1/14. Pain associated with testicular retraction treated with Gore-Tex external inguinal ring reconstruction.We present our experience with three patients with chronic testicular pain due to retractile testes and propose a new operative solution to the problem. Three patients with chronic testicular pain associated with testicular retraction and relieved by pushing the testicle into the scrotum were identified. Full history and physical examinations were performed to rule out other causes of testicular pain. The patients underwent open inguinal exploration, aborted attempt at repair of an attenuated or obliterated external oblique aponeurosis, and construction of a neo-external inguinal ring with a Gore-Tex strip. The patients were reevaluated in the clinic postoperatively to determine change in physical examination and symptoms. All three patients had nonretractile testes on follow-up examination and reported improvement of their testicular pain. An attenuated or torn external oblique aponeurosis can result in a patulous external inguinal ring and painful retractile testicle. If traditional orchidopexy is insufficient to prevent severe retraction, reconstruction of the external inguinal ring with Gore-Tex mesh can correct the anatomical deficiency, reduce testicular retraction, and improve pain symptoms.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/14. Intratesticular varicocele treated with percutaneous embolization.Intratesticular varicocele is an extremely rare and a relatively new clinical entity. A 22-year-old man was admitted to our hospital with left testicular pain. On physical examination, a grade III varicocele was noted on the left side, and the testis was soft as well. Gray-scale ultrasound and color Doppler ultrasound examinations revealed intratesticular and extratesticular varicocele. Testicular venography failed to demonstrate the testicular vein. Percutaneous embolization was performed through direct puncture to the dilated veins. Percutaneous embolization under local anesthesia is an alternative treatment to other techniques.- - - - - - - - - - ranking = 0.5keywords = physical examination, physical (Clic here for more details about this article) |
3/14. Case of mediastinal seminoma with testicular microlithiasis.Testicular microlithiasis is a rare condition in which calcified concretions fill the lumina of the seminiferous tubules. We report the case of a 19-year-old Japanese man with mediastinal seminoma, normal testicular physical findings and bilateral testicular microlithiasis seen on ultrasonography. Testicular needle biopsy demonstrated multiple laminated calcifications within the seminiferous tubules without any signals of a viable germ cell tumor. To our knowledge, this is only the sixth reported case of extragonadal germ cell tumor with testicular microlithiasis.- - - - - - - - - - ranking = 0.023189444804434keywords = physical (Clic here for more details about this article) |
4/14. Sclerosing lipogranuloma of the testis.Sclerosing lipogranuloma is an uncommon, benign condition that can affect several organs, particularly of the genitourinary system in males. We describe a patient who presented with an intratesticular mass on physical examination. Pathologic evaluation confirmed the diagnosis of testicular sclerosing lipogranuloma. Most case reports involve self-injection with a foreign substance that is pathognomonic. Treatment is often conservative after establishing the diagnosis.- - - - - - - - - - ranking = 0.5keywords = physical examination, physical (Clic here for more details about this article) |
5/14. Wegener's granulomatosis diagnosed by testicular biopsy.Urogenital involvement, other than the kidneys, is extremely rare in Wegener's granulomatosis (WG) and occurs in less than 1% of the cases. When encountered it is confined to prostate, bladder, urethra, cervix, and vagina. Granulomatous infiltration of the testis from WG has not been cited in the medical literature. We report a case of WG in a Hispanic male who presented with sensorineural hearing loss and hemoptysis. He had a pulmonary lesion and a painless right testicular mass, which was found to have necrotizing granulomas on excisional biopsy. This may be the first reported case of WG diagnosed by testicular biopsy as testicular involvement is rare in WG. We believe that the actual incidence of testicular involvement in WG may be higher as genital examination may be ignored during routine physical examinations.- - - - - - - - - - ranking = 0.5keywords = physical examination, physical (Clic here for more details about this article) |
6/14. Treatment of testicular pain using conservative management of the thoracolumbar spine: a case report.Unsuccessful recognition of the origin of testicular pain and a high failure rate of surgical interventions lead to poor outcomes, psychologic distress, and increased costs of care. A frequently overlooked cause of testicular and buttock pain is irritation of the T10-L1 sensory nerve roots, the genitofemoral nerve, and the ilioinguinal nerve. We present the case of a 36-year-old policeman with a 5-year history of back pain and testicular pain of unknown origin. physical examination of the thoracolumbar region revealed that active movement provoked the patient's buttock symptoms, and local mobility restrictions were present in the thoracolumbar region. A central disk protrusion at T12-L1 was noted on upper lumbar spine magnetic resonance imaging, which supports dysfunction of this region. The diagnosis of thoracolumbar stiffness led to implementation of passive and active mobilization of that region and to specific hip stretching and strengthening exercises. After a course of direct and guided physical therapy, the patient attained complete symptom resolution. The patient returned to full work duties as a police officer and resumed his full recreational activity. The excellent outcome achieved in managing this patient was attributed to identifying the origin of referred pain from the thoracolumbar junction.- - - - - - - - - - ranking = 0.023189444804434keywords = physical (Clic here for more details about this article) |
