Effects of individualized treatment of contralateral patent processus vaginalis during laparoscopic high ligation of processus vaginalis / 现代泌尿外科杂志

【Objective】 To explore the rational management of contralateral patent processus vaginalis (CPPV) in laparoscopic high ligation of processus vaginalis. 【Methods】 A total of 300 children with unilateral oblique inguinal hernia/hydrocele who received laparoscopic high ligation of processus vaginalis in Baoding Children’s Hospital during Jun.2018 and Jun.2022 were selected and divided into two groups by random number table method, with 150 in either group. In the control group, 53 cases of CPPV were found intraoperatively, which were treated simultaneously. In the study group, 58 cases of CPPV were detected, among which 11 met the indications of high ligation and received simultaneous surgical treatment. The incidence of recurrence was compared between the two groups. 【Results】 After 1 year of follow-up, the recurrence rate was 8.62% in the study group and 1.88% in the control group (P>0.05). The detection rate of CPPV was 23.02% in children with unilateral inguinal hernia, significantly lower than that in children with unilateral hydrocele (49.07%, P<0.001). The detection rate of CPPV was 42.71% in children with left patent processus vaginalis and 32.95% in children with right patent processus vaginalis (P=0.19). The detection rate of CPPV was 62.93% in the age group of 1-2 years, significantly higher than that in other age groups (P<0.001). 【Conclusion】 The incidence of CPPV conversion into oblique inguinal hernia or hydrocele is low. Only children who meet the indications can be treated at the same time during surgery.

Tunica vaginalis flap – is it a better surgical choice for urethro-cutaneous fistula following circumcision?

Objective: To study the effectiveness of tunica vaginalis flap in repair of post circumcision urethro- cutaneous fistula. Materials and Methods: The current study reviewed all patients having surgical repair of post-circumcision urethrocutaneous fistula from December 2014 to April 2019 at our institution. Results: Ten cases presenting at age 5 to 22 years were operated. Most [60%] of the circumcisions were performed by a doctor at peripheral hospitals and others were done by traditional circumcisers. All cases had a single fistula and the size was more than 5mm in all cases. Three-layered fistula closure was done in all cases using the tunica vaginalis flap as the second layer for closure. There was no recurrence in any case. Conclusion: Use of Tunica vaginalis flap for repair of post circumcision urethro-cutaneous fistula is a highly effective technique regardless of size and site of the fistula. It is a simple procedure without any postoperative complications and without any recurrence

The application of pedicled tunica vaginalis flap cover new urethra in redo and second-stage hypospadias repair / 中华泌尿外科杂志

Objective To investigate the application of pedicled tunica vaginalis flap cover new urethra in redo and second-stage hypospadias repair.Methods Retrospective analysis was performed in 45 redo hypospadias repair cases,aged from 1 year 3 months to 9 years 4 months (median 5 years 3month).All patients were divided into urethral dehiscence after hypospadias repair (group A) and the second stage surgery of two-stage hypospadias repair (group B) based on medical history.According to the site of dehiscence,the group A were further divided into midshaft urethral dehiscence (A1) and glans and distal urethral dehiscence with urethral opening located on midshaft (A2).After new urethra was completed,the appropriate size of the pedicledtunica vaginalis flap was transferred to cover the new urethra.Results There was no scrotal hematoma occurred in all 45 cases,and somecomplications occurred,including scrotal swelling in 1 case,high-riding testicle in 2 cases,penile clockwise torsion in 1 case,urethrocutaneous fistula in 6 cases.All the 45 cases were followed up for 1 to 4 years,with mean of 1.8 years.One more urethrocutaneous fistula occurred in group A2 and 1 more urethrocutaneous fistula with urethral stricture occurred in group B.There was no penile curvature and urethral diverticulum occurred in all cases.Conclusions Pedicled tunica vaginalis flap could be used as waterproofing layer to cover new urethra in redo hypospadias repair and presented a low incidence rate of postoperative complications.

