Scroto-perineal hidradenitis suppurativa complicated by giant scrotal elephantiasis

Scrotal elephantiasis has been a recognized complication of inguinal node irradiation, filarial infection, tumor involvement and surgical lymphatic destruction, but has rarely been reported in association with hidradenitis suppurativa [HS]. HS, also known as acne inversa, is a chronic and often debilitating disease primarily affecting the axillae, inframammary regions and perineum. The location of the lesions may lead to social embarrassment and failure to seek medical treatment. Scroto-preineal HS complicated by scrotal elephantiasis is a distressing disease. Excisional surgery with reconstruction is the recommended treatment with a high likelihood of good outcome. We present a 38-year-old male patient with long-standing scroto-perineal HS complicated by giant scrotal elephantiasis

Clinical, endocrinological and histopathological patterns of infertile Saudi men subjected to testicular biopsy: a retrospective study from a single center

To evaluate the outcome of testicular biopsies as well as the etiology of azoospermia and severe oligospermia in Saudi men referred for tertiary care. To correlate testicular histology with patients' clinical and hormonal profiles. Charts of men subjected to testicular biopsies in the last 10-year period were retrospectively reviewed. Relative history and physical examination findings were reported. Results of male fertility profile tests and semen analysis of at least two ejaculates were collected. Reported histopathology was obtained. Reports of 229 patients were included; 199 [86.9%] with azoospermia and 30 [13.1%] with severe oligospermia. The mean [SD] age was 30.6 [6.4] years. A small right or left testis was reported in 88 [38.4%] and 87 [38%] of the patients, respectively. The mean [SD] testosterone and follicle stimulating hormone [FSH] values were 17.2 [7.2] nmol/L and 13.1 [10.9] IU/L, respectively. Hypospermatogenesis was the most common histology encountered [36.5%], followed by Sertoli cell-only [SCO] histology [31.5%]. Low testicular volume [P = 0.000], high FSH [P = 0.001] and high leutenizing hormone [LH] [P = 0.001] were found to be of significantly adverse effect on spermatogenesis. Despite having bilateral small testes, high serum FSH and LH, 24.3% of our patients showed active spermatogenesis. Hypospermatogenesis was the most common pattern of spermatogenic defect in our patients. SCO histology was the most common pattern in patients with small testes, primary testicular failure, primary infertility and azoospermia. Low testicular volume, high FSH and LH are significantly associated with impaired spermatogenesis. Even with severe male factor infertility disorders, infertile men can have some spermatogenesis