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BMJ Case Rep 2018 Sep 19;2018. Epub 2018 Sep 19.

Hull and East Yorkshire Hospitals NHS Trust, Hull, UK.

A retired businessman presented to the infectious diseases department with a history of ongoing fevers and myalgia and raised inflammatory markers. This continued despite adequate antibiotic treatment of an epididymo-orchitis. Extensive investigations, including bone marrow and liver biopsies and a positron emission tomography, did not reveal a cause but showed reactive change in the bone marrow. Read More

J Vasc Bras 2017 Jul-Sep;16(3):258-261

Manipal University, Melaka Manipal Medical College, Department of Anatomy, Manipal, Karnataka, India.

The testicular artery is frequently subjected to radiographic imaging techniques such as angiography for diagnosis and treatment of conditions like epididymitis, testicular torsion, tumor, hematoma, and hydrocele and in cases of undescended testis. Radiologists and surgeons should therefore be aware of testicular artery variants. Although there are numerous studies and case reports that mention testicular artery variants, this is probably the first case, reporting a bilateral low origin of the testicular artery and discussing its probable embryological etiology. Read More

Medicine (Baltimore) 2018 06;97(25):e11164

Department of Urology, The First Hospital of Quanzhou Affiliated to Fujian Medical University.

Rationale: Most patients with paratesticular rhabdomyosarcoma may typically present as a unilateral, painless palpable scrotum mass. However, only a few cases of RMS presenting as painful edema of the scrotum mimicing epididymitis. We herein report an unusual case of alveolar paratesticular rhabdomyosarcoma misdiagnosed as epididymitis. Read More

Zhonghua Nan Ke Xue 2017 Apr;23(4):337-342

Department of Urology, The Second Hospital of Shandong University, Jinan, Shandong 250033, China.

Objective: To compare three different pathways for transurethral seminal vesiculoscopy (SVS) and investigate the reliability and efficiency of transrectal ultrasonography (TRUS)-guided SVS (TRUS-SVS).

Methods: We retrospectively analyzed 90 cases of seminal vesiculoscopy conducted directly through the ejaculatory duct or prostatic utricle or under the guide of TRUS. We compared the success rate and complications among the three approaches. Read More

Emerg Radiol 2018 Aug 21;25(4):341-348. Epub 2018 Apr 21.

Department of Radiologic Sciences, Wake Forest University Baptist Medical Center, Medical Center Blvd, Winston-Salem, NC, 27157, USA.

Scrotal pain is a common acute presentation for medical care. Testicular torsion and epididymo-orchitis are two diagnoses for which early detection is critical and their sonographic imaging features have been thoroughly described in the radiologic literature. Other important conditions for which radiologists must be aware have received less attention. Read More

N Engl J Med 2018 03;378(13):1233-1240

From the Departments of Medicine (R.W.T.), Radiology (H.Y.), Urology (D.M.D.), and Pathology (D.P.S.), Massachusetts General Hospital, and the Departments of Medicine (R.W.T., R.M.H.), Radiology (H.Y.), Urology (D.M.D.), and Pathology (D.P.S.), Harvard Medical School - both in Boston.

Pediatr Radiol 2018 05 21;48(5):735-744. Epub 2018 Feb 21.

Department of Radiology, Children's National Health System, Washington, DC, USA.

Testicular sonography has contributed greatly to the preoperative diagnosis of testicular torsion in the pediatric patient and is the mainstay for evaluation of acute scrotal pain. Despite its high sensitivity and specificity, both false-negative and false-positive findings occur. Presence of documented Doppler flow within the testis might be a dissuading factor for surgical exploration with resultant testicular loss in the false-negative cases. Read More

BMJ Case Rep 2018 Jan 12;2018. Epub 2018 Jan 12.

Department of Plastic Surgery, JIPMER, Puducherry, India.

Zhonghua Nan Ke Xue 2016 Nov;22(11):996-1000

Department of Urology, Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China.

