RESUMO
Treatment for chronic male genital lymphedema (GL) is limited. No standard treatment or validated instrument to assess GL is available. The aim of this study was to explore whether magnetic resonance lymphography (MRL) could be used to assess GL, select proper treatment for patients, and monitor postoperative progress.This is a retrospective analysis of a prospectively acquired cohort of men with GL presenting for MRL over a 7-year period. Thirty-six of 47 eligible men were included. All men were offered preoperative and postoperative MRL and assigned a morphology and function classification. Men with mild, moderate, and severe nodal dysfunction underwent complex decongestive physiotherapy (CDP), lymphoveneous microsurgery, and surgical excision, respectively. The volume reductions in the genitalia of patients with mild and moderate nodal dysfunction were recorded and compared using Student t test.The abnormal superficial and deep lymphatic vessels in the lymphedematous genitalia were detected by MRL, and inguinal lymph node dysfunction was classified by MRL. Seven patients with mild dysfunction who underwent CDP showed a more significant mean volume reduction in the genitalia than did 9 patients with moderate dysfunction. Three patients with hyperplasia and moderate dysfunction who underwent microsurgical operations and 17 patients with hypoplasia and moderate or severe nodal dysfunction who underwent surgical excision had excellent cosmetic results with no lymphedema at the 3- to 5-year follow-up.MRL can be used to assess morphological and functional lymphatic abnormalities in GL, preoperatively select appropriate treatment, and postoperatively evaluate treatment outcomes.
Assuntos
Doenças dos Genitais Masculinos/diagnóstico por imagem , Linfedema/diagnóstico por imagem , Linfografia/métodos , Imageamento por Ressonância Magnética/métodos , Doenças dos Genitais Masculinos/reabilitação , Doenças dos Genitais Masculinos/cirurgia , Humanos , Linfonodos/diagnóstico por imagem , Vasos Linfáticos/diagnóstico por imagem , Linfedema/reabilitação , Linfedema/cirurgia , Masculino , Estudos Prospectivos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
A Cowper's syringocele in an adult is rare. Ten cases are reported in the world literature. The authors report a case of painful haematuria due to the presence of a Cowper's syringocele in an adult. The classification of lesions of the Cowper's gland is discussed together with common symptoms and differential diagnosis.
