Database : MEDLINE
Search on : Spermatic and Cord and Torsion [Words]
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[PMID]: 29460046
[Au] Autor:Bertolotto M; Muça M; Currò F; Bucci S; Rocher L; Cova MA
[Ad] Address:Department of Radiology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149, Trieste, Italy. bertolot@units.it.
[Ti] Title:Multiparametric US for scrotal diseases.
[So] Source:Abdom Radiol (NY);, 2018 Feb 19.
[Is] ISSN:2366-0058
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Multiparametric US is increasingly recognized as a valuable problem-solving technique in scrotal pathologies. Compared to conventional Doppler modes, contrast-enhanced ultrasonography (CEUS) has higher sensitivity in assessing the presence or absence of flows, and to improve differentiation between poorly vascularized tumors and non-neoplastic, avascular lesions. Characterization of benign and malignant complex cysts is improved. In trauma patients, CEUS can help evaluating the viability of testicular parenchyma. In patients with severe epididymo-orchitis, it allows unequivocal assessment of post-inflammatory ischemic changes and abscess formation. CEUS does not add significantly to conventional Doppler modes in spermatic cord torsion. Attempt of differentiating benign and malignant tumors remains a research tool. In the clinical practice, elastography has a limited role for tumor characterization. The majority of malignant tumors are stiff at elastography, but they may display soft areas, or appear globally soft. A quantitative evaluation of testicular stiffness is feasible using shear-wave elastography. Potential clinical applications for elastographic modes could include work-up of infertile patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[St] Status:Publisher
[do] DOI:10.1007/s00261-018-1510-7

  2 / 2429 MEDLINE  
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[PMID]: 29406065
[Au] Autor:Manjunath AS; Hofer MD
[Ad] Address:Department of Urology, Northwestern University Feinberg School of Medicine, 303 East Chicago Avenue 16-703, Chicago, IL 60611, USA.
[Ti] Title:Urologic Emergencies.
[So] Source:Med Clin North Am;102(2):373-385, 2018 Mar.
[Is] ISSN:1557-9859
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Urologic emergencies can involve the kidneys, ureters, bladder, urethra, penis, scrotum, or testicles. History and physical examination are essential to diagnosis, whereas imaging is increasingly used to confirm diagnoses. Acute urinary retention should be relieved with Foley placement. Penile emergencies include paraphimosis, which can be treated by foreskin reduction, whereas penile fracture and priapism require urologic intervention. Fournier gangrene and testicular torsion are scrotal emergencies requiring emergent surgery. Nephrolithiasis, although painful, is not an emergency unless there is concern for concomitant urinary tract infection, both ureters are obstructed by stones, or there is an obstructing stone in a solitary kidney.
[Mh] MeSH terms primary: Urologic Diseases/diagnosis
Urologic Diseases/therapy
[Mh] MeSH terms secundary: Acute Disease
Emergencies
Female
Female Urogenital Diseases/diagnosis
Female Urogenital Diseases/therapy
Fournier Gangrene/diagnosis
Fournier Gangrene/therapy
Humans
Male
Male Urogenital Diseases/diagnosis
Male Urogenital Diseases/therapy
Nephrolithiasis/diagnosis
Nephrolithiasis/microbiology
Nephrolithiasis/therapy
Paraphimosis/diagnosis
Paraphimosis/therapy
Penis/injuries
Priapism/diagnosis
Priapism/therapy
Referral and Consultation
Rupture
Spermatic Cord Torsion/diagnosis
Spermatic Cord Torsion/therapy
Urinary Retention/diagnosis
Urinary Retention/therapy
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180208
[Lr] Last revision date:180208
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180207
[St] Status:MEDLINE

