standard treatment in these cases is bilateral orchiectomy. Diferent approaches have been proposed that seek to preserve testicular function. Among these alternatives the literature describes Partial orchiectomy (OP), High Intensity Focused Ultrasound (HIFU for its acronym in English) and primary radiotherapy. Our goal is to review this issue and describe treatment alternatives to radical orchiectomy, with the idea of preserving androgenic function. We focus on the management of patients with palpable testicular mass, not palpable mass and it therapeutic alternatives.


Subject(s)
Humans , Male , Testicular Neoplasms/therapy , Neoplasms, Germ Cell and Embryonal/therapy , Orchiectomy/methods , Radiotherapy , High-Intensity Focused Ultrasound Ablation , Combined Modality Therapy
11.
Int. braz. j. urol ; 38(6): 750-759, Nov-Dec/2012. tab, graf
Article in English | LILACS | ID: lil-666024

ABSTRACT

Purpose

The study evaluates the clinical and pathological findings of 16 patients with locally advanced penile carcinoma (PC) submitted to emasculation, and discusses questions related to the usefulness of bilateral orchiectomy. Materials and Methods

Between 1999 and 2010, 172 patients with PC were treated. Sixteen (9%) underwent emasculation. Data were retrieved from the institution's database including age, ethnicity, date of surgery, residential setting, level of schooling, time to diagnosis, type of reconstruction, complications, tumor stage and grade, vascular and perineural invasion along with invasion of corpus cavernosum, corpus spongiosum, testicles, scrotum and urethra. Results

A total of 16 patients (average: 63.1 years) with locally advanced PC were included. All were illiterate or semiliterate rural dwellers and 87% were white. The time to diagnosis was 8-12 months. The mean follow-up time was 31.9 months (1-119). By the time of the last follow-up, only seven patients (43.75%) were alive. Tumors were pT4 (n = 6), pT3 (n = 8), pT2 (n = 2), Grade I (n = 5) and Grade II (n = 11). The histopathological examination revealed invasion of the urethra (n = 13), scrotum (n = 5) and testicles (n = 1). The surgical margin was positive in one patient. Six patients (37.5%) had vascular invasion and 11 (68.7%) had perineural invasion. Currently, only one of the former is alive. Conclusions

The finding of focal microscopic testicular infiltration in only one of 32 testicles, even in the presence of clinically apparent scrotal invasion, suggests that emasculation without bilateral orchiectomy is a safe treatment option for patients with locally advanced PC. .


Subject(s)
Adult , Aged , Humans , Male , Middle Aged , Carcinoma, Squamous Cell/surgery , Orchiectomy/methods , Penile Neoplasms/surgery , Testis/surgery , Carcinoma, Squamous Cell/pathology , Follow-Up Studies , Kaplan-Meier Estimate , Organ Sparing Treatments/methods , Prognosis , Penile Neoplasms/pathology , Time Factors , Treatment Outcome
12.
Int. braz. j. urol ; 38(5): 695-700, Sept.-Oct. 2012.
Article in English | LILACS | ID: lil-655998

ABSTRACT

MAIN FINDINGS: A 22-year-old woman with complete androgen insensitivity syndrome (CAIS) presenting with primary amenorrhea and normal female external genitalia was referred for laparoscopic gonadectomy. She had been diagnosed several years earlier but was reluctant to undergo surgery. CASE HYPOTHESIS: Diagnosis of this X-linked recessive inherited syndrome characterizes by disturbance of virilization in males with an AR mutation, XY karyotipe, female genitalia and severely undescended testis with risk of malignization. The optimal time to orchidectomy is not settled; neither the real risk of malignancy in these patients. Early surgery impacts development of a complete female phenotype, with enlargement of the breasts. Based on modern diagnostic imaging using DCE-MRI and surgical technology with single port laparoscopic access we hypothesize that the optimum time for gonadectomy is not at the time of diagnosis, but once feminization has completed. PROMISING FUTURE IMPLICATIONS: An umbilical laparoendoscopic single-site access for bilateral gonadectomy appears to be the first choice approach as leaves no visible incision and diminishes the psychological impact of surgery in a patient with CAIS absolutely reassured as female. KeyPort, a single port access with duo-rotate instruments developed by Richard Wolf facilitates this surgery and allows excellent cosmetic results.


