Do retractile testes have anatomical anomalies?

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.

Generalidades de colgajos y su importancia en la relación con la reparación del daño corporal / General flap and its importance in relation to repair bodily harm

El daño corporal es tema de gran discusión en el marco médico legal. Las repercusiones funcionales y estéticas constituyen una secuela de gran importancia para los pacientes. Es mediante técnicas quirúrgicas como los colgajos, que se ha logrado prevenir cicatrices retráctiles y marcas indelebles en el rostro. Siendo estos últimos bloques vascularizados de tejido que se movilizan a partir de un sitio donador y se clasifican según su composición, vascularización y el método de diseño y transferencia. Dichos puntos, se discutirán a continuación.

Bodily harm is the subject of much discussion in the forensic context. The functional and aesthetic impact constitute a sequel of great importance for patients. It is through surgical techniques such as flaps, which has been successful in preventing retractile scars and indelible facial mark. Latter being vascularized tissue blocks that move from a donor site and are classified according to their composition, vascularization and the design method and transfer. This subjects, are discussed below.

Four Cases of Postoperative Sclerosing Mesenteritis

Mesenteric panniculitis is an extremely rare inflammatory condition of the adipose tissue of unknown etiology. It is characterized by extensive, progressive fibrosis of the mesenteric fat tissue, leading to tumor formation. Clinical manifestations vary according to the process involving the structures. Abdominal pain accompanied by nausea, malaise, pyrexia, and weight loss and a poorly defined mass are common presentations. Major pathologic changes include (1) degeneration of mesenteric fat, (2) an inflammatory reaction, and (3) fibrosis of the adipose tissue. We present four patients with an aggressive form of mesenteric pannicultis with characteristic histopathologic features. We discuss the relationship between the histopathologic features and the surgical intervention in these cases.

Sclerosing Mesenteritis

Sclerosing mesenteritis is a rare condition; it's an idiopathic nonspecific inflammatory process in the adipose tissue of the small bowel mesentery. It often develops into huge masses that contain necrotic fat, and these masses mimick malignancy. It has two pathologically different variants: mesenteric panniculitis (acute or subacute) and retractile-mesenteritis (chronic). Although infection, trauma, local ischemia, surgery and malignancy have been implicated in the etiology of this disease, the exact causes are unknown. The disease usually has a favorable prognosis. The diagnosis is confirmed by biopsy. A 59 year-old man visited in our hospital with vague abdominal pain and diarrhea that he had suffered with during the previous three months. A computed tomography (CT) scan showed a dilated small intestine and also masses in the small bowel mesentery. On the operative findings, fibrous masses were noted in the mesentery. The pathologic report revealed sclerosing mesenteritis. We report here on a case of sclerosing mesenteritis along with a review of the literatures.

Cases of Postoperative Mesenteric Panniculitis

Mesenteric panniculitis is a rare inflammatory condition of mesenteric adipose tissue in which the mesentery is replaced with fibrosis. The frequent symptoms of mesenteric panniculitis are palpable mass, abdominal pain and gastrointestinal obstructive symptoms. In the majority of cases, its course is self-limiting and the prognosis is favorable. 3 cases of mesenteric panniculitis are described that presented with obstructive symptoms of gastrointestinal tract, which occurred in 2 weeks following colectomy of colonic tumors. And reviewed the symptomatology, pathology, treatment, and outcome of this disorder.

Gross and Microscopic Findings of the Testes Ascended into abdomen During Neonatal and Prepubertal age in Rats / 대한비뇨기과학회지

PURPOSE: Because cryptorchid testes are known to undergo histopathologic changes affecting development, maturation, and tertility, early surgical correction is usually recommended. However there are differing opinions concerning whether retractile testes are affected by similar changes and also whether there is a need for surgical treatment. We aimed to assess the histopathologic changes in retractile testis by studying the changes in testes artificially placed back in the abdomen after they have descended to scrotum in experimental rat models. MATERIALS AND METHODS: Male Sprague-Dawley rats were divided into 3 groups; a control group(controls), prepubertal ascent group (P) in which testis were placed back intraabdominally by bilateral inguinal canal obstruction at 6 weeks, a neonatal group(N) in which intraabdminal testis was induced by bilateral inguinal canal obstruction at birth. The relative weight of the testis, morphology of the seminiferous tubules including Leydig cells, tubular degeneration phase(TDP), spermatogonia per tubules(S/T), and Sertoli cell index (SCI) of these three groups were analyzed and compared. RESULTS: The relative weight of testis was significantly decreased in the group of N(0.0016+/-0.001) and P(0.0015+/-0.0002) compared to controls(0.0037+/-0.0002) (p<0.05). The S/T value was also decreased in P(2.05+/-18.2) and N(73.2+/-32.4) when compared to controls (360.2+/-21.3). Similar changes were observed in SCI of both P(64.5+/-6.4) and N (91.2+/-14.2) when compared to controls (227.9+/-31.1). Only minority of N and P showed higher TDP values. However, although statistically insignificant, TDP was increased in both P and N when compared to controls. The Leydig cells in N and P showed cellular distortion and hypertrophy. CONCLUSIONS: This study demonstrate that prepubertal ascent, similar to that of innate cryptorchid testis, also can induce histopathologic changes such as changes in testicular seminiferous tubule, decrease in the S/T value and decrease in SCI value. Our findings supports that hypothesis that retractile testis may cause histological damage thus surgical correction may also be warranted similar to in case of genuine cryptorchism.

Pathological Characteristics in Retractile Testis comparing Cryptorchid Testis / 대한비뇨기과학회지

PURPOSE: Although retractile testes are frequently found in the pediatric population, there are controversies in the management of retractile testes. We investigated the necessity of treatment for retractile testes by analyzing their histologic findings. MATERIALS AND METHODS: Sixty-one testicular biopsies were performed during orchiopexy from 36 boys(range: 1.3-12.9 years, mean: 5.4 years) with retractile testes(11 unilateral, 50 bilateral) and 115 testicular biopsies from 83 cryptorchid patients(range: 0.6-15.0 years, mean: 3.7 years, 51 unilateral, 64 bilateral). Parameters for both Sertoli cell and germ cell were determined in each group. RESULTS: The average tubular degeneration phase(TDP) V-VII were 0.23+/-0.18 for retractile testes and 0.22+/-0.17 for cryptorchid testes and were not statistically different. Both the average sertoli cell index(SCI) and mean spermatogonia per tubules(S/T) value were statistically different between retractile and cryptrochid testes with values of 26.81+/-6.75, 23.04+/-5.85(p<0.01) and 2.96+/-1.33, 0.61+/-0.87(p<0.01), respectively. CONCLUSIONS: Although S/T value of retractile testes was higher than that of cryptorchid testes, Sertoli cell degenerative patterns were similar. These findings might indicate that retractile testis needs treatment like cryptorchid testis does. However, further investigation is warranted to elucidate whether these changes are normal variations since changes are observed in both Sertoli & germ cells in normal boys as they are aging.

New Method of Correction for Severe or Recurrent Concealed Penis after Operation by Conventional Method / 대한비뇨기과학회지

A concealed penis is a normally developed penis that becomes camouflaged by the suprapubic fat pad. This anomally can be congenital or iatrogenic following circumcision. A special variety of this disease is a retractile concealed penis with dysgenetic band of dartos fascia which produce recurrence not infrequently after operative correction by conventional method. We herein report 2 cases of concealed penis of which one case was a recurrent one and another was a case of severe degree with concomittent obesity where a new method for operative correction was applied.