scholarly journals The Prevalence of Grade III Varicocele and Undescended Testis in Turkish Adolescent Males

2020 ◽  
Vol 2 (4) ◽  
Keyword(s):  
Progressive Disease ◽  
Undescended Testis ◽  
Turkish Population ◽  
Testicular Atrophy ◽  
Adolescent Boys ◽  
Treatment Rate ◽  
Atrophy Rate ◽  
Treatment Data ◽  
History Of ◽  
Grade Iii

Objective: To determine the grade III varicocele and undescended testis (UDT) prevalence, testicular atrophy rate, and treatment rate in adolescent boys aged 13-15 in the Turkish population. Methods: Healthy boys who were candidates for military high schools were evaluated between June and July 2015. Patients with undescended testis or grade III varicocele were recorded. Also, the presence of testicular atrophy and history of previous surgeries were recorded. The prevalence of grade III varicocele and UDT, testicular atrophy rate and treatment data were assessed. Results: Grade III varicocele was detected in 627 (6.48%) of 9669 boys. Testicular atrophy due to grade III varicocele was detected in 213 (33.97%) of the cases. Patients who did not undergo varicocelectomy are more likely to have testicular atrophy than patients who underwent varicocelectomy (35.37% vs 19.64%, p=0.018). The UDT was detected in 96 (0.99%) candidates. Of those, 76 (79.16%) candidates had unilateral, and 20 (20.83%) candidates had bilateral UDT. 84 (87.50%) candidates underwent at least one surgery for the management of UDT and 12.5% of the candidates (n=12) were not aware of their diseases. Conclusion: This study shows us the prevalence of grade III varicocele in our population. Varicocele is a progressive disease that can cause fertility and testicular atrophy increases with the puberty.

scholarly journals Timing of orchidopexy and its relationship to postoperative testicular atrophy: results from the ORCHESTRA study

BJS Open ◽  
2021 ◽  
Vol 5 (1) ◽  
Author(s):  
◽  
C Skerritt ◽  
C Bradshaw ◽  
N Hall ◽  
L McCarthy ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Testicular Atrophy ◽  
Wound Infections ◽  
Atrophy Rate ◽  
Younger Age ◽  
Increased Risk ◽  
Hospital Stays ◽  
Reoperation Rates ◽  
International Audit

Abstract Background In 2011 a consensus statement from the British Association of Paediatric Urologists recommended lowering the age at orchidopexy to under 1 year. There are concerns that a younger age at operation may increase postoperative testicular atrophy. The ORCHESTRA study aimed to establish the current age at orchidopexy in a multicentre, international audit and to see whether testicular atrophy was affected by age at operation. Methods The study was undertaken over a 3-month period in 28 centres in boys undergoing orchidopexy for unilateral, palpable undescended testes. Data collection was done using a standardized, predetermined protocol. The primary outcome was postoperative testicular atrophy. Secondary outcomes were wound infections, reoperations, and unplanned hospital stays related to anaesthetic events. Results A total of 417 patients were included, of whom only 48 (11.5 per cent) underwent orchidopexy before 1 year of age. There was no difference in anaesthetic complications in boys aged less than 1 year versus older patients: 0 of 48 (0 per cent) versus 6 of 369 (1.6 per cent) (P = 0.999). Complete follow-up was available for 331 patients (79.4 per cent). There was no difference in atrophy rate between those aged less than 1 year and older boys: 1 of 37 (3 per cent) versus 9 of 294 (3.1 per cent) (P = 0.999). Reoperation rates were 0 of 37 (0 per cent) and 7 of 294 (2.4 per cent) respectively (P = 1.000). There were more wound infections in boys under 1 year of age: 4 of 37 (11 per cent) versus 7 of 294 (2.4 per cent) (P = 0.025). Conclusion Only 11.5 per cent of boys underwent surgery before the age of 1 year. There was no increased risk of postoperative testicular atrophy with early surgery, although there was a higher rate of wound infection. Further study is required to demonstrate that early orchidopexy is not inferior to orchidopexy undertaken in boys aged over 1 year.

scholarly journals The fat anchor orchiopexy technique: results and outcomes from 150 cases surgical experience