  3 / 2429 MEDLINE  
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[PMID]: 29287198
[Au] Autor:Refaie MMM
[Ad] Address:Department of Pharmacology, Faculty of Medicine, Minia University, 61511, Minia, Egypt. Electronic address: marwamonier@yahoo.com.
[Ti] Title:Upregulation of peroxisome proliferator activated receptor alpha by fenofibrate in induced testicular ischemia reperfusion.
[So] Source:Biomed Pharmacother;98:507-515, 2018 Feb.
[Is] ISSN:1950-6007
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:Torsion of the spermatic cord is a common urological emergency among infants and adolescents that can lead to testicular necrosis and infertility. We investigated the effect of fenofibrate (FEN) on induced testicular ischemia reperfusion (testicular (I-R). FEN (100, 300 mg/kg/day) was administered orally in presence or absence of testicular (I-R). We measured testicular weight changes and serum testosterone level. In addition; Testicular tissue reduced glutathione (GSH), malondialdehyde (MDA), total nitrites (NO ) and superoxide dismutase (SOD) activity were measured. Moreover; tumor necrosis factor alpha (TNF-α), nuclear factor kappa B (NF-κB) immunoexpressions and histopathology were evaluated. Testicular (I-R) induced group showed significant decrease in serum testosterone level and testicular weight with increase in testicular tissue MDA and NO levels. Testicular (I-R) induced group showed the histopathological changes of marked testicular damage according to Johnsen's score. In addition, there was significant reduction in GSH and SOD testicular tissue levels but significant increase in TNF-α and NF-κB immunoexpressions. FEN was able to markedly improve testicular (I-R) induced changes through its action on peroxisome proliferator activated receptor alpha (PPARα), anti-oxidant, anti-inflammatory and anti-apoptotic effects.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180209
[Lr] Last revision date:180209
[St] Status:In-Process

  4 / 2429 MEDLINE  
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[PMID]: 29240370
[Au] Autor:Hazeltine M; Panza A; Ellsworth P
[Ti] Title:Testicular Torsion: Current Evaluation and Management.
[So] Source:Urol Nurs;37(2):61-71, 93, 2017 Mar-Apr.
[Is] ISSN:1053-816X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Testicular torsion is a urologic emergency, requiring prompt identification and management. Understanding the risk factors, presentation, and management is essential to decrease delays in diagnosis and intervention. This review discusses the prevalence, pathophysiology, management, and outcomes of testicular torsion.
[Mh] MeSH terms primary: Physical Examination
Spermatic Cord Torsion/diagnosis
Ultrasonography
[Mh] MeSH terms secundary: Age Factors
Disease Management
Humans
Male
Risk Factors
Spermatic Cord Torsion/surgery
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1801
[Cu] Class update date: 180123
[Lr] Last revision date:180123
[Js] Journal subset:N
[Da] Date of entry for processing:171215
[St] Status:MEDLINE

  5 / 2429 MEDLINE  
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[PMID]: 29335899
[Au] Autor:McDowall J; Adam A; Gerber L; Enyuma COA; Aigbodion SJ; Buchanan S; Laher AE
[Ad] Address:Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, 07 York Road, Parktown, Johannesburg, 2193, South Africa. jmc_dowall@icloud.com.
[Ti] Title:The ultrasonographic "whirlpool sign" in testicular torsion: valuable tool or waste of valuable time? A systematic review and meta-analysis.
[So] Source:Emerg Radiol;, 2018 Jan 15.
[Is] ISSN:1438-1435
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: A positive whirlpool sign (WS) is defined as the presence of a spiral-like pattern when the spermatic cord is assessed during ultrasonography (US), using standard, high-resolution ultrasonography (HRUS) and/or color Doppler sonography (CDS), in the presence of testicular torsion. The objective of this review was to assess the validity and accuracy of this sign by performing a comprehensive systematic literature review and meta-analysis. METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a comprehensive literature search was performed (August, 2017), using the following databases: BMJ Best Practice, Cochrane Library, Embase, PubMed, Scopus, and Web of Science. Selected studies were further assessed for relevance and quality using the Oxford 2010 Critical Appraisal Skills Program (CASP). RESULTS: Of the studies assessed, a total of 723 participants were included, with a mean of 72.3 (SD 71.9) participants. Of the participants, 226 (31.3%) were diagnosed with testicular torsion (TT). Meta-analysis of the studies that provided sufficient data resulted in a pooled sensitivity and specificity of the WS of 0.73 (95% CI, 0.65-0.79) and 0.99 (95% CI, 0.92-0.99), respectively. Removal of all neonates increased the pooled sensitivity to 0.92 (95% CI, 0.70-0.98) while the pooled specificity remained almost unchanged at 0.99 (95% CI, 0.95-1.00). The estimated summary effect of all studies with sufficient data was 4.34 (95% CI, 1.01-7.67; n = 394; p = 0.001). A large degree of heterogeneity was suggested by an I statistic of 88.27% (95% CI, 68.60-98.68%). Removal of neonatal subjects increased the estimated summary effect to 5.32 (95% CI, 1.59-9.05; n = 375; p = 0.001). CONCLUSION: The WS, when correctly diagnosed, may be viewed as a very definitive sign for TT in the pediatric and adult populations. However, its role in neonates is limited.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180116
[Lr] Last revision date:180116
[St] Status:Publisher
[do] DOI:10.1007/s10140-018-1579-x