Subject(s)
Female , Humans , Male , Young Adult , Androgen-Insensitivity Syndrome , Laparoscopy/methods , Orchiectomy/methods , Laparoscopy/instrumentation , Orchiectomy/instrumentation , Risk Factors , Time Factors , Treatment Outcome , Umbilicus
13.
Acta cir. bras ; 27(6): 388-395, June 2012. ilus, tab
Article in English | LILACS | ID: lil-626257

ABSTRACT

PURPOSE: To determine whether the testicular torsion causes long-term effects on the spermatogenesis of the contralateral testis, and whether the orchiepididymectomy of the twisted testis could prevent them, using specific spermatogenesis parameters to elucidate the conflicting results in the literature. METHODS: Seventy-four pubertal male Wistar rats were randomly selected. The experimental group consisted of 40 rats, divided into four subgroups, submitted to 1.080 degrees counterclockwise left testicular torsion and its scrotal fixation at the beginning of the experiment, and left orchiepididymectomy at one, five, ten and 90 days, respectively. The control group consisted of 24 rats, divided into four sham operation control subgroups. An additional control subgroup consisted of the ten remaining rats, submitted only to the left orchiepididymectomy at the beginning. At 90 days, the contralateral testes of the experimental and control subgroups were collected for the evaluation of their spermatogenesis parameters: testicular weight, seminiferous tubular diameter, Johnsen score and differential counting of the germ cells. RESULTS: No statistically significant differences were observed among the experimental and control subgroups for all of the spermatogenesis parameters of the contralateral testes. CONCLUSIONS: Testicular torsion does not cause long-term effects on the spermatogenesis of the contralateral testis in pubertal rats, and the orchiepididymectomy of the twisted testis is not necessary for preventive purposes for the contralateral spermatogenesis.


OBJETIVO: Determinar se a torção testicular causa efeitos tardios sobre a espermatogênese do testículo contralateral e se a orquiepididimectomia do testículo torcido poderia preveni-los, usando parâmetros específicos da espermatogênese para elucidar os resultados conflitantes na literatura. MÉTODOS: Foram selecionados aleatoriamente 74 ratos machos púberes da linhagem Wistar. O grupo experimental foi composto por 40 ratos divididos em quatro subgrupos, submetidos à torção anti-horária de 1,080 graus do testículo esquerdo e sua fixação escrotal no início do experimento e à orquiepidimectomia esquerda com um, cinco, dez e 90 dias, respectivamente. O grupo controle foi composto por 24 ratos divididos em quatro subgrupos de cirurgias simuladas. Um subgrupo controle adicional foi constituído pelos dez ratos restantes submetidos unicamente à orquiepididimectomia esquerda no início do experimento. Aos 90 dias, os testículos contralaterais dos subgrupos experimentais e controles foram coletados para avaliação dos parâmetros de suas espermatogêneses: peso testicular, diâmetro do túbulo seminífero, graduação de Johnsen e contagem diferencial das células germinativas. RESULTADOS: Não houve diferença estatisticamente significativa entre todos os subgrupos experimentais e controles para todos os parâmetros analisados da espermatogênese dos testículos contralaterais. CONCLUSÕES: A torção testicular não causa efeitos tardios sobre a espermatogênese do testículo contralateral em ratos púberes e a orquiepididimectomia do testículo torcido não é necessária para fins preventivos da espermatogênese contralateral.