2021 ◽  
Author(s):  
Claudio Spinelli ◽  
Alessia Bertocchini ◽  
Gianmartin Cito ◽  
Marco Ghionzoli ◽  
Silvia Strambi
Keyword(s):  
Undescended Testis ◽  
Healing Process ◽  
Day Surgery ◽  
Post Surgery ◽  
Post Operative Pain ◽  
Surgical Wounds ◽  
Bilateral Cryptorchidism ◽  
Long Time ◽  
History Of

Abstract Purpose The purpose of the study is to evaluate results and outcomes in a long-time follow-up period, by performing a novel testicular fixation procedure, known as “fat anchor orchidopexy” (FAO), for the treatment of palpable low inguinal undescended testis. Materials and methods We retrospectively reviewed all patients who underwent scrotal orchiopexy technique, from May 2013 to May 2019, at the Pediatric Surgery Division of Department of Surgical Pathology, University of Pisa (Italy). FAO (Spinelli’s technique) consists in anchoring the testicles to sub-scrotal fat with a single trans-scrotal incision. All the patients enrolled had history of unilateral or bilateral undescended testis. Data collected included patient’s age, operative times and complications. Results A total of 150 children with cryptorchidism were treated using a single trans-scrotal orchiopexy. Of them, 130 patients (86.7%) had unilateral undescended testis and 20 (13.3%) bilateral cryptorchidism. Mean patient’s age was 21 months (range: 14–28 months). All the procedures were planned in a day-surgery setting. Trans-scrotal orchiopexy was successful in all cases and no patients required an additional groin incision. No intraoperatively and postoperatively major complications were observed. Patients’ post-operative pain was mild (mean pediatric visual analog scale = 2). In all cases, the healing process was rapid and no surgical wounds infections were reported during the post-operative period, referring excellent cosmesis results. During a mean 48-month follow-up period, no testicular retraction, recurrence or testis atrophy was reported. Conclusion The original Spinelli’s technique (FAO) proves to be a safe and effective method for the treatment of palpable or distal-to-external-inguinal-ring testes. No immediate and delayed post-surgery complications were reported. In all cases, the anchored testicle remained in the scrotal position with normal vascularization. This novel surgical technique could give better options for scrotal fixation in case of low-lying cryptorchid testes.

Clinical course in multiple sclerosis patients presenting with a history of progressive disease

2014 ◽  
Vol 3 (1) ◽  
pp. 67-71 ◽  
Author(s):  
K.S. Pandey ◽  
S.C. Krieger ◽  
C. Farrell ◽  
C. Hannigan ◽  
T. DeAngelis ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Progressive Disease ◽  
Clinical Course ◽  
History Of ◽  
Multiple Sclerosis Patients

scholarly journals Acute Testicular Torsion in Children: A Tertiary Hospital Experience in a Developing Country

2021 ◽  
Vol 2 (4) ◽  
pp. 01-03
Author(s):  
Chukwubuike Kevin Emeka
Keyword(s):  
Pediatric Surgery ◽  
Testicular Torsion ◽  
Undescended Testis ◽  
Tertiary Hospital ◽  
Prior History ◽  
Testicular Pain ◽  
History Of ◽  
The Mean ◽  
Urological Emergency ◽  
The Right

Background: Testicular torsion is a urological emergency in which there is a race against time to salvage the testis. The aim of this study was to evaluate our experience in the management of children who presented with acute testicular torsion. Materials and Methods: This was a retrospective study of children aged 15 years and below who had surgery for acute testicular torsion between January 2013 and December 2017 at the pediatric surgery unit of a teaching hospital in Enugu, Nigeria. Results: Sixty-four children were managed during the study period. The ages of the patients ranged from 2 months to 14 years with a median of 6 years. The right testis was mostly affected and the mean duration from the onset of symptom to presentation was 4 hours. All the patients presented with testicular pain and half of the patients had a prior history of intermittent testicular pain. Four (6.3%) patients had a history of trauma precipitating the testicular torsion and 3 (4.7%) patients had undescended testis. Detorsion and Orchidopexy was the most performed surgical procedure and wound infection was the most common post-operative complication. There was no mortality. Conclusion: Testicular torsion is not uncommon in children and may be associated with testicular loss. The right testis is mostly involved in children. Prior history of intermittent testicular pain, trauma and undescended testis are important considerations. Prompt detorsion and orchidopexy remains the cornerstone of treatment.