  6 / 2429 MEDLINE  
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[PMID]: 29246339
[Au] Autor:Arevalo MK; Sheth KR; Menon VS; Ostrov L; Hennes H; Singla N; Koral K; Schlomer BJ; Baker LA
[Ad] Address:Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
[Ti] Title:Straight to the Operating Room: An Emergent Surgery Track for Acute Testicular Torsion Transfers.
[So] Source:J Pediatr;192:178-183, 2018 Jan.
[Is] ISSN:1097-6833
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To assess the effect of implementing an emergency surgery track for testicular torsion transfers. We hypothesized that transferring children from other facilities diagnosed with torsion straight to the operating room (STOR) would decrease ischemia time, lower costs, and reduce testicular loss. STUDY DESIGN: Demographics, arrival to incision time, hospital cost in dollars, and testicular outcome (determined by testicular ultrasound) at follow-up were retrospectively compared in all patients transferred to our tertiary care children's hospital with a diagnosis of testicular torsion from 2012 to 2016. Clinical data for STOR and non-STOR patients were compared by Wilcoxon rank-sum, 2-tailed t test, or Fisher exact test as appropriate. RESULTS: Sixty-eight patients met inclusion criteria: 35 STOR and 33 non-STOR. Children taken STOR had a shorter median arrival to incision time (STOR: 54 minutes vs non-STOR: 94 minutes, P < .0001) and lower median total hospital costs (STOR: $3882 vs non-STOR: $4419, P < .0001). However, only 46.8% of STOR patients and 48.4% of non-STOR patients achieved surgery within 6 hours of symptom onset. Testicular salvage rates in STOR and non-STOR patients were not significantly different (STOR: 68.4% vs non-STOR: 36.8%, P = .1), but follow-up was poor. CONCLUSIONS: STOR decreased arrival to incision time and hospital cost but did not affect testicular loss. The bulk of ischemia time in torsion transfers occurred before arrival at our tertiary care center. Further interventions addressing delays in diagnosis and transfer are needed to truly improve testicular salvage rates in these patients.
[Mh] MeSH terms primary: Patient Transfer/methods
Quality Improvement
Spermatic Cord Torsion/surgery
[Mh] MeSH terms secundary: Adolescent
Child
Child, Preschool
Clinical Protocols
Delayed Diagnosis/economics
Delayed Diagnosis/prevention & control
Early Diagnosis
Emergencies
Follow-Up Studies
Hospital Costs/statistics & numerical data
Hospitals, Pediatric/economics
Hospitals, Pediatric/standards
Humans
Infant
Male
Operating Rooms
Orchiectomy/economics
Patient Transfer/economics
Patient Transfer/standards
Quality Improvement/economics
Retrospective Studies
Spermatic Cord Torsion/diagnosis
Spermatic Cord Torsion/economics
Tertiary Care Centers/economics
Tertiary Care Centers/standards
Time Factors
Treatment Outcome
United States
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171226
[Lr] Last revision date:171226
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:171217
[St] Status:MEDLINE

