1/13. Congenital penoscrotal lymphedema complicated by sepsis associated with a streptococcal infection.Congenital lymphedema is a relatively rare disease caused by congenital abnormality of the lymphatic system. Although bacterial infection frequently causes complications with lymphedema, severe sepsis in congenital lymphedema of the genitalia has not yet been reported. We describe a patient with congenital penoscrotal lymphedema complicated by cellulitis, lymphangitis, and severe sepsis associated with a streptococcal infection. This case represents the importance of obtaining a detailed clinical history and physical findings.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/13. Acute scrotal swelling in Henoch-Schonlein purpura: a case report.Henoch-Schonlein purpura is a systemic vasculitis and sometimes presents as acute scrotal swelling in children. We report a case of Henoch-Schonlein purpura with acute scrotal swelling, which was correctly diagnosed based upon local physical findings. Scrotal ultrasonography showed normal testes and hydrocele testis around the affected testis 3 hours after the sudden onset of the pain. The scrotal symptoms improved in 2 days with steroid therapy. Scrotal ultrasonography was useful to diagnose Henoch-Schonlein purpura with scrotal involvement. Steroid treatment appeared to be effective for this condition.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/13. Expanding the differential diagnosis of the acute scrotum: ventriculoperitoneal shunt herniation.An 18-month-old boy presented to the emergency department after 4 hours of inconsolability and acute scrotal swelling. The physical examination revealed a new scrotal hydrocele with migration of a ventriculoperitoneal shunt into the right hemiscrotum. The presence of a ventriculoperitoneal shunt has been associated with increased patency of the processus vaginalis and scrotal hydroceles. The presentation of an acute scrotum in a child with a ventriculoperitoneal shunt should be recognized as a possible shunt complication. Migration of the shunt through the processus vaginalis is an extremely uncommon event.- - - - - - - - - - ranking = 11.954147470444keywords = physical examination, physical (Clic here for more details about this article) |
4/13. The male genital skin burning syndrome (Dysaesthetic Peno/Scroto-dynia).Men may complain of penile and/or scrotal skin burning with no evidence of positive physical signs or investigations. The condition is cumbersome and leads to stress and disruption in social and sexual relationships. The patients report no response to previous medications (including antibiotics, antifungals and topical corticosteroids); and identify improvement in symptoms and quality of life on selective serotonin re-uptake inhibitors (SSRI). A similar condition has been recognized in the female patients (dysaesthetic vulvodynia). We report the occurrence of this condition in three men and suggest it being recognized as 'the male genital skin burning syndrome' (Dysaesthetic Peno/Scroto-dynia).- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/13. Vanishing penis syndrome: the Ife experience.Twenty-five cases of vanishing penis syndrome as a rare cause of mechanical impotence seen over a nine year period in Ile-Ife are presented. Local aetiological factors some distinct from those earlier recorded in literature are highlighted. The prominent role which surgery can play in the management of this form of physical and mental handicap, loss of sexual function let alone becoming a social out cast is stressed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/13. Microlymphaticovenous anastomosis for treating scrotal elephantiasis.Scrotal elephantiasis can be physically disabling and psychologically distressing to the victim. Ablative procedure has been used in its treatment and has achieved limited success. The authors developed a microlymphaticovenous procedure to treat elephantiasis of the scrotum and applied it clinically in three patients. The immediate and long-term (13-24 months) results have been very satisfactory. The scrotum size was dramatically reduced to a nearly normal level, and subjective symptoms and objective signs were improved. The operative techniques are described, the three case histories are illustrated, and the advantages of microlymphaticovenous anastomosis, the selection of patients, and the factors required for success of the surgery are discussed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/13. Sonographic findings in clinically unsuspected acute and chronic scrotal hematoceles.Three patients with scrotal swelling for 2 days, a year, and many years, respectively, were shown ultimately to have hematoceles even though their clinical history and physical findings were atypical. Contact B-scans of these lesions all showed a basically anechoic mass traversed by thick irregular septations. The septations in one acute case decreased in size and number over 10 days. hematocele should be considered in the differential diagnosis when sonographic ultrasound studies of a scrotal swelling reveal a multicystic mass even if the history and physical findings are more compatible with neoplasm.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
8/13. Congenital lymphedema of the penis: a method of reconstruction.Congenital lymphedema of the genitalia has profound physical and psychological consequences for the growing child. Extensive resection of this tissue and reconstruction by skin grafting offers a less than satisfactory cosmetic result. Over the past year we have employed a method of total excision of the lymphedematous tissue of the penile shaft with cosmetic reconstruction without skin grafting. A circumferential incision was made 5-10 mm from the coronal sulcus and deepened to the level of Buck's fascia. The skin and subcutaneous tissue were then completely dissected away from the penis. The skin was everted and all of the abnormal lymphedematous tissue excised up to the dermal skin margin. The skin was then tailored to the size of the penile shaft and reapproximated. This method has been employed in two patients with the advantages of (1) shorter hospitalization, (2) lack of morbidity associated with the skin donor site, and (3) satisfactory cosmetic results.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/13. Spontaneous idiopathic hematoma of the spermatic cord: a report of 2 cases.We present 2 cases of spontaneous idiopathic spermatic cord hematoma and review the literature. These hematomas predominately occur in untraumatized young adults after physically stressful exercise. Surgical exploration was performed in 4 previously reported cases and our own. In each case the preoperative diagnosis was incorrect. Since this clinical entity cannot clearly be distinguished from other causes of an acute scrotum surgical exploration seems warranted. Possible etiologies of spontaneous idiopathic spermatic cord hematoma are spermatic cord vein rupture and tear in the cremasteric muscle.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/13. adult acute idiopathic scrotal edema.We report here a rare case of adult acute idiopathic scrotal edema (AISE). Its characteristics and management are the same for adults as for prepubertal boys. AISE typically affects prepubertal boys, with an acute onset of a relatively painless scrotal erythema and subcutaneous edema, which resolves spontaneously, without sequela, in 1 to 3 days. The erythema and swelling can also extend to the perineum, abdomen, or penis. Its diagnosis is primarily made by exclusion. Vital signs, urinalysis, urine and tissue culture, and white blood cell count are normal. Palpably normal scrotal contents on physical examination and thickened scrotal wall and normal testis arterial flow on scrotal ultrasound with color flow Doppler further confirm the diagnosis. Differentiating AISE from a scrotal surgical emergency is essential in order to avoid unnecessary exploration.- - - - - - - - - - ranking = 11.954147470444keywords = physical examination, physical (Clic here for more details about this article) |
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