Paediatric surgery
Roy Palmer, Diana Wetherill in Medicine for Lawyers, 2020
Testicular torsion (twisting of a testicle within the scrotum) is heralded by the sudden onset of excruciating pain in the scrotum. There are two peaks in incidence: first in the neonatal period, and second in the early teenage years. So-called neonatal torsion almost certainly occurs in utero prior to birth and the affected testis is unsalvageable. It is mandatory that the contralateral testis is ‘fixed’ to prevent torsion occurring in the remaining functional testis. In older children, diagnosis and treatment should be carried out within six hours to prevent irreversible damage and, again, the contralateral testis must be fixed. A common error is to diagnose torsion as epididymo-orchitis and to delay treatment while investigations such as Doppler ultrasound or radioisotope studies are carried out.
The urinary tract and male reproductive system
C. Simon Herrington in Muir's Textbook of Pathology, 2020
The male reproductive system comprises the following structures: The testes, in which the seminiferous tubules produce spermatozoa and the interstitial (Leydig) cells produce the male hormone testosterone. Spermatozoa pass from the testis via the rete testis through the epididymis and the vas deferens to the urethra, and thence to the exterior via the penis at ejaculation. Fluid produced from the seminal vesicles, which are posterior to the prostate, are added to the spermatozoa on ejaculation through the penis.The prostate gland, which is situated at the base of the bladder and surrounds the prostatic urethra. In the normal male this gland is about the size of a walnut and adds secretions to semen that are necessary for sperm viability. Neither seminal vesicles nor the prostate are a place of storage for sperm.
Metagonimus
Dongyou Liu in Handbook of Foodborne Diseases, 2018
It is well acknowledged that the adult flukes of M. yokogawai (Figure 71.1a) have a unique position and arrangement of two testes, which are closely adjacent to each other near the posterior extremity of the body.15,19,29 However, in M. takahashii (Figure 71.1b) and M. miyatai (Figure 71.1c) adults, the two testes are more or less separated from each other.9,22,31 Moreover, in M. yokogawai adults, the vitelline follicles are distributed in lateral fields from the level of the ovary to the posterior end of the posterior testis but seldom beyond the posterior testis.9,22 In comparison, vitelline follicles of M. miyatai are distributed from the level of the ovary to the anterior level of the posterior testis, with no vitellaria distribution beyond the posterior testis.9,36 However, vitelline follicles of M. takahashii are abundant from the level of the ovary to the posterior level of the posterior testis, even with extension beyond the posterior testis level.9,36 Moreover, uterine tubules of M. yokogawai never overlap or cross over the middle portion of the anterior testis, whereas those of M. takahashii and M. miyatai overlap the whole anterior testis.9,36M. suifunensis is morphologically close to M. yokogawai, M. takahashii, and M. miyatai, but it differs from them in its molecular characteristics.11
Yolk Sac Tumour Arising in the Glans Penis an Achondroplasic Child: A Case Report with Summary of Prior Published Cases
Published in Fetal and Pediatric Pathology, 2023
Sanjana Karan, Raktim Mukherjee, Pritam Singha Roy, Md. Mohin, Wasim Firdous, Uttara Chatterjee
A 2-year-old boy with achondroplasia, born to achondroplastic parents, came with an ulcerated penile mass at the tip of the glans penis measuring 1 × 1 cm. A punch biopsy taken from the mass showed typical features of YST. It contained primarily a reticular pattern along with glandular structures lined by polygonal cells with moderate amount of eosinophilic cytoplasm, subnuclear vacuolation, round vesicular nuclei with prominent nucleoli and fine chromatin. Occasional Schiller-Duval bodies and eosinophilic globules were noted. Ulcerated and thinned out epidermis was present on the surface. No other germ cell tumor component was identified. Based on this, a diagnosis of pure YST was made. On immunohistochemistry the tumor cells were positive for glypican 3. The testes were normal. Serum alpha-fetoprotein (AFP) level was raised (1300 ng/ml), while β-HCG was normal. The child was treated with 4 cycles of BEP (bleomycin/etoposide/cisplatin) chemotherapy regimen, and the tumor regressed.
The effects of inhaled pollutants on reproduction in marginalized communities: a contemporary review
Published in Inhalation Toxicology, 2023
Ramsés Santacruz-Márquez, Alison M. Neff, Vasiliki E. Mourikes, Endia J. Fletcher, Jodi A. Flaws
In males, LH and FSH target their cognate receptors in the testes. The testes are male reproductive structures that produce spermatozoa (male gametes) and sex steroid hormones. The testes contain a network of coiled tubules called the seminiferous tubules. The interstitium surrounding the seminiferous tubules contains a population of LH receptor expressing cells called the Leydig cells (Lei et al. 2004). In response to LH, Leydig cells convert cholesterol into testosterone (Eacker et al. 2008). Testosterone and dihydrotestosterone (DHT) act through the androgen receptor to drive the development of male sexual characteristics and facilitate spermatogenesis (Matsumoto et al. 2013). The seminiferous tubules contain a population of FSH receptor expressing cells called Sertoli cells (Oduwole et al. 2018). FSH stimulation increases Sertoli cell proliferation (Oduwole et al. 2018). Additionally, FSH acts through Sertoli cells to promote spermatogenesis (Ramaswamy and Weinbauer 2014; Oduwole et al. 2018).
Balancing efficacy with long-term side-effects: can we safely de-escalate therapy for germ cell tumors?
Published in Expert Review of Anticancer Therapy, 2023
The contribution of chemotherapy to infertility in testicular cancer survivors is complicated by the fact that the rate of infertility is higher in this group any way. Testicular maldescent may be a cause, and the increased frequency of smaller contralateral testes may also contribute. There is a clear association between preexisting infertility and subsequent development of testicular cancer [31]. In patients who have received adjuvant carboplatin for stage 1 seminoma, the overall effect on fertility seems positive. The number of patients who were azoospermic or oligospermic pre-chemotherapy fell from 12% and 53% to 0% and 32%, respectively, at 4-year post-chemotherapy, strongly refuting the argument that a low sperm count pre-orchidectomy is a contraindication to adjuvant therapy on the basis of fertility preservation [32]. In the case of non-seminomatous germ cell tumors, the use of up to 2 cycles of BEP does not seem to have an adverse effect on fertility in men [33], and a similar finding exists for women with ovarian germ cell tumors [34]. It is clear that the more chemotherapy is given, the lower the fertility rate becomes – this is a particular problem in patients undergoing salvage chemotherapy.
Related Knowledge Centers
- Anterior Pituitary
- Gonad
- Homology
- Luteinizing Hormone
- Ovary
- Sperm
- Testosterone
- Scrotum
- Androgen
- Follicle-Stimulating Hormone