ABSTRACT
Los tumores testiculares representan el 1-2% de las neoplasias masculinas, siendo el más frecuente el seminoma. En pacientes con aparición de una masa o dolor testicular subagudo, es importante hacer una anamnesis exhaustiva y una exploración física. Hemos de apoyarnos en dos técnicas exploratorias para poder hacer un diagnóstico diferencial adecuado y detectar patología testicular urgente: transiluminación y ecografía testicular. El tratamiento incluye una orquiectomía y, según el estadio tumoral, quimioterapia.(AU)
Testicular tumors account for 1% to 2% of male neoplasms, the most common being seminoma. In patients who consult due to the presence of a mass or subacute testicular pain, it is important to undertake a thorough history and physical examination. We must rely on two exploratory techniques to be able to perform a suitable differential diagnosis and detect urgent testicular pathology: transillumination and testicular ultrasound. Treatment includes performing an orchiectomy and depends on tumor stage and chemotherapy.(AU)
Subject(s)
Humans , Transillumination , Testicular Neoplasms , Primary Health Care , Seminoma , Orchitis , Testis , Inpatients , Physical Examination , Symptom AssessmentABSTRACT
OBJECTIVE: The main objective of this revision is to summarize the current existing evidence of the potential adverse effects of SARS-CoV-2 on the male reproductive system and provide the recommendations of the Asociación Española de Andrología, Medicina Sexual y Reproductiva (ASESA) concerning the implications of COVID-19 infection in the management of male infertilty patients and testicular endocrine dysfunction. METHODS: A comprehensive systematic literature search of the databases of PubMed, Web of Science, Embase, Medline, Cochrane and MedRxiv, was carried out. RESULTS: The presence of orchitis as a potential complication of the infection by SARS-CoV-2 has not yet been confirmed. One study reported that 19% of males with COVID-19 infection had scrotal symptoms suggestive of viral orchitis which could not be confirmed. It is possible that the virus, rather than infecting the testes directly, may induce a secondary autoimmune response leading to autoimmune orchitis. COVID-19 has been associated with coagulation disorders and thus the orchitis could be the result of segmental vasculitis. Existing data concerning the presence of the virus in semen are contradictory. Only one study reported the presence of RNA in 15.8% of patients with COVID-19. However, the presence of nucleic acid or antigen in semen is not synonyms of viral replication capacity and infectivity. It has been reported an increase in serum levels of LH in males with COVID-19 and a significant reduction in the T/LH and FSH/LH ratios, consistent with subclinical hypogonadism. CONCLUSIONS: The findings of recent reports related to the potential effects of COVID-19 infection on the male reproductive system are based on poorly designed, small sample size studies that provide inconclusive, contradictory results. Since there still exists a theoretical possibility of testicular damage and male infertilty as a result of the infection by COVID-19, males of reproductive age should be evaluated for gonadal function and semen analysis. With regard to the sexual transmission of the virus, there is not sufficient evidence to recommend asymptomatic couples to abstein from having sex in order to protect themselves from being infected by the virus. Additional studies are needed to understand the long-term effects of SARS-CoV-2 on male reproductive function, including male fertility potential and endocrine testicular function.
Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Pandemics , Pneumonia, Viral/complications , Reproductive Health , Sexual Health , Adult , Betacoronavirus/isolation & purification , Betacoronavirus/pathogenicity , Betacoronavirus/physiology , COVID-19 , Follicle Stimulating Hormone/blood , Humans , Hypogonadism/blood , Hypogonadism/etiology , Immunoglobulin G/analysis , Leukocytes , Luteinizing Hormone/blood , Male , Orchitis/etiology , Orchitis/virology , Prostate/virology , RNA, Viral/analysis , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2 , Semen/virology , Semen Preservation , Spain , Testis/immunology , Testis/pathology , Testis/virology , Testosterone/blood , Vasculitis/etiology , Young AdultABSTRACT
La afectación osteoarticular es la complicación más frecuente de la brucelosis. La espondilodiscitis es una complicación grave, ya que suele estar asociada con la formación de abscesos. Se presenta el caso de un varón de 43 años de edad, natural de Marruecos, con síntomas, signos y hallazgos imagenológicos de espondilodiscitis de larga evolución, orquitis y endocarditis. Mediante la realización de pruebas de laboratorio complementarias se llega al diagnóstico de infección por Brucella spp. El presente caso busca concientizar a la comunidad médica sobre la importancia de considerar la infección por Brucella spp. como diagnóstico diferencial en pacientes con sospecha de espondilodiscitis infecciosa, especialmente en aquellos pacientes con antecedentes epidemiológicos, permitiendo así realizar un acertado y oportuno diagnóstico. Este caso resulta interesante porque nunca antes se había descrito la presencia simultánea de estas tres manifestaciones de la brucelosis en un paciente inmuno competente. (Acta Med Colomb 2015; 40: 166-168).