MMPI--A Profiles of Adolescent Boys With a History of Firesetting

1996 ◽  
Vol 67 (1) ◽  
pp. 116-126 ◽  
Author(s):  
James M. Moore Jr. ◽  
Susan K. Thompson-Pope ◽  
Richard M. Whited
Keyword(s):  
Adolescent Boys ◽  
History Of

scholarly journals Management of HAM/TSP

2020 ◽  
pp. 10.1212/CPJ.0000000000000832 ◽  
Author(s):  
Abelardo Araujo ◽  
Charles R.M. Bangham ◽  
Jorge Casseb ◽  
Eduardo Gotuzzo ◽  
Steve Jacobson ◽  
...  
Keyword(s):  
Progressive Disease ◽  
Spastic Paraparesis ◽  
Oral Prednisolone ◽  
Interferon Α ◽  
High Dose ◽  
First Line Therapy ◽  
Methyl Prednisolone ◽  
Disease Modifying Therapy ◽  
History Of

Purpose of reviewTo provide an evidence-based approach to the use of therapies that are prescribed to improve the natural history of HTLV-1–associated myelopathy/tropical spastic paraparesis (HAM/TSP)—a rare disease.Recent findingsAll 41 articles on the clinical outcome of disease-modifying therapy for HAM/TSP were included in a systematic review by members of the International Retrovirology Association; we report here the consensus assessment and recommendations. The quality of available evidence is low, based for the most part on observational studies, with only 1 double-masked placebo-controlled randomized trial.SummaryThere is evidence to support the use of both high-dose pulsed methyl prednisolone for induction and low-dose (5 mg) oral prednisolone as maintenance therapy for progressive disease. There is no evidence to support the use of antiretroviral therapy. There is insufficient evidence to support the use of interferon-α as a first-line therapy.

Durable Molecular Remission in Two Acute Promyelocytic Leukemia (APL) Patients Treated with Arsenic Trioxide at First Molecular Relapse.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1847-1847 ◽  
Author(s):  
Dan Douer ◽  
Laleh Ramezani ◽  
Kristy Watkins ◽  
Robert Louie ◽  
Martin S. Tallman
Keyword(s):  
Arsenic Trioxide ◽  
Liver Toxicity ◽  
Single Agent ◽  
Disease Free Survival ◽  
Rest Period ◽  
Clinical Relapse ◽  
Rt Pcr ◽  
History Of ◽  
Optimal Approach ◽  
Grade Iii

Abstract Background: The recurrent detection of the PML- RARα transcripts in APL patients in complete remission (CR) is predictive of clinical relapse. Intervention at the time of molecular relapse rather than at the time of overt clinical relapse may minimize the risks associated with the disease as well as treatment-related complications. Previous studies have shown that patients treated at molecular relapse had improved overall survival compared to patients treated at clinical relapse; however, the optimal approach to the treatment of molecular relapse has not yet been established. Arsenic trioxide is active as a single agent in APL patients who developed overt clinical relapse after treatment with ATRA and anthracycline chemotherapy. We evaluated the use of single agent arsenic trioxide in APL patients who are still in first hematological CR but have become RT-PCR positive. Methods: So far, 2 patients were studied, both females with the long form of RAR RARα (bcr1), aged 29 and 39 years. These patients had normal bone marrow morphology but were found to be RT-PCR positive twice in an interval of at least 2 months, while in first CR at 12 and 36 months, respectively. Arsenic trioxide, 0.15 mg/kg/dose, was administered intravenously for 5 days per week for 5 weeks (total of 25 doses) with a 3 to 6 week rest period between cycles up to a maximum of 4 cycles. Results: Both patients became PCR negative after the first cycle of arsenic trioxide. One patient completed four cycles of therapy. The second patient had a history of diabetes mellitus, received only 20 doses of the first cycle and was removed from the study because of grade III sensory neurotoxicity. The only other side effects were grade II headache in both patients and self-limited grade III liver toxicity in one patient. Both patients remain RT-PCR negative at 30 and 28 months after enrollment, respectively, without further therapy. Conclusions: Without treatment, these patients could be expected to have developed a clinical relapse within 4–10 months. Arsenic trioxide induced a durable second molecular relapse, extending disease-free survival and obviating the need for more intensive treatment, such as chemotherapy and stem cell transplantation.

