| abscess formation involving the seminal vesicle occurs rarely. We report a case of seminal vesicle abscess due to tuberculosis. urine and fluid cultures and histologic examination of the prostate were negative for mycobacteria. The cause of the abscess was confirmed only after tissue cultures were done. ( info) |
2/505. The importance of peritoneal imaging in the workup of genital edema in patients on continuous ambulatory peritoneal dialysis. BACKGROUND: Genital edema is a well-reported complication of peritoneal dialysis. This phenomenon has been associated with extravasation of dialysate from the peritoneal cavity through a defect in the abdominal wall or through an wall or through an inguinal hernia (or patent processus vaginalis, persistent sac). In the first case, fluid tracks through the soft tissues of the abdominal wall and settles in the dependent genitalia. In the second, fluid tracks through the inguinal hernial defect and infiltrates into the tissues distal to the defect. It is difficult to precisely diagnose the etiology of many of these cases but it is obviously important. METHOD: We report a case of a patient who presented with penile and scrotal edema and was eventually found to have bilateral patent processus vaginalae. We used computed tomography and peritoneal scintigraphy in order to ascertain the diagnosis. RESULTS/CONCLUSIONS: We believe that computed tomography and peritoneal scintigraphy are extremely helpful in the workup of genital edema in patients on continuous ambulatory peritoneal dialysis. ( info) |
3/505. Agenesis of the penis: patterns of associated malformations. Agenesis of the penis is a rare malformation that occurs in otherwise normal males or together with other anomalies. In this article, we document unusual patterns of malformations in four such infants and analyze the nature and incidence of defects in 57 cases by clinical evaluation and numerical classification techniques. Although patients with this condition previously have been divided into groups based on the position of the urethral meatus in relation to the anus (presphincteric, postsphincteric, urethral atresia), our analyses suggest that most cases can be classified into either a severe form (16%) with renal aplasia or dysplasia and other caudal anomalies or a second group (72%) with low mortality and fewer additional malformations. The remaining cases in our group represented unique patterns stemming from a variety of causes, including etretinate embryopathy and the human homologue of the disorganization mutation. Agenesis of the penis occurs as a consequence of single gene disorders, teratogenic effects, or malformation sequences and associations and in unrecognized patterns of anomalies. It thus should be considered a developmental field defect. Its concurrence with scrotal hypoplasia, absent raphe, and anal anomalies implies a major disturbance of the caudal mesoderm. In such cases, severe renal defects are usually seen, and the prognosis is poor. When the patient has a patent urethra and normal scrotum, raphe, and testes, however, penile agenesis may be a localized malformation of the genital tubercle potentially related to penoscrotal transposition, a phylogenetic anomaly that is the normal genital arrangement in male marsupials, rabbits, and certain other mammals. Infants with isolated penile agenesis have generally done well. In the past, many were not treated; however, current recommendations are to use appropriate surgical and endocrine techniques to reassign female gender and enhance sexual and psychosocial functioning, though this approach is the subject of controversy. ( info) |
| orchiectomy was performed in a 37-year-old Hungarian man exhibiting a swelling in his right testicle. histology revealed a nodule attached to the spermatic cord, consisting of a granulomatous tissue around sections of a nematode. The worm was identified as dirofilaria repens, an uncommon parasite in hungary. As the patient had been abroad only in italy where cases of dirofilariosis in dogs and humans are relatively frequent, it is assumed that the infection might have been acquired in that country 5 years earlier. This is the fifth case, published so far in the world, of such a localization in a human. The human cases of dirofilariosis reported in hungary are reviewed. ( info) |
5/505. Isolated periarteritis nodosa of the spermatic cord presenting as a scrotal mass: report of a case. We report a 57-year-old man who visited a local hospital because of a fist-sized swelling and pain in his right scrotum. Surgically resected tissue revealed necrotizing arteritis in a small spermatic artery. As systemic symptoms for angiitis were not present, this is thought to be the second case of isolated angiitis occurring in the spermatic cord. ( info) |
6/505. Unusual masses in the spermatic cord: report of six cases and review of the literature. Differential diagnosis of spermatic cord swellings includes direct inguinal hernia, hydrocele, spermatocele, hematocele, lipoma, tuberculosis, and filariasis. This communication focuses attention on other unusual swellings of the spermatic cord. Three cases of sarcoma, two cases of foreign body in the spermatic cord, and one case of vasitis are presented. Although unusual, these conditions should be considered in the differential diagnosis of spermatic cord swellings. ( info) |
7/505. Two cases of seminal vesicle fistula. Two cases of fistulation into the seminal vesicles are described. One related to Crohn's disease and the other following surgery for carcinoma of the rectum. Both cases were diagnosed by CT sinography. This technique is described and is recommended when attempting to demonstrate the internal communications of difficult perineal fistulae when standard techniques of fistulography fail. ( info) |
8/505. Recovery of ejaculated spermatozoa for intracytoplasmic sperm injection after anti-inflammatory treatment of an azoospermic patient with genital tract infection: a case report. In this paper our experiences with anti-inflammatory treatment of an infertile patient with azoospermia and concomitant silent genital infection are reported. The patient was referred to our fertility centre with prediagnosed non-obstructive azoospermia and no spermatozoa were found in the ejaculate on two occasions. The patient showed leukocytospermia and was suspected to be affected by genital infection. Therefore, anti-inflammatory treatment was initiated and 8 weeks later examination of the ejaculate revealed a decreased number of leukocytes and the presence of few but motile spermatozoa. Subsequently, two ICSI cycles were performed with anti-inflammatory therapy in parallel and a sufficient number of spermatozoa could be retrieved for injection. However, in a third cycle without previous treatment, examination of the ejaculate again revealed azoospermia and leukocytospermia. It is concluded that, in cases of azoospermia and chronic genital infection, some patients will benefit from anti-inflammatory treatment prior to and during ICSI treatment. This may allow retrieval of spermatozoa from the ejaculate and thus may avoid the need for a therapeutic testicular biopsy. Using this approach, sufficient spermatozoa in three out of four ICSI cycles could be retrieved and a pregnancy was finally achieved. ( info) |
| Four cases of migration of the ventriculoperitoneal (V-P) shunt tip through patent processus vaginalis resulting in scrotal hydrocele are presented. These cases are considered a rare complication of V-P shunts and causal mechanisms are discussed with a review of the literature. ( info) |
| We present a patient with leopard syndrome and hyperelastic skin. Biochemical analysis using cultured skin fibroblasts showed normal type III and V collagen synthesis, lysyl hydroxylation level of type I procollagen and processing of pro-alpha(1) and alpha(2)(I). Our results suggest that molecular defects of hyperelasticity in leopard syndrome are not related to abnormal collagen metabolism, although not all steps of collagen synthesis have been investigated. ( info) |