Osteoarticular involvement is the most common complication of brucellosis. Spondylodiscitis is a serious complication as it is often associated with abscess formation. The case of a 43 years old man born in Morocco with symptoms, signs and imaging findings of longstanding spondylodiscitis, orchitis and endocarditis is presented. Through the implementation of complementary laboratory tests, diagnosis infection by Brucella spp. was made.This case aims to raise awareness in the medical community about the importance of considering Brucella spp. as a differential diagnosis in patients with suspected infectious spondylodiscitis, especially in those patients with epidemiological background, allowing make a successful and timely diagnosis. This case is interesting because never before had been described the simultaneous presence of these three manifestations of brucellosis in an immunocompetent patient. (Acta Med Colomb 2015; 40: 166-168).
Subject(s)
Humans , Male , Adult , Discitis , Orchitis , Brucella , Brucellosis , Diagnosis, Differential , EndocarditisABSTRACT
Out of 1608 Nigerian Sahel male goats (bucks) examined for cryptorchidism in an abattoir, 9 (0.6 percent) had right unilateral cryptorchidism. The coat colour-specific prevalence was highest among the brown bucks (2.1 percent); and was 0.8 percent, 0.6 percent, and 0.3 percent among black, white, back-and-white bucks, respectively. The condition was not found among bucks with brown-and-black, brown-and-white, and multiple coat colours. The right and left testes of normal bucks and the descended testes of cryptorchid bucks had comparable gross testicular measurements, but the retained cryptorchid testes were smaller in size. The estimates of the testicular measurements showed that testicular weights (with the entire epididymes), peripheral longitudinal lengths and mid-circumferences of the cryptorchids were reduced by 5.8-6.5, 1.8-1.9, and 1.7-1.8 folds, respectively, when compared with the normal values; an indication that reduction in weight was the most remarkable index of change in testicular size. In 2 cases (20 percent), cryptorchid testes were at a subcutaneous location, embedded in a subcutaneous fascia in the ventral perineal region, while in the other 8 cryptorchid cases (80 percent), the testes were in the abdomen. Histopathological changes in the cryptorchid testes included hypoplasia, degeneration, interstitial non-suppurative inflammation and fibroplasia. This is the first report of cryptorchidism in the Sahel goat and the first evidence that cryptorchid testis may be located subcutaneously in the goat.
De las 1608 cabras Sahel Nigerianas macho examinadas para criptorquidismo en un matadero, 9 (0,6 por ciento) tuvieron criptorquidia unilateral derecha. La prevalencia en relación al color específico del pelaje fue mayor entre las cabras marrones (2,1 por ciento), y fue de 0,8 por ciento, 0,6 por ciento y 0,3 por ciento entre cabras de color negro, blanco, y blanco/negro respectivamente. La condición no fue encontrada entre las cabras con pelajes marrón y negro, marrón y blanco, y pelajes de múltiples colores. Los testículos derecho e izquierdo de las cabras normales y los testículos descendentes de las cabras con criptorquídia tuvieron mediciones testiculares comparables, pero los testículos retenidos por criptorquídia fueron de menor tamaño. Las estimaciones de las mediciones testiculares mostraron que los pesos testiculares (con todo el epidídimo), la longitud periférica y la circunferencia media de las criptorquídicas fueron reducidas por 5,8-6,5; 1,8-1,9 y 1,7-1,8 pliegues respectivamente, en comparación con el los valores normales; una indicación que la reducción de peso fue el índice de cambio más notable en el tamaño testicular. En 2 casos (20 por ciento), los testículos criptorquídicos se encontraron en una ubicación subcutánea, inmersos en una fascia subcutánea en la región perineal ventral, mientras que en los otros 8 casos criptorquídicos (80 por ciento), los testículos fueron encontrados en el abdomen. Cambios histopatológicos en los testículos criptorquídicos incluyeron hipoplasia, degeneración, inflamación intersticial no supurativa y fibroplasia. Este es el primer informe de criptorquidia en cabras Sahel y la primera evidencia de que los testículos criptorquídicos pueden ser localizados por vía subcutánea en la cabra.