PVAG (Prednisone, Vinblastine, Doxorubicin and Gemcitabine) In Elderly Patients with Intermediate or Advanced Stage Hodgkin Lymphoma: Final Results of a Phase II Study of the German Hodgkin Study Group (GHSG).

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2827-2827
Author(s):  
Boris Böll ◽  
Teresa Halbsguth ◽  
Helen Görgen ◽  
Henning Bredenfeld ◽  
Hans Eich ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Hodgkin Lymphoma ◽  
Phase Ii ◽  
Poor Prognosis ◽  
Progressive Disease ◽  
Phase Ii Study ◽  
Advanced Stage ◽  
Who Grade ◽  
Who Grade Iii ◽  
Grade Iii

Abstract Abstract 2827 About 20% of all patients diagnosed with Hodgkin lymphoma (HL) are older than 60 years. These patients have a rather poor prognosis, particularly when presenting in intermediate or advanced stages. Besides a biologically more aggressive disease, the main reason is a drastically increased toxicity of chemo- and radiotherapy resulting in a higher treatment-related mortality and insufficient dosing of the applied treatment. In the GHSG-HD9 trial, elderly patients did not benefit from the BEACOPP regimen in terms of overall survival due to a high toxicity related death rate. In order to improve tolerability, the PVAG regimen (prednisone, vinblastine, doxorubicin, and gemcitabine) was developed. This is a modification of the ABVD regimen in which bleomycin and dacarbazine were replaced by prednisone and gemcitabine. Here we report for the first time on the final analysis of this multi-center phase II study for elderly HL patients. 61 patients were recruited between 2004 and 2007. 2 patients were excluded due to histology review not confirming HL, resulting in 59 patients with intermediate- or advanced-stage HL aged between 60 and 75 years. Treatment consisted of 6 cycles PVAG in patients achieving a complete remission (CR) after 4 cycles or 8 cycles PVAG in case of partial remission (PR) after 4 cycles. Patients who did not achieve CR after the end of chemotherapy received additional radiotherapy. Primary endpoints were administration of adequate dose without excessive delays, and response rate 3 months after end of treatment. Secondary endpoints included WHO grade III/IV toxicities, and occurrence of early progression. 59 patients with a median age of 68 years were evaluated, of which 59% were male and 93% had advanced stage disease. The relative dose intensity (relative dose divided by relative chemotherapy duration) was at least 80% in 44 patients (76%). Regarding the single cycles, of which 85% started without major delay (max. 1 day), the mean relative dose of all agents was slightly decreasing over time but always exceeded 90%. WHO grade III/IV toxicities were documented in 43 patients (75%). Only 3 patients terminated CT because of excessive toxicity. 10 Patients (17%) received consolidating radiotherapy. In total, 46 patients responded with CR/CRu (78%; 95% CI: 65% to 88%), 2 with PR (3%), 2 with no change (3%) and 4 with progressive disease (7%). 3 patients died before restaging with unknown response and in 2 patients treatment outcome is unknown. With a median observation time of 37 months, 6 patients (10%) had progressive disease and 9 patients (15%) relapsed. In total, 10 patients died from relapsing or progressing HL, 2 from second malignancies (one of lung cancer after 23 months, and one of AML after 25 months) and 5 patients due to other reasons. Overall 17 patients (29%, 95% CI: 18% to 42%) have died so far. In conclusion, PVAG is safe and feasible in Hodgkin patients older than 60. The PFS indicates activity of this regimen in this poor prognosis patient cohort. However, a controlled randomized trial to determine the best treatment in this patient population is warranted. This trial was registered at www.clinicaltrials.gov as #NCT00147875. Disclosures: No relevant conflicts of interest to declare.

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