Subject(s)
Animals , Male , Rats , Epididymis/surgery , Orchiectomy/methods , Spermatic Cord Torsion/complications , Spermatogenesis/physiology , Disease Models, Animal , Germ Cells/pathology , Necrosis , Random Allocation , Rats, Wistar , Seminiferous Tubules/pathology , Spermatic Cord Torsion/prevention & control , Spermatic Cord Torsion/surgery , Testis/surgery
14.
Article in English | IMSEAR | ID: sea-157360

ABSTRACT

A case of locally confined primary signet ring cell carcinoma of the prostate in an 85 years old male with complaints of retention of urine, dysuria and frequent nocturia is reported. On per rectal digital examination, hard nodular prostate of grade 3 enlargement was palpated. Serum prostate specific antigen (PSA) level was 33.7ng/ ml. Chest x-ray and computed tomography of the pelvis was negative for metastatic disease. Hematological and biochemical investigations were within normal limits. Transurethral prostatic biopsy was done and histopathology revealed the diagnosis of poorly differentiated adenocarcinoma. Transurethral resection of prostate (TURP) with bilateral orchidectomy along with radiotherapy was selected as modality of treatment. After histopathological examination of TURP specimen with Haematoxylin and Eosin (H & E) and Periodic acid Schiff (PAS) stain, a diagnosis of primary signet ring cell carcinoma of prostate was given which was confirmed by immunohistochemical analysis.


Subject(s)
Acid Phosphatase/analysis , Acid Phosphatase/blood , Aged, 80 and over , Carcinoma, Signet Ring Cell/diagnosis , Carcinoma, Signet Ring Cell/radiotherapy , Carcinoma, Signet Ring Cell/surgery , Humans , Immunohistochemistry/methods , Male , Orchiectomy/methods , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/radiotherapy , Prostatic Neoplasms/surgery , Prostate-Specific Antigen/analysis , Prostate-Specific Antigen/blood , Transurethral Resection of Prostate/methods
15.
Int. braz. j. urol ; 37(3): 347-354, May-June 2011. ilus, graf, tab
Article in English | LILACS | ID: lil-596009

ABSTRACT

PURPOSE: Burdizzo clamp ablation of the testes (CAT) may provide an incisionless, cost-effective form of androgen deprivation therapy (ADT) in men with adenocarcinoma of the prostate (ACP) who find bilateral orchiectomy (BO) unacceptable or can not afford medical ADT. The aim of this study was to compare CAT with BO as primary ADT in men with ACP. MATERIALS AND METHODS: Written, informed consent was obtained from men with locally advanced or metastatic ACP. Patients were prospectively randomized to BO (n = 9) or CAT (n = 10) under local anaesthesia, and were evaluated 3 and 7 days, 6 weeks and 3 months post-procedure. The protocol was approved by the local institutional ethics committee. Statistical analysis was performed using Student's, Mann-Whitney's and Fisher's tests. RESULTS: Mean duration of the procedure was significantly longer for BO than CAT (16.9 vs. 10.9 minutes). Mean pain scores during and after the procedure did not differ significantly. Serum testosterone decreased significantly on days 3 and 7 after CAT, but increased at 6 weeks, and was significantly higher than after BO. Serum luteinizing hormone increased significantly from day 3 after BO and from day 7 after CAT. Serum prostate specific antigen decreased significantly after BO, but not after CAT. Minor complications were more common after BO (89 percent) than CAT (40 percent). In the 9 men who did not achieve castrate levels of testosterone after CAT, BO was performed. CONCLUSIONS: CAT was quicker to perform and had a lower complication rate, but was not as effective as BO in achieving castrate serum testosterone levels.


Subject(s)
Aged , Humans , Male , Middle Aged , Adenocarcinoma/surgery , Orchiectomy/methods , Prostatic Neoplasms/surgery , Adenocarcinoma/blood , Adenocarcinoma/pathology , Equipment Design , Feasibility Studies , Luteinizing Hormone/blood , Orchiectomy/adverse effects , Orchiectomy/instrumentation , Pain Measurement , Pain, Postoperative/etiology , Prostate-Specific Antigen/blood , Prostatic Neoplasms/blood , Prostatic Neoplasms/pathology , Testis , Time Factors , Testosterone/blood
16.
Pesqui. vet. bras ; 30(10): 887-890, out. 2010. ilus, graf, tab
Article in English | LILACS | ID: lil-567932

