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Ultrasonography of the Bovine Reproductive System: Ultrasound Management of the Male Reproductive System
Published in Juan Carlos Gardón, Katy Satué, Biotechnologies Applied to Animal Reproduction, 2020
Giovanni Gnemmi, Juan Carlos Gardón, Cristina Maraboli
The spermatic cord grows to 14 months of age (Kastelic and Thundathil, 2008). The spermatic cord is circumscribed by the vaginal tunic (visceral and parietal lamina lamina); inside is the pampiniform plexus, formed by the two testicular veins and the tortuous testicular artery. The two testicular veins communicate with each other and form an extraordinary tangle of vessels near the artery. The vas deferens also form a part of the spermatic cord. Outside the vaginal tunic is the crematorium muscle. The spermatic cord is always evaluated with a posterior approach, in the transversal sections or with a longitudinal section.
Ultrasound Imaging of the Infertile Male
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Amr Abdel Raheem, Giulio Garaffa, Hatem El-Azizi
Normal findings: The testis normally has an intermediate homogenous echogenicity with thin echogenic bands that represent the fibrous septa that divide the testis into lobules. The epididymis lies behind the posterior border of the testis and consists of head, body, and tail and is similar in echogenicity to the testis. The vas deferens appears as a straight dense cord with a hypoechoic lumen in the posteromedial aspect of the spermatic cord. The appendix testis and appendix epididymis can be seen in some patients and appear as small oval structures of similar echogenicity to the testis. A thin echogenic band, the tunica albuginea, surrounds the testis. Normally there is a small physiological amount of fluid that appears anechoic between the tunica albuginea and surrounding tunica vaginalis. The mediastinum testis, which contains the testicular vessels and nerves, appears as a thin echogenic band on the posteromedial border of the testis. The rete testes can be seen in some patients and appears as a hypoechoic area behind the mediastinum. The spermatic cord containing the vas deferens and testicular vessels can be seen above the testis and within the inguinal canal [6].
The abdominal wall and inguinoscrotal conditions
Published in Spencer W. Beasley, John Hutson, Mark Stringer, Sebastian K. King, Warwick J. Teague, Paediatric Surgical Diagnosis, 2018
Spencer W. Beasley, John Hutson, Mark Stringer, Sebastian K. King, Warwick J. Teague
A varicocele is enlargement of the veins of the pampiniform plexus in the spermatic cord, and almost always involves the left side and develops around the time of puberty. There may be little abnormality to observe when the adolescent is supine apart from an asymmetrical scrotum (with the left side redundant), but on standing the veins fill and become visible, and feel like ‘a bag of worms’. A small secondary hydrocele may be observed. Varicoceles are usually symptomless, although some boys complain of a dragging ache or discomfort in the groin. If untreated, the left testis may not grow as much as the right testis at puberty, a reflection of the effect on spermatogenesis of unilateral warming of the testis by the surrounding veins. Uncommonly, a varicocele may develop from obstruction of one of the renal veins by a renal or perirenal tumour, of which Wilms tumour and neuroblastoma are the most common. Because the left testicular vein drains directly into the left renal vein, this sign is seen almost always on the left side. Consequently, an underlying cause must be suspected in a boy under 6 years of age who develops a varicocele; the tumour will usually be palpable as an abdominal mass.
Astaxanthin Protects Testicular Tissue against Torsion/Detorsion-Induced Injury via Suppressing Endoplasmic Reticulum Stress in Rats
Published in Journal of Investigative Surgery, 2022
Selim Demir,, Ilke Onur Kazaz, Gokcen Kerimoglu, Elif Ayazoglu Demir, Fatih Colak, Sedanur Yilmaz, Ahmet Mentese
Testicular torsion (TT) is a urological emergency caused by the entanglement of the spermatic cord [1]. It is estimated that 5 out of every 100,000 men under the age of 25 experience TT each year, with the greatest incidence seen in men of perinatal and adolescence age [2, 3]. Rotation of the spermatic cord results in the interruption of blood flow to the testicular tissue [4]. This process, called ischemia, causes biochemical and histological changes [1]. As the cell loses aerobic conditions during ischemia, the ATP pool decreases [2]. The only clinical option of the treatment of TT is the detorsion procedure. However, the reperfusion of the tissues with the detorsion process causes a more serious tissue damage than the ischemic state. This paradoxical situation is known as ischemia/reperfusion (I/R) injury and is reported to be the main mechanism underlying the etiopathogenesis of TT [4]. I/R damage occurs as a result of the explosion of reactive oxygen species (ROS) that cannot be tolerated in reoxygenated cells and can cause the body’s defense systems to collapse over time. Under these conditions, cell death pathways, such as apoptosis and autophagy, are activated to prevent multiple organ failure [5].
Non-pharmacological treatments for chronic orchialgia: A systemic review
Published in Arab Journal of Urology, 2021
Kareim Khalafalla, Mohamed Arafa, Haitham Elbardisi, Ahmad Majzoub
The present review identified 19 individual studies including 1676 testicular units for which MSCD was performed. In most cases an open approach for surgery was performed (inguinal [n = 14]; subinguinal [n = 3]; Table 1) [9–27]. Depending on the level of the incision, the aponeurosis of the external oblique muscle is either spared or opened. The ilioinguinal nerve is identified and a 2 cm segment is excised and ligated with proximal part buried well to avoid neuroma formation. Under microscopic magnification, the spermatic cord is brought up and its fascia is opened to expose the cord contents. Micro-Doppler ultrasonography (US) is used to identify the arterial flow in attempt to preserve testicular and cremasteric arteries during the procedure. The contents of the cord are ligated and dissected, which includes the cremasteric fascia, spermatic cord fat, and the pampiniform plexus of veins. Lymphatics are preferably spared to avoid hydrocele formation. The vas deferens is also preserved to reduce epididymal congestion, which decreases the incidence of post-vasectomy pain syndrome (PVPS). However, stripping of the perivasal tissues is performed to ensure obliteration of all the neural fibres.
A funny case of Funiculitis
Published in Acta Clinica Belgica, 2021
CT angiography of the splanchnic and renal vessels revealed no abnormalities. A surgical biopsy of the spermatic cord was performed. Histopathological analysis revealed abnormal intravascular and perivascular neutrophilic collections without vascular wall damage or fibrinoid necrosis. Positron emission tomography showed an increased 18FDG-uptake in the aortic wall, the carotid, subclavian, iliac and femoral arteries (Figure 1). A diagnosis of medium vessel vasculitis was made and treatment with methylprednisolone 32 mg/d was started perorally. The patient showed a rapid clinical improvement with resolution of fever and testicular swelling and tenderness. Inflammatory markers normalized. At an outpatient visit four months after discharge from the hospital, the patient was doing well with absence of inflammation and no recurrence of initial symptoms under treatment with methylprednisolone at a dose tapered to 8 mg/d.