Objective: To analyze the high-frequency ultrasound image features of acute scrotum in children and explore the value of high-frequency ultrasonography in the diagnosis and differential diagnosis of the disease.

Methods: This retrospective study included 256 children aged 2 days to 14 years undergoing color Doppler ultrasonography at 2 hours to 3 days after onset of acute scrotum. We analyzed the morphology, internal echo and blood supply of the testis in comparison with the clinical and pathological results. Read More

Hinyokika Kiyo 2017 Oct;63(10):439-443

The Department of Urology, Osaka General Medical Center.

We report a case of seminal vesicle abscess associated with Zinner syndrome. A 26-year-old male was admitted to our hospital because of fever and right scrotal swelling. Ultrasound showed an enlarged epididymis and color Doppler ultrasound showed increased vascularity in the epididymis. Read More

Hinyokika Kiyo 2017 Sep;63(9):387-390

The Department of Urology, Yokohama Municipal Hospital.

Testicular nodules are occasionally palpable in patients with acute epididymitis. In these patients, we need to rule out testicular tumors. Advancement in imaging technology such as doppler ultrasound or magnetic resonance imaging (MRI) has enabled us to distinguish segmental testicular infarction from testicular tumor and refrain from orchiectomy. Read More

BMJ Case Rep 2017 Sep 19;2017. Epub 2017 Sep 19.

Christian Medical College and Hospital Vellore, Vellore, India.

Congenital anomalies of the kidney and urinary tract (CAKUTs) occur in 3-6 per 1000 live births, accounting for most cases of paediatric end-stage kidney disease. However, the molecular basis of CAKUT and anomalies of the external genitalia is poorly understood. We, herein, describe a case with left recurrent epididymo-orchitis with a coexistent urethral duplication and an ectopic ureter with an ipsilateral non-functioning kidney, which is, to the best of our knowledge, the first reported case of its kind. Read More

Abdom Radiol (NY) 2017 Dec;42(12):2955-2956

Imaging Department, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, São Paulo, 05652-901, Brazil.

Acta Radiol 2018 Mar 1;59(3):346-354. Epub 2017 Jun 1.

3 Institut Langevin, ESPCI Paris, PSL Research University CNRS UMR 7587, INSERM U979, Paris, France.

Background Ultrasensitive Doppler is a novel non-invasive ultrasound (US) Doppler technique that improves sensitivity and resolution for the detection of slow flow. Purpose To investigate the feasibility of ultrasensitive Doppler (USD) for testicular disease diagnosis, using both qualitative and quantitative results. Material and Methods This prospective study was conducted in 160 successive men referred for scrotal US including B-mode and conventional Color-Doppler. Read More

J Med Case Rep 2017 May 18;11(1):140. Epub 2017 May 18.

Department of Urology, University Hospital Brussels (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium.

Background: Segmental testicular infarction is a very rare condition, which can mimic a testicular torsion or testicular cancer. Correct diagnosis is difficult but it is important to avoid unnecessary radical treatment.

Case Presentation: We report a clinical case of a 36-year-old white man who presented at our emergency department with subacute testicular pain. Read More

Aktuelle Urol 2017 Sep 16;48(5):443-451. Epub 2017 May 16.

Sektion Kinderradiologie, Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Mainz, Mainz.

Acute scrotum is one of the most common urologic emergencies in children and adolescents. This condition involves acute testicular pain, which is often accompanied by scrotal swelling and erythema. It is most important to distinguish between cases that require immediate surgery and those that can be treated conservatively. Read More

J Pediatr Urol 2017 Oct 1;13(5):492.e1-492.e5. Epub 2017 Mar 1.

Department of Urology, Wake Forest University, Winston-Salem, NC, USA.

Introduction: Pediatric presentations of a prostatic utricle have received only scant attention. Though recognized with increased frequency in boys with hypospadias, little is described about their incidence and potential for morbidity in boys with normal external genitalia.