ABSTRACT

The aim of the present experiment was to investigate the effect of corticosteroids (exogen) on in vitro testosterone secretion after stress by transportation (40 minutes). Feline testes (Felis silvestris catus) were incubated in the following media: TCM 199; TCM 199 + hCG 10_7M; TCM 199 + hydrocortisone 10_7M, or TCM 199 + hCG + hydrocortisone. The animals (n=21) were allocated into three groups: (S) that arrived at 3 h prior to surgery, (A) that remained in the laboratory for 36 h before being submitted to surgical procedure, and (C) that were also allowed to remain for 36 hours in the laboratory before the surgical procedure, but whose testes had been incubated with hydrocortisone prior to incubation in the referred media. The results showed that group S secreted higher levels of testosterone, regardless of the culture media. It is noteworthy that the suppressing action of hydrocortisone sodium succinate led to a reduction in the testosterone concentration, despite the presence of hCG.


O objetivo deste trabalho foi investigar o efeito da hidrocortisona sobre a secreção de testosterona após cultivo in vitro dos testículos, em distintas situações de estresse (transporte) de gatos domésticos (Felis silvestris catus). Testículos foram incubados nos seguintes meios de cultura: TCM 199; TCM 199 + hCG 10_7M; TCM 199 + hydrocortisona 10_7M e TCM 199 + hCG + hidrocortisona. Os animais (n=21) foram alocados em 3 sub-grupos: (S) animal admitido 3 horas antes da orquiectomia, (A) animais orquiectomizados após 36 horas de permanência no biotério e (C) animais que permaneceram por 36 horas no biotério antes da cirurgia e que tiveram seus testículos pré-incubados em hidrocortisona. Os resultados demonstraram que o grupo S secretou maiores valores de testosterona em todas as condições estudadas. É válido mencionar que a supressão promovida pela hidrocortisona também promoveu redução na concentração de testosterona no meio TCM 199, a despeito da presença de hCG.


Subject(s)
Animals , Chorionic Gonadotropin/analysis , Hydrocortisone/administration & dosage , Hydrocortisone/adverse effects , Orchiectomy/methods , Orchiectomy/veterinary , Testosterone/analysis , Testosterone/adverse effects
17.
Rev. Col. Bras. Cir ; 37(4): 269-273, jul.-ago. 2010. ilus, tab
Article in Portuguese | LILACS | ID: lil-564248

ABSTRACT

OBJETIVO: Analisar as possíveis complicações que a ablação hormonal cirúrgica possa causar aos pacientes a ela submetidos. Estudo transversal analítico com uma amostra de 25 pacientes, de 58 a 82 anos, portadores de câncer de próstata metastático, submetidos à orquiectomia bilateral, no período de janeiro de 2003 a dezembro de 2008. Foi realizada avaliação por meio de questionário objetivo para aqueles que ainda encontravam-se vivos. RESULTADOS: Dos 25 pacientes avaliados, 56 por cento encontravam-se vivos, com média de idade atual de 71 anos, tendo apresentado como complicações mais frequentes: diminuição da libido e impotência sexual (100 por cento), fragilidade óssea (64 por cento), problemas de memória e variações de humor (57 por cento), fogacho e ganho de peso (50 por cento); 86 por cento dos entrevistados referiram estarem satisfeitos com os resultados do procedimento e afirmaram que conseguem ter uma vida cotidiana normal, com melhora significativa do quadro clínico. E quanto a tratamentos adjuvantes, apenas 36 por cento realizaram, sendo os mais comuns, quimioterapia (36 por cento) e radioterapia (29 por cento). CONCLUSÃO: A orquiectomia bilateral constitui-se em boa alternativa para pacientes portadores de câncer de próstata metastático, uma vez que foi observada satisfação da maioria dos pacientes em relação à melhora dos sintomas. As complicações apresentadas não tiveram grande impacto na vida cotidiana dos pacientes.