7/14. Sparing surgery for an epiderom cyst of the testis: a case report and literature review.Epidermoid cyst of the testis is relatively rare and accounts for less than 1% of all testicular neoplasms. This condition usually occurs in young men and it is mostly detected by self-examination or routine physical examination. The case of a 27-year-old male with an epidermoid cyst of the testis is discussed. The diagnosis was based on ultrasonography and management was with testicular-sparing surgery. At 2-year follow-up, the patient had had no relapse or metastasis. In epidermoid cysts of the testis, high-frequency ultrasonography is a reliable diagnostic imaging method. Organ-preserving surgery is recommended in the management of these lesions.- - - - - - - - - - ranking = 0.5keywords = physical examination, physical (Clic here for more details about this article) |
8/14. Testicular epidermoid cyst in Klinefelter's syndrome.A 38-year-old Japanese man was referred to our outpatient clinic for treatment of infertility. semen analysis showed azoospermia. Chromosome analysis revealed a 47XXY karyotype, and non-mosaic Klinefelter's syndrome (KFS) was diagnosed. Upon physical examination, the patient's right testicular volume was 30 mL and the left testicular volume was 3 mL. Laboratory tests showed normal levels of lactate dehydrogenase, alpha-fetoprotein, and human chorionic gonadotropin beta-subunit. The plasma luteinizing hormone and follicle-stimulating hormone levels were increased to 15.7 mIU/mL and 45.9 mIU/mL, respectively. The plasma testosterone was decreased to 0.25 ng/mL. magnetic resonance imaging showed a right testicular mass of low-signal intensity on the T1-weighted image and of high-signal intensity on the T2-weighted image. Therefore, the final diagnosis was KFS with a right testicular tumor. Thus, a right high orchiectomy was performed. Histological examination revealed an epidermoid cyst of the right testis. Epidermoid cysts in cases of KFS are rare. To our knowledge, only seven cases, including ours, have been reported in the literature.- - - - - - - - - - ranking = 0.5keywords = physical examination, physical (Clic here for more details about this article) |
9/14. R831X mutation of the androgen receptor gene in an adolescent with complete androgen insensitivity syndrome and bilateral testicular hamartomata.An 18-year old, phenotypically female individual was examined for primary amenorrhea. Three months before her referral, the patient underwent surgery and a pelvic mass was removed. The physical examination revealed normal female external genitalia, normal breast development, sparse pubic hair and absence of axillary hair. The gynecological examination revealed a short blind vagina pouch and absence of cervix and uterus. serum testosterone and dihydrotestosterone levels were very high. karyotype was that of a normal male (46,XY). The transabdominal ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) showed absence of uterus and fallopian tubes and revealed testis-like gonads located at the internal opening of the inguinal canal bilaterally. Bilateral gonadectomy was subsequently performed. The pathology report was that of "hamartomatous testes" and associated paratesticular leiomyoma. The clinical, laboratory, imaging, genetic and histological findings confirmed the diagnosis of complete androgen insensitivity syndrome. dna analysis revealed a R831X mutation in exon 7 of the androgen receptor gene. A Sertoli-cell dynamic test showed elevated basal serum inhibin-B and anti-mullerian hormone levels without further rise following FSH stimulation. The patient was started on hormone replacement therapy with conjugated estrogens. Complete androgen insensitivity syndrome must be considered in any case of primary amenorrhea. Gonadectomy must be planned to eliminate the risk of gonadal malignancy.- - - - - - - - - - ranking = 0.5keywords = physical examination, physical (Clic here for more details about this article) |
10/14. Ultrasonographic findings of testicular microlithiasis associated with intratubular germ cell neoplasia.Testicular microlithiasis is an uncommon condition in which calcified concretions fill the lumina of seminiferous tubules. We report the case of a twenty-three-year-old white man with a metastatic germ cell tumor and normal findings on testicular physical examination, but abnormal ultrasonography of the right testis. orchiectomy revealed intratubular germ cell neoplasia with testicular microlithiasis. Multiple circular echogenic foci on ultrasound correlated with the histologic finding of testicular microlithiasis. Further studies are indicated for assessing ultrasonography as an adjunct for screening the population at risk for intratubular germ cell neoplasia.- - - - - - - - - - ranking = 0.5keywords = physical examination, physical (Clic here for more details about this article) |
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