Methods: We initially reviewed a cohort of 64 patients with hypospadias seen over a 3-year period to determine the frequency of investigative lower urinary tract studies and utricle identification. Read More

Surg Clin North Am 2017 Feb;97(1):161-172

Section of Urology, Department of Surgery, Children's Mercy Hospital, University of Missouri-Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA.

The pediatric patient presenting with acute scrotal pain requires prompt evaluation and management given the likelihood of testicular torsion as the underlying cause. Although other diagnoses can present with acute testicular pain, it is important to recognize the possibility of testicular torsion because the best chance of testicular preservation occurs with expeditious management. When testicular torsion is suspected, prompt surgical exploration is warranted. Read More

Biomed Res Int 2016;2016:8903635. Epub 2016 Sep 8.

Department of Orthopaedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.

. To evaluate the clinical, laboratory, and radiological presentation of 16 cases of brucellar spondylitis. . Read More

Ultrasound Q 2016 Sep;32(3):283-9

*Departments of Radiology and †Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine; ‡Department of Biomedical Engineering, I-Shou University; and §Division of Urology, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China.

Acute epididymo-orchitis (AEO)-related global testicular infarction (GTI) is rare. We report herein the clinical and ultrasound findings of 6 patients with AEO-related GTI. Seventeen patients with torsion-related GTI were also reviewed and compared. Read More

Urology 2016 Dec 24;98:167-169. Epub 2016 May 24.

Department of Pediatric Surgery, Virgen del Rocio Children's Hospital, Seville, Spain.

Vas deferens ectopia is a rare congenital anomaly frequently associated with anorectal abnormalities and hypospadias. We present a Currarino syndrome case with an ectopic vas deferens terminating in a distal retroiliac ureter. A left vasectomy, ureteral decussation over the iliac vessels, and a Cohen's-type ureteral reimplantation were performed. Read More

Zhonghua Nan Ke Xue 2016 Mar;22(3):225-8

Objective: To investigate the clinical application value of 8.5/11.5 F transurethral seminal vesiculoscopy in the diagnosis and treatment of refractory hematospermia. Read More

J Urol 2016 Sep 23;196(3):883-90. Epub 2016 Apr 23.

Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York. Electronic address:

Purpose: Partial prostate gland ablation is a strategy to manage localized prostate cancer. Irreversible electroporation can ablate localized soft tissues. We describe 30 and 90-day complications and intermediate term functional outcomes in men undergoing prostate gland ablation using irreversible electroporation. Read More

Urologe A 2016 Apr;55(4):444-53

Klinik für Urologie, Kliniken Maria Hilf GmbH, Viersener Str. 450, 41063, Mönchengladbach, Deutschland.

Background: In addition to epididymitis and testicular torsion, emergencies of the external genital are rare. Rapid diagnosis and therapy are essential so that immediate therapy can be provided, which is important for survival (Fournier gangrene) of the patient or for the preservation of erectile function (priapism and penile fracture). A detailed patient history and clinical examination are generally sufficient for correct diagnosis. Read More

J Endourol 2016 06 20;30(6):704-8. Epub 2016 Apr 20.

Department of Urology, Shanghai Changhai Hospital, Second Military Medical University , Shanghai, China .

Purpose: To introduce scrotoscopy in the diagnosis of testicular torsion and evaluate its value in clinical application.

Patients And Methods: From February 2010 to June 2013, 14 patients, aged 12 to 24 years, were included into this study due to acute onset of scrotal pain. On Doppler ultrasound imaging, the blood flow decreased in seven cases (including two "no flow" cases) and remained normal in the other seven. Read More

Curr Probl Diagn Radiol 2017 Jan - Feb;46(1):74-83. Epub 2016 Feb 11.

Mallinckrodt Institute of Radiology, St. Louis, MO.

