ABSTRACT
The authors report the case of a patient with a history of testicular cryptorchidism followed for 4 years for infertility and who developed seminoma. Bilateral testicular microlithiasis was initially detected on ultrasonography. On the basis of this case and a review of the literature, the authors discuss the aetiopathogenesis and management of these microscopic stones in a context of cancer.
Subject(s)
Lithiasis/complications , Seminoma/etiology , Testicular Diseases/complications , Testicular Neoplasms/etiology , Adult , Cryptorchidism/complications , Cryptorchidism/surgery , Humans , Infertility, Male/etiology , Lithiasis/diagnostic imaging , Lithiasis/therapy , Male , Orchiectomy , Seminoma/diagnostic imaging , Seminoma/therapy , Testicular Diseases/diagnostic imaging , Testicular Diseases/therapy , Testicular Neoplasms/diagnostic imaging , Testicular Neoplasms/therapy , UltrasonographyABSTRACT
Postprostatectomy incontinence remains a disabling condition. Sphincter injury, detrusor instability, and decreased bladder compliance have been previously reported as major factors. The aim of this study was to evaluate the urethral sphincter intrinsic component, which may provide passive continence. A urodynamic evaluation was performed in 20 patients undergoing a radical retropubic prostatectomy in the preoperative period and 3 months after surgery. Patients with disabled urinary incontinence underwent a new urodynamic evaluation 6 months later. The urethral pressure profile was measured just before, then 10, 20, and 30 minutes after the injection of 0.5 mg/kg moxisylyte chlorhydrate, an alpha adrenergic blocker. Three different pressure components were defined in urethral sphincter capacity: baseline, adrenergic, and voluntary. A postoperative intrinsic urethral sphincter pressure component was found in 17 patients and its value was under 6 cm H(2)O in five cases of severe incontinence. No significant difference was observed for these patients on urethral profile components 6 months later. In contrast, in cases of significant intrinsic component value, no incontinence was observed in most patients. Passive continence after radical prostatectomy should be a matter of concern and may also explain paradoxical incontinence, despite high voluntary urethral pressure obtained after reeducation. A follow-up evaluation of the intrinsic sphincter component is suggested, by using an alpha receptor blockage test during urodynamic studies in the management of patients with postprostatectomy incontinence.
Subject(s)
Prostatectomy/adverse effects , Urethra/physiopathology , Urinary Incontinence/etiology , Urinary Incontinence/physiopathology , Urodynamics , Adrenergic alpha-Antagonists , Aged , Humans , Male , Middle Aged , Moxisylyte , Pressure , Prospective Studies , SympatholyticsSubject(s)
Herniorrhaphy , Laparoscopy/methods , Urinary Diversion , Hernia/etiology , Humans , Male , Middle Aged , Polytetrafluoroethylene , Postoperative Complications , Surgical Mesh , Surgical StomasABSTRACT
OBJECTIVES: We report the usefulness of ultrasonography and magnetic resonance imaging (MRI) findings in testicular infarction, in order to avoid surgical exploration. METHODS: In December 2000, a 37-year-old African male presented with left testicular pain and no prior history of trauma. Physical examination, ultrasonography and MRI were performed by an experienced radiologist (D.T.), which suggested a segmental testicular infarction. Surgical exploration was not performed and a period of watchful waiting with evolution control by ultrasonography was decided. RESULTS: After a 3 month follow-up, the ultrasonography control revealed a total re-vascularization of the vessels and a reduction of the lesion size. CONCLUSION: The authors suggest that the combination of ultrasonography and MRI, in the management of testicular infarction, may avoid invasive surgery.