Corporoplasty using autologous tunica vaginalis graft for Peyronie's disease / 中华男科学杂志

<p><b>Objective</b>To assess the effect of corporoplasty with autologous tunica vaginalis graft in the treatment of Peyronie's disease.</p><p><b>METHODS</b>Ten patients with Peyronie's disease underwent plaque excision and corporoplasty with autologous tunica vaginalis graft. We obtained and compared IIEF-5 scores of the patients before and at 1 and 5 years after operation.</p><p><b>RESULTS</b>After surgery, penile curvature was obviously relieved and all the patients achieved normal penile erection and satisfactory sexual intercourse without erection-related pain or recurrent erectile dysfunction. The mean IIEF-5 score was significantly improved at 1 year (22.40±1.08) and 5 years postoperatively (23.00±1.14) as compared with the baseline, (19.20±2.28) (P<0.05 or 0.01).</p><p><b>CONCLUSIONS</b>Corporoplasty with autologous tunica vaginalis graft is a safe, simple and effective option for the treatment of Peyronie's disease, though its definite efficiency is to be further supported by large-sample clinical studies.</p>

Application of vascularized tunica vaginalis flap technique in repairing recurrent urethrocutaneous fistula following hypospadias surgery / 中华泌尿外科杂志

Objective To investigate the feasibility and efficacy of tunica vaginalis flap cover in treatment of recurrent urethrocutaneous fistula (UCF).Methods We reviewed the clinical datas of 25 cases of UCF after urethroplasty of hypospadias from January 2011 to January 2015.The mean age of the patients was 6.2 years(range 1.6-14.0 years).All patients had undergone previous hypospadias repair and at least one previous failed attempt to close the urethrocutaneous fistulae.There were 5 cases of fistula in the coronary sulcus,6 cases of fistula in the penile body and 14 cases of fistula at the junction of penis and scrotum.The diameter of urethrocutaneous fistulae were 3-10 mm.Single fistula was present in all patients.16 cases had undergone UCF repair for two times, 9 cases had undergone UCF repair for more than two times.After closing the fistula with inverting running stitch, a tunica vaginalis flap was mobilized to cover the repair site through a subcutaneous tunnel and the skin closed.Results The mean follow-up time was 2.1 years(range 0.5-4 years).The overall success rate was 96％ (24/25).Penile cosmesis was excellent.There was no evidence of recurrent fistulas or urethral strictures.All parents reported a straight penis when erected, and one patient in whom there was leak from the fistula site because of local wound infection.No postoperative complication was encountered in the testis.The testis was of normal size and position, and the ultrasound findings were normal.Conclusions Repairment of recurrent urethrocutaneous fistulas with a tunica vaginalis flap could be effective regardless of fistula location.The technique is simple to improve the success rate of the repair of UCF effectively and reduce the occurrence of postoperative complications.

Mesotelioma bem diferenciado (benigno) de túnica vaginal: relato de um caso e revisão da literatura / Well-differentiated (benign) mesothelioma of the tunica vaginalis: report of a case and literature review

Mesoteliomas são tumores oriundos das células mesoteliais da pleura, peritônio, pericárdio ou túnica vaginal, sendo a exposição prolongada ao asbesto o principal fator de risco. Neoplasias mesoteliais benignas da região paratesticular são raras. Relata-se um caso de Mesotelioma de Túnica Vaginal associado à hidrocele, destacando a utilidade da ecografia na avaliação das massas escrotais (AU)

Mesotheliomas are tumors originating from the mesothelial cells of the pleura, peritoneum, pericardium or tunica vaginalis, with prolonged exposure to asbestos the main risk factor. Benign mesothelial neoplasms of the paratesticular region are rare. Here we report a case of tunica vaginalis mesothelioma associated with hydrocele, highlighting the usefulness of ultrasound in the evaluation of scrotal masses (AU)

Well-Differentiated Papillary Mesothelioma of the Tunica Vaginalis: A Case Study and Review of the Literature

Well-differentiated papillary mesothelioma is an uncommon tumor of the testes that usually presents as a hydrocele. Here, we present the case of one patient who did not have a history of asbestos exposure. The tumor was localized in the tunica vaginalis and was composed of three pedunculated masses macroscopically. Microscopically, branching papillary structures with focal coagulative necrosis were present. In addition to immunohistochemistry, simian virus 40 DNA was also tested by polymerase chain reaction. This report presents one case of this rare entity, its clinical and macroscopic features, and follow-up results.

Epithelioid malignant mesothelioma of tunica vaginalis with deciduoid features: An unusual malignancy clinically masquerading an inguinal hernia.

Paratesticular/scrotal and inguinal canal mass lesions in elderly patients may pose a diagnostic challenge to both the surgeon as well as the pathologist. In most cases, these represent hernial sacs with their contents, and true neoplasms like lipomas, rhabdomyosarcomas, and fibrous pseudotumors are infrequent. Malignant mesotheliomas arising from the tunica layers are rare cause of inguinal and paratesticular tumors. Herein, we report a case of an elderly patient who presented with an inguinal hernia which pathologically had features of deciduoid malignant mesothelioma.