This article provides pictorial review of complicated upper and lower genitourinary infections and their mimics. Imaging features of upper urinary tract infections including uncomplicated acute pyelonephritis, xanthogranulomatous pyelonephritis (XGPN), emphysematous pyelonephritis, perirenal abscess, and pyonephrosis are first reviewed and then followed by pictorial review of their mimics including contrast-associated nephrotoxicity, renal infarcts, malakoplakia, renal cell cancer, leukemia or lymphoma and Castleman's disease. Next, imaging features of lower urinary tract infections including cystitis, emphysematous cystitis, enterovesical, colovesical and vesicovaginal fistulas, Fournier gangrene, prostatitis, epididymitis, and orchitis are reviewed and then followed by pictorial review of their mimics including gas in the bladder and perineum related to instrumentation, radiation cystitis, bladder cancer, testicular torsion, testicular trauma, and testicular cancer and lymphoma. Read More

Ultrasonography 2016 Jul 24;35(3):180-97. Epub 2016 Feb 24.

Department of Radiology, UMass Memorial Medical Center, University of Massachusetts Medical Center, Worcester, MA, USA.

Ultrasonography is the ideal noninvasive imaging modality for evaluation of scrotal abnormalities. It is capable of differentiating the most important etiologies of acute scrotal pain and swelling, including epididymitis and testicular torsion, and is the imaging modality of choice in acute scrotal trauma. In patients presenting with palpable abnormality or scrotal swelling, ultrasonography can detect, locate, and characterize both intratesticular and extratesticular masses and other abnormalities. Read More

BMJ Case Rep 2016 Mar 9;2016. Epub 2016 Mar 9.

Ealing Hospital, London, UK.

Harefuah 2015 Dec;154(12):799-803

Gonadal inflammation (GI) is a common disease that may affect prepubertal boys. Neonates may suffer from bacterial infection due to congenital or aging processes affecting the urinary tract. This inflammatory process is also prevalent in prepubertal boys. Read More

Eur Urol 2016 09 6;70(3):447-55. Epub 2016 Jan 6.

University Hospital Heidelberg, Heidelberg, Germany.

Background: Magnetic resonance imaging-guided transurethral ultrasound ablation (MRI-TULSA) is a novel minimally invasive technology for ablating prostate tissue, potentially offering good disease control of localized cancer and low morbidity.

Objective: To determine the clinical safety and feasibility of MRI-TULSA for whole-gland prostate ablation in a primary treatment setting of localized prostate cancer (PCa).

Design, Setting, And Participants: A single-arm prospective phase 1 study was performed at three tertiary referral centers in Canada, Germany, and the United States. Read More

Int J Urol 2016 Mar 21;23(3):266-9. Epub 2015 Dec 21.

Department of Urology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.

The management of acute scrotum can be challenging, especially in infants or patients with a neurological or neurodevelopmental disorder in whom presentation, diagnosis and definitive management tends to be delayed. This leads to poor outcomes, such as loss of the affected testis. Here we present two cases of testicular torsion in patients with neurodevelopmental disorders, and a further two cases of epidydimo-orchitis in whom measurement of CD64 expression on neutrophils was helpful for differential diagnosis. Read More

Andrologia 2016 Sep 20;48(7):761-4. Epub 2015 Dec 20.

Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

To explore the aetiology of obstructive azoospermia (OA) in Chinese infertility patients, 133 OA patients was included in this study diagnosed and evaluated by one major specialist trained urological infertility. We retrospected the medical records to collect relative information. All of the patients had been underwent physical examination, ultrasound scan to the urogenital system, serum hormone tests, genetic tests and two separate semen analyses. Read More

J Emerg Med 2016 Jan 9;50(1):e23-4. Epub 2015 Oct 9.

Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan; Department of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.

Asian J Androl 2016 Sep-Oct;18(5):769-72

Section of Andrology, Endocrinology and Internal Medicine, Department of Clinical and Experimental Medicine, Policlinico "G. Rodolico" University Hospital, University of Catania, Catania, Italy.

