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General Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Testicular or epididymal infections (orchitis or epididymitis) both cause painful inflammation and swelling within the ipsilateral scrotal sac, which should be visible to thermography. Varicocele is essentially a varicose vein within the scrotum. These usually painless varicosities appear warmer than the surrounding tissue in a serpentine pattern, similar to varicosities over other body locations (Figure 10.72).182 Non-painful, chronic scrotal swelling that appears cool thermographically may be due to a hydrocele.
Varicocele
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Charlotte V. Melling, David J.B. Keene, Raimondo M. Cervellione
A prospective study of 91 patients undergoing antegrade sclerotherapy in our center has shown the success rate for the above procedure using microfoam to be 96%. The study compared liquid scleroscant via y-connector, liquid via cannula, and foam via cannula (success rates 58%, 90%, and 96% respectively). There were 11 recurrences across the three groups. Any persistent varicoceles were successfully managed with repeat sclerotherapy, and there were no instances of postoperative testicular atrophy. One postoperative hydrocele was managed surgically with a Jaboulay procedure.
Genital
Published in A. Sahib El-Radhi, Paediatric Symptom and Sign Sorter, 2019
Following completion of testicular descent, the processus vaginalis closes and its lower portion becomes the tunica vaginalis testis. Failure to close results in a patent processus allowing the development of the two most common causes of painless scrotal swelling: hydrocele and inguinal hernia. Hydrocele is caused by drainage of peritoneal fluid through a narrow patent processus vaginalis (communicating hydrocele), while a wide patent processus vaginalis causes inguinal hernia by allowing omentum or bowel to pass into the scrotum. Failure to close the processus vaginalis in females results in formation of a patent pouch of the peritoneum with possible complication of inguinal hernia and hydrocele (hydrocele of canal of Nuck). The four most common painful causes of testicular swelling are testicular torsion, torsion of testicular appendage, incarcerated inguinal hernia and epididymitis/orchitis. Children with any of these causes may present as an acute scrotum, which is a medical emergency defined as scrotal pain, swelling and redness.
Microscopic subinguinal varicocelectomy in 100 consecutive cases: Spermatic cord vascular anatomy, recurrence and hydrocele outcome analysis
Published in Arab Journal of Urology, 2018
Ahmed M. Al-Kandari, Abdulnasser Khudair, Abdelghaffar Arafa, Fouad Zanaty, Ahmed Ezz, Mohamed El-Shazly
There is still considerable difficulty in discriminating small veins from lymphatic vessels even when using a microscope, which may account for the relatively high percentage of hydroceles. Oswald et al. [29] first described the application of isosulfan blue in varicocele surgery. Lymphatics were clearly stained in 86% after scrotal injection and no cases of hydrocele were evident [24[25]–26]. Finally, use of magnification to identify and preserve lymphatics in microsurgical varicocelectomy can virtually eliminate the risk of hydrocele formation after varicocelectomy [27,7,28]. In our present study, the incidence of hydrocele was 0.07%, which is clinically not significant. The strengths of our present study are a good sized sample and being prospective. The limitation of our study is the lack of the semen analysis outcome data, which we think would have been useful; however, the aim of the present study was to report vascular anatomy details and the relationship with recurrent varicoceles and hydrocele formation. Furthermore, we have reported on outcomes for semen analysis and pregnancy in a previous paper [8]. The effectiveness of microscopic varicocelectomy for semen improvement and pregnancy has been established [30[31]–32].
Metastatic seminoma presenting as neck and axillary lymphadenopathy in an elderly man
Published in Baylor University Medical Center Proceedings, 2023
Binoy Yohannan, Allen Omo-Ogboi, Johncy John Kachira, Syed H. Jafri
Seminoma is the most common (74%) malignant GCT in elderly men.3,4 The histological variants of seminoma include classic (85%), anaplastic (5% to 15%), and spermatocytic seminoma, with the latter more common in the elderly.3 The differential diagnosis of an elderly man with cervical lymphadenopathy includes lymphoma, metastatic head and neck cancer, metastatic cancer from the aerodigestive tract, and infection. Testicular neoplasms usually present as a painless mass in the testicle or with a secondary hydrocele. Occasionally, the primary testicular GCT may be absent due to spontaneous regression or “burnt-out primary,” which is well recognized, and the only manifestation may be testicular microlithiasis.5
Is aspiration and sclerotherapy treatment for hydroceles in the aging male an evidence-based treatment?
Published in The Aging Male, 2019
W. St. J. Taylor, J. Cobley, W. Mahmalji
The majority of hydroceles are treated with conservative treatment. The patient has an ultrasound scan to reassure them and the clinician that the underlying testicle is normal. If the hydrocele is particularly large or symptomatic then the patient can consider treatment. In the UK, the majority of hydroceles that require treatment are treated with surgery. Two main surgical techniques are used. The Lords plication, described in 1964 [6] and the Jaboulay repair in 1902 [7]. Aspiration and sclerotherapy are only usually considered in UK practice if the patient is not fit for surgical repair or unwilling to undergo scrotal surgery.