Ultrasonographic Findings of Fibrous Pseudotumor Arising from the Tunica Vaginalis Testis: A Case Report

Fibrous pseudotumors are rare, benign fibroproliferative tumor-like lesions in the scrotum, and they most commonly arise from the tunica vaginalis testis (75%). There have been few reported cases of the fibrous pseudotumor of the tunica vaginalis testis with the radiologic findings, so we report on this rare case with focusing on the ultrasonographic findings. A 20-year-old man was admitted with a palpable mass in the right scrotum. On ultrasonography, multiple nodules were seen together with posterior shadowing along the inner surface of the scrotal wall. Fibrous pseudotumor arising from the tunica vaginalis testis was pathologically confirmed after surgical excision.

Malignant mesothelioma of the tunica vaginalis testis: one case report / 国际外科学杂志

Objective To study the clinical and pathological features, diagnosis and treatment of malig-nant mesothelioma of the tunica vaginalis testis. Methods One case of malignant mesothelioma of the tuni-ca vaginalis testis was reported. The patient was a 73 years old man, presented with a history of aggravated hydrocele for 1 year. B-ultrasound showed 7.5 cm×4.1 cm liquid anechoic area around the testis. The Pubmed and CBM databases were searched for related articles, and the clinical data were reviewed. Results An operation was performed to incise the tunica vaginalis. The pathology showed fecal caneeration in the tunica vaginalis testis and the immunohistology showed CK5/6, Calretinin and E-cadlberin positive. Right or-chiectomy was performed after three weeks. Local tumor recurrence and inguinal lymph nodes metastasis were found 11 months after operation, and local tumor and lymph nodes were resected. The tumor was diagnosed as malignant mesothelioma of the tunica vaginalis testis and CK5/6 and Calretinin fecal positive. Conclu-sions Malignant mesothelioma of the tunica vaginalis is a rare disease of the testis with potentially aggres-sive behavior. Due to the lack of tumor markers and characteristic symptoms, correct preoperative diagnosis is extremely difficult. Radical surgical treatment is of major importance to the survival of the patients. Life-long follow-up should be offered to patients with malignant mesothelioma of the tunica vaginalis.

Malignant mesothelioma of the tunica vaginalis testis (a case report and literature review) / 中华泌尿外科杂志

Objective To review the clinical manifestation,pathological characteristics,treat ment and prognosis of malignant mesothelioma of the tuniea vaginalis testis.Methods A case of ma lignant mesothelioma of the tunica vaginalis testis was reported and relative literature was reviewed.A34 year old man was admitted to hospital with a history of aggravated hydroeele for 5 years.A hardtumor was palpated above the right testis,which was smooth and slight tenderness.The level of β-hCG and AFP was normal.Ultrasonography revealed a 2.05 cm× 1.97 cm,well demarcated,mixedecho tumor.Results An operation was performed to incise the tumor and tunica vaginalis undersubarachnoid space block anesthesia.The tumor was histologically diagnosed as low potential malig nant mesothelioma of the tunica vaginalis testis.Microscopic examination showed that the tumor wasmalignant with a biphasic pattern composed of epithelial and stromal components.The former compo nent was dominant.The epithelial cells proliferated obviously with atypia and mitosis.Immunohisto chemical staining showed cytokeratin and vimentin were strongly positive.The capillary,lymph ves sel,spermatic cord and testis were not infiltrated.Right radical orchiectomy and right scrotectomywas performed one month after the first operation.There was no evidence of relapse during 38 monthfollow up after operation.Conclusions The major symptom of patients with malignant mesotheliomais hydrocele,malignant mesothelioma is diagnosed by histopathology.Due to the invasive potential ofthis disease and the risk of tumor recurrence,radical orchiectomy and close follow up are strongly rec ommended.