We have previously demonstrated a high frequency of premature ejaculation (PE) among patients with male accessory gland infection (MAGI). The aim of this study was to evaluate the ultrasound (US) features of patients with MAGI and acquired premature ejaculation (APE) associated (MAGI-APEpos). US evaluation of 50 MAGI-APEpos patients compared to 50 patients with MAGI without PE (MAGI-PEneg) which represent the control group. Read More

Rofo 2015 Dec 26;187(12):1132-4. Epub 2015 Jun 26.

Eur Radiol 2016 Mar 12;26(3):613-21. Epub 2015 Jun 12.

Department of Clinical Radiology, Medical School, University of Ioannina, 45110, Ioannina, Greece.

Objectives: The aim was to determine the magnetization transfer ratio (MTR) of normal testes, possible variations with age and to assess the feasibility of MTR in characterizing various testicular lesions.

Methods: Eighty-six men were included. A three-dimensional gradient-echo MT sequence was performed, with/without an on-resonance binomial prepulse. Read More

Top Companion Anim Med 2015 Mar 7;30(1):28-30. Epub 2015 Mar 7.

Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA; PetCare Veterinary Hospital East, Santa Rosa, CA.

A 2-year-old intact male South African Boerboel presented for semen cryopreservation and was discovered to be azoospermic. The dog had excellent libido and had sired litters within 6 months, so a further investigation of why his collection lacked sperm was warranted. On further examination of his scrotal contents, his right epididymis had an enlarged area with a hard texture. Read More

J Ultrasound Med 2015 Jun;34(6):1083-9

Department of Diagnostic Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Korea.

Objectives: To evaluate characteristic sonographic findings for mumps orchitis with epididymal involvement.

Methods: This study included 18 patients (aged 12-18 years) with mumps orchitis. We assessed the volume, echogenicity, and vascularity of the testes and the transverse diameter, echogenicity, and vascularity of the epididymal head, body, and tail. Read More

Ultrasound Q 2015 Sep;31(3):202-4

University of North Carolina, Chapel Hill, NC.

Rev Bras Reumatol 2015 Mar 4. Epub 2015 Mar 4.

Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil; Divisão de Reumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. Electronic address:

Introduction: Systemic histoplasmosis is an invasive fungal infection that may mimic primary vasculitis, particularly granulomatosis with polyangiitis (GPA), and was rarely described in adult patients. We reported an immunocompetent patient with disseminated histoplasmosis mimicking GPA who fulfilled European League Against Rheumatism (EULAR)/Pediatric Rheumatology International Trials Organisation (PRINTO)/Pediatric Rheumatology European Society (PRES) validated classification criteria.

Case Report: A 6-year old boy presented acute migratory polyarthritis with spontaneous improvement, sinus inflammation, fever, headache and abdominal pain. Read More

Pediatr Radiol 2015 Aug 19;45(9):1382-91. Epub 2015 Mar 19.

Department of Pediatric Radiology, Children's Hospital Colorado, 13123 East 16th Ave., Box 125, Aurora, CO, 80045, USA.

Extratesticular cystic and solid scrotal masses are commonly encountered in pediatrics. The most common extratesticular malignancy is paratesticular rhabdomyosarcoma. The remainder of the common pathologies encountered -- appendage torsion, epididymitis and varicoceles -- are mostly benign. Read More

J Clin Ultrasound 2015 Oct 20;43(8):485-9. Epub 2015 Feb 20.

Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Purpose: The most common cause of acute scrotum in prepubertal boys is torsion of the testicular or epididymal appendages. The purpose of this retrospective study was to characterize the features of these lesions as viewed on sonographic (US) and color Doppler US examination.

Methods: During a 220-week period, 527 male patients 0-17 years old had been referred from the pediatric emergency department for scrotal US evaluation. Read More

Cancer Imaging 2014 Oct 8;14:29. Epub 2014 Oct 8.