OBJECTIVE: To analyze the possible complications that the surgical hormonal ablation can cause to the submitted patients. METHODS: That's an analytical transversal study with a sample of 25 patients, between 58 to 82 years, carriers of metastatic prostate câncer, submitted to the bilateral orchiectomy in the Professor Alberto Antunes University Hospital 's (HUPAA - UFAL), in the period of January of 2003 to December of 2008. It was maked an evaluation by an objective questionnaire for those who were still alive. RESULTS: Of the 25 evaluated patients, 56 percent were still alive, with average of current age of 71 years, having presented as more frequent complications: reduction of the libido and sexual impotence (100 percent), bone fragility (64 percent), problems of memory and variations of mood (57 percent), hot waves and gain of weight (50 percent). 86 percent of the interviewed ones had related to be satisfied with the results of the procedure and had affirmed that they can have a normal daily life, with significant improvement of the clinical stage. About the adjuvant treatments, only 36 percent had carried through, being most common, chemotherapy (36 percent) and x-ray (29 percent). CONCLUSION: The bilateral orchiectomy constitutes in a good alternative for metastatic prostate cancer patients, in a way that it is observed satisfaction of the majority of the patients in relation to the improvement of the symptoms and the presented complications had not great impact in the daily life of the same ones.


Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Orchiectomy/adverse effects , Prostatic Neoplasms/surgery , Cross-Sectional Studies , Neoplasm Metastasis , Orchiectomy/methods , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Prostatic Neoplasms/pathology
18.
Rev. venez. oncol ; 22(2): 123-125, abr.-jun. 2010. ilus
Article in Spanish | LILACS | ID: lil-574470

ABSTRACT

Reportamos el caso de un paciente con metástasis hepáticas, secundarias a adenocarcinoma de colon, quien presentaba una masa paratesticular dolorosa, cuya aparición coincidió con una progresión de la neoplasia de base. La resección quirúrgica de la masa identificó células neoplásicas provenientes del adenocarcinoma de colon.


We report the case of a patient with hepatic metastases secondary to colon adenocarcinoma. Who presented a par testicular and pain mass, which apparitions coincide with a progression of his basic neoplasic. The surgical resection of the mass identifies neoplásica cells with colon adenocarcinoma origin.


Subject(s)
Humans , Male , Aged , Scrotum/injuries , Neoplasm Metastasis/physiopathology , Testicular Neoplasms/diagnosis , Sigmoid Neoplasms/physiopathology , Adenocarcinoma/pathology , Biopsy/methods , Orchiectomy/methods
19.
Rev. venez. oncol ; 21(2): 92-98, abr.-jun. 2009. ilus
Article in Spanish | LILACS | ID: lil-549465

ABSTRACT

Los tumores testiculares y paratesticulares del tipo epiteliales son raros. Existe poca preferencia en la literatura de la variedad mucinosa. Se plantea controversia en la histogénesis debido a su asociación con teratomas, y establecer origen germinal. Se presenta el caso de paciente masculino de 38 años con clínica de dolor lumbar, masa abdominal palpable, aumento de volumen testicular izquierdo de 2 años de evolución. Se le practicó orquidectomía izquierda con hallazgo de tumor quístico de 7 cm x 6 cm x 3,5 cm, de contenido mucoide; se reportó como tumor mucinoso de bajo grado de malignidad para testicular (limítrofe). En vista de síntomas abdominales compresivos, se realiza laparotomía exploradora, encontrándose tumor lobulado de 21 cm x 19 cm x 12 cm en el retroperitoneo, que correspondió a carcinoma mucinoso variedad intestinal desarrollado en teratoma quístico maduro. Se concluyó que ambos tumores no guardaban relación entre sí, se consideraron sincrónicos.