The tunica vaginalis dorsal graft urethroplasty: initial experience

INTRODUCTION: Nowadays, buccal mucosa grafts are the most successful method to reconstruct bulbar urethral strictures. Dorsal placement of the graft has been recently proposed, allowing the graft to be spread fixed on the tunica albuginea of the corporal bodies overlying the stricture. The dorsal graft is ingenious and represents a useful addition to the surgical armamentarium, since it offers a better chance for graft take than does the spongiosum when the urethra is diseased and poorly vascularized. We developed an additional reconstructive option using tunica vaginalis grafts, placed dorsally, for the treatment of anterior urethral strictures. SURGICAL TECHNIQUE: A total of 11 patients with anterior urethral strictures were treated with a tunica vaginalis graft urethroplasty. The surgical technique was done as described by Barbagli. The urethra was dissected from the corpora cavernosa and rotated 180 degrees. The dorsal urethral surface was exposed and fully opened. Both the distal and proximal lumina were calibrated. The tunica vaginalis graft was sutured, splayed and quilted over the corpora cavernosa using 6-0 PDS running stitches. The left side of the urethral mucosa was sutured to the graft using 6-0 PDS sutures. A 18F silicone Foley catheter was inserted at this point. The urethra was rotated back to its original position and sutured laterally to the right side of the graft. At the end of the procedure, the graft was completely covered by the urethra. With a follow-up ranging from 7 weeks to 5 months, all patients were voiding well (uroflowmetry > 14 mL per second). CONCLUSION: This initial experience in 11 patients indicates that tunica vaginalis dorsal graft urethroplasty may be considered within the reconstructive armamentarium of genitourinary surgeons.

Fibrous Pseudotumor in the Testicular Tunica / 대한비뇨기과학회지

Fibrous pseudotumor of the testicular tunics is uncommon lesion. They typically arise as painless scrotal masses that may be associated with a hydrocele or history of trauma or infection. Two-thirds involve the tunica vaginalis testis, with infrequent involvement of other scrotal structures. Once excised, these lesions behave in a benign fashion. Typically, these masses are multinodular, but in rare cases they are diffuse, band-like myofibroblastic proliferations that encase the testis. We report here on a case of fibrous pseudotumor of the tunica vaginalis in 76 year-old patient. (Korean J Urol 2006;47:1130-1132)

A Case of Scrotal Swelling Induced by Tunica Vaginalis Abscess

Scrotal swelling may be acute or chronic, painful or painless. Common causes of scrotal swelling in newborns are hydrocele, inguinal hernia, testicular torsion, testicular tumor, scrotal hematoma, meconium peritonitis and epididymitis. Abrupt onset of a painful scrotal swelling necessitates prompt evaluation. Testicular torsion and incarcerated inguinal hernia require urgent surgical management. We report a case of scrotal swelling caused by a tunica vaginalis abscess in a 20-days-old boy. He was admitted to the hospital due to fever, irritability and left scrotal swelling with local heat, tenderness and redness. Exploratory laparotomy was performed to rule out testicular torsion. On the operative field, congestive erythematous inflammation on the left tunica vaginalis was noted and it was filled with a pus like discharge. The cultured organism was Streptococcus agalactiae(group B). He recovered quickly after debridement and administration of empirical antibiotics.

Tubularized tunica vaginalis graft for male urethral reconstruction

Graft substances such as skin, bladder and buccal mucosa have been used for urethral replacement when local epithelial tissue is not available. However, these subtances have been associated with meatal prolapse, stricture and fistula formation. We tried tunica vaginalis as a urethral graft in rabbitsA graft of tunica vaginalis was placed in the excised portion of the urethra in five experimental rabbits. After 6 weeks retrograde urethrograms revealed no strictures and a fistula formation in one rabbit. The histopathologic examination revealed that the tunica vaginalis was covered by the transitional epithelium of the urethra. The tunica vaginalis could be used as a urethral graft in animals with a fistula formation as a complication. (Author)

Mesothelioma of the Tunica Vaginalis of the Testis / 대한비뇨기과학회지

Mesothelioma is an uncommon tumor arising from the serosal surfaces of the pleural, pericardial and peritoneal cavities. We report two cases of mesothelioma of the tunica vaginalis of the testis. A literature review of mesothelioma of the tunica vaginalis of the testis is presented.

A case of primary malignant mesothelioma of tunica vaginalis testis / 대한비뇨기과학회지

Mesothelioma is a neoplasm arising from the mesothelial cells lining the serous membrane such as pleura, peritoneum. and tunica vaginalis of testis. Primary malignant mesothelioma of tunica vaginalis is rare and there was no report in Korean literature yet. We report a case of a 43-year-old man with a painless palpable growing mass and histopathologically demonstrated to a malignant mesothelioma arising from the tunica vaginalis of testis.