Background: Sonoelastography is a novel and promising imaging tool, which has been applied to breast, thyroid, and prostate tissues. The aim of this study was to evaluate focal lesions of the testes with diameters of <10 mm using sonoelastography, B-mode sonography (US), and colour Doppler ultrasonography (CDU).

Methods: Thirty patients who were referred to our outpatient clinics for varicocoeles, scrotal pain, scrotal enlargements, epididymitis, palpable testicular nodules, or infertility, were prospectively enrolled into this study. Read More

Pomeranian J Life Sci 2015 ;61(2):163-6

Purpose: Comparison of preoperative scrotal Doppler sonography and final diagnosis of subsequent exploration in patients with acute scrotum.

Material And Methods: Retrospective analysis of the medical history of 61 patients operated on in The Department of Paediatric and Oncological Surgery in Szczecin in 2008-2014.

Results: Mean patient age (years) with testicular torsion was 12. Read More

Clin Nucl Med 2015 Feb;40(2):e171-2

From the Department of Radiology, University of Southern California, Los Angeles, CA.

A 52-year-old man with HIV was referred for an F-FDG PET/CT scan for the cause of kidney injury. FDG PET/CT scan revealed increased renal cortical FDG activity, which can be seen in HIV nephropathy or acute interstitial nephritis. Diffuse increased FDG uptake was demonstrated within the right testicle and epididymis, consistent with the patient's known right epididymo-orchitis, as diagnosed on ultrasound 1 week before admission. Read More

J Clin Ultrasound 2015 Mar 19;43(3):199-202. Epub 2014 Sep 19.

UCSF Department of Radiology, L374, University of California, 505 Parnassus Avenue, San Francisco, CA, 94143-0628.

Testicular malakoplakia is a rare, benign condition that most often occurs in an immunocompromised patient with chronic infection. Its occurrence is acute, with pain and testicular enlargement. Sonography is commonly performed to evaluate the patient for epididymitis or torsion. Read More

J Clin Microbiol 2014 Dec 17;52(12):4412-3. Epub 2014 Sep 17.

Department of Infection Control, Oulu University Hospital, Oulu, Finland.

Coxsackievirus A6 (CV-A6) caused hand, foot, and mouth disease (HFMD) with a unique manifestation of epididymitis. The patient underwent operation due to suspicion of testicular torsion. Epididymitis was diagnosed by ultrasound examination. Read More

PLoS One 2014 5;9(8):e104170. Epub 2014 Aug 5.

University Institute of Diagnostic, Interventional and Pediatric Radiology, University Hospital and University of Bern, Bern, Switzerland.

Objectives: Sexuality is an essential aspect of human function, well-being and quality of life. Many people have sex without complications. However, there are some people who need to seek emergency medical help for related health problems. Read More

J Urol 2015 Jan 28;193(1):103-10. Epub 2014 Jul 28.

Department of Urology, Tokai University, Isehara, Japan.

Purpose: We evaluated the association between long-term clinical outcomes and morbidity with high intensity focused ultrasound.

Materials And Methods: We included patients with stage T1c-T3N0M0 prostate cancer who were treated with Sonablate® (SB) devices during 1999 to 2012 and followed for more than 2 years. Risk stratification and complication rates were compared among the treatment groups (ie SB200/500 group, SB500 version 4 group and SB500 tissue change monitor group). Read More

Vet Radiol Ultrasound 2015 Jan-Feb;56(1):77-83. Epub 2014 Jul 30.

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907-2026.

Uterus masculinus (persistent Mullerian duct) is a vestigial embryological remnant of the paramesonephric duct system in males and has been associated with clinical signs such as dysuria, incontinence, tenesmus and urethral obstruction in dogs. The radiological appearance of cystic uterus masculinus in dogs has been described previously with the aid of retrograde positive or negative contrast cystography. The purpose of this retrospective study was to describe ultrasonographic features of confirmed or presumed uterus masculinus in a group of dogs with confirmed or presumed disease. Read More