Testicular and par testicular tumors of type epithelial are rare. There is little reference in literature of mucinous variety; the vast majorities are serous. In this article we discussed the case of 38 year old male who presented with a two year history of left low quadrant pain, abdominal mass and enlarged left testicle. Left orchiectomy was performed finding a mucoid cystic tumor, measuring 7 cm x 6 cm x 3.5 cm which was reported as a low grade malignancy par testicular mucinous (tumor Borderline). Consequently, since compressive symptoms persisted,the patient underwent exploratory laparotomy. A lobular tumor measuring 21 cm x 19 cm x 12 cm was found in the retroperitoneum. It corresponded to mucinous carcinoma of the intestinal variety within a mature cystic teratoma. Based on these findings and after reviewing the literature it was concluded that both tumors were independent from each other, considering them synchronous tumors.


Subject(s)
Humans , Male , Adult , Pain/diagnosis , Testicular Neoplasms/surgery , Testicular Neoplasms/pathology , Orchiectomy/methods , Adenocarcinoma, Mucinous/pathology , Low Back Pain/diagnosis , Medical Oncology , Palpation/methods
20.
Arq. bras. med. vet. zootec ; 61(3): 676-681, jun. 2009. ilus, tab
Article in Portuguese | LILACS | ID: lil-519462

ABSTRACT

Foram estudados 48 bovinos machos oriundos de inseminação artificial, criados em pasto, sendo 24 (12 Nelore e 12 F1 ½ Red Angus-Nelore ) tratados com antiparasitários alopáticos e 24 (mesmo número de puros e cruzados) tratados com o antiparasitário bioterápico Fator C&MC. Os animais foram desmamados aos oito meses, metade de cada subgrupo genético (6) foi castrado aos 13 meses e todos abatidos aos 32 meses, com o objetivo de verificar a influência do tratamento antiparasitário, do grupo genético e da condição sexual sobre as medidas de área de olho de lombo (AOL) e espessura de gordura de lombo (EGL). Usaram-se medidas de ultrassonografia no animal vivo (AOLU e EGLU) e na carcaça, plástico quadriculado e paquímetro (AOLC e EGLC). Os animais F1, os inteiros e os tratados com alopatia apresentaram peso vivo maior quando comparados aos Nelores, castrados e tratados com bioterápicos. Não houve diferença da AOLU e AOLC entre os grupos genéticos. EGLC foi mais alta nos cruzados. Os animais inteiros apresentaram AOLU e AOLC maiores que os castrados, e EGLU e EGLC menores. Foram altamente significativos os coeficientes de correlação entre as medidas por ultrassom e na carcaça para área de olho de lombo (0,87) e espessura de gordura do lombo (0,95).


Forty-eight male bovines, products of artificial insemination and raised on pasture, were studied, being 24 (12 Nelore, 12 F1 ½ Nelore ½ Red Angus) treated with allopathic antiparasitic drugs and 24 (same number of pure and crossbred) treated with a biotherapic antiparasitic drug Factor C&MC. Animals were weaned at eight months of age and half of each genetic subgroup (six) was castrated at 13 months of age. All animals were slaughtered at 32 months of age, in an attempt to evaluate the influence of antiparasitic treatment, genetic group, and gender condition in the measurements of rib eye area (AOL) and fat thickness (EGL) of loin. Measurements of ultrasonography were used for live animals (AOLU and EGLU), whereas a direct plastic grid reading of the eye muscle and a pachymeter (AOLC and EGLC) were used for carcasses. F1 animals, non-castrated, and those treated with allopathic drugs showed higher live weight when compared with Nelore, castrated, and biotherapic treated animals. There were no differences between genetic groups of AOLU and AOLC. EGLC was higher in crossbred animals. Non-castrated animals showed higher AOLU and AOLC when compared with castrated animals, and lower EGLU and EGLC. Correlation coefficients for ultrasound and carcass measurements were highly significant for rib eye area (0.87) and fat thickness (0.95).


Subject(s)
Animals , Male , Antiparasitic Agents/adverse effects , Antiparasitic Agents , Biotherapics , Cattle , Models, Genetic , Orchiectomy/adverse effects , Orchiectomy/methods , Orchiectomy/veterinary , Ultrasonography/methods
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