  7 / 2429 MEDLINE  
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[PMID]: 29219274
[Au] Autor:Lorenzo L; Martínez-Cuenca E; Broseta E
[Ad] Address:Hospital Universitario y Politécnico La Fe, Valencia, Espanha.
[Ti] Title:Bilateral testicular torsion in an adolescent: a case with challenging diagnosis.
[So] Source:Int Braz J Urol;43, 2017 Dec 11.
[Is] ISSN:1677-6119
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:Bilateral testicular torsion is a very uncommon emergency, with a challenging differential diagnosis. We describe the case of a 15-year-old patient with a left testicular torsion of 48 hours of duration and a sudden onset of right scrotum pain during his stay at the emergency area. Bilateral testicular torsion was diagnosed after repeat physical examination and doppler ultrasound, which had been normal for right testis in a first evaluation. Surgical exploration was performed with orchiectomy in left testis and fixation in right testis. In previous literature, there are reported bilateral torsion only in four adolescents and five adults. With this case, we demonstrate that bilateral spermatic cord torsion may be easily overlooked in a patient with acute scrotum and we emphasize the importance of bilateral exploration in testicular torsion.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171208
[Lr] Last revision date:171208
[St] Status:Publisher
[do] DOI:10.1590/S1677-5538.IBJU.2017.0371

  8 / 2429 MEDLINE  
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[PMID]: 29138449
[Au] Autor:Goktas S; Yalcin O; Ermek E; Piskin S; Capraz CT; Cakmak YO; Pekkan K
[Ad] Address:Koc University, Mechanical Engineering Department, Istanbul, 34450, Turkey.
[Ti] Title:Haemodynamic Recovery Properties of the Torsioned Testicular Artery Lumen.
[So] Source:Sci Rep;7(1):15570, 2017 Nov 14.
[Is] ISSN:2045-2322
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Testicular artery torsion (twisting) is one such severe vascular condition that leads spermatic cord injury. In this study, we investigate the recovery response of a torsioned ram testicular artery in an isolated organ-culture flow loop with clinically relevant twisting modes (90°, 180°, 270° and 360° angles). Quantitative optical coherence tomography technique was employed to track changes in the lumen diameter, wall thickness and the three-dimensional shape of the vessel in the physiological pressure range (10-50 mmHg). As a control, pressure-flow characteristics of the untwisted arteries were studied when subjected to augmented blood flow conditions with physiological flow rates up to 36 ml/min. Both twist and C-shaped buckling modes were observed. Acute increase in pressure levels opened the narrowed lumen of the twisted arteries noninvasively at all twist angles (at ∼22 mmHg and ∼35 mmHg for 360°-twisted vessels during static and dynamic flow experiments, respectively). The association between the twist-opening flow rate and the vessel diameter was greatly influenced by the initial twist angle. The biomechanical characteristics of the normal (untwisted) and torsioned testicular arteries supported the utilization of blood flow augmentation as an effective therapeutic approach to modulate the vessel lumen and recover organ reperfusion.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171122
[Lr] Last revision date:171122
[St] Status:In-Data-Review
[do] DOI:10.1038/s41598-017-15680-3

  9 / 2429 MEDLINE  
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[PMID]: 29121037
[Au] Autor:Patoulias D; Farmakis K; Kalogirou M; Patoulias I
[Ad] Address:Department of Internal Medicine, GH of Veria, Veria, Greece. dipatoulias@gmail.com
[Ti] Title:Transient testicular torsion: from early diagnosis to appropriate therapeutic intervention (a prospective clinical study).
[So] Source:Folia Med Cracov;57(2):53-62, 2017.
[Is] ISSN:0015-5616
[Cp] Country of publication:Poland
[La] Language:eng
[Ab] Abstract:Transient testicular torsion (TTT) occurs when the torsion of the spermatic cord is reversed automatically within few minutes, with subsequent restoration of the blood ow to the suffering testis. e main clinical manifestation is acute scrotal pain, which resolves within a short period of time, usually few minutes. In 25% of patients su er from nausea and vomiting, besides the scrotal discomfort. Episodes of torsion can be repeated 1-30 times, leading progressively to development of ischemic trauma of the testis, while in 30-61% of all cases they constitute a precursor of testicular torsion. From January, 2016 to December, 2016, 11 patients in total were admitted to the Emergency Department due to acute scrotal pain that lasted a few minutes (1-5 minutes in most), which had already elapsed at the time of their admission, accompanied with nausea in all patients and vomiting in 5 of them. No swelling or rubor of the scrotum was revealed during physical examination, while in 9 patients it was observed that the suffering testis had transverse orientation. Ultrasonography was negative for pseudotumor or Whirlpool sign, while transverse orientation of the testis was confirmed in 9 patients. All the patients underwent surgical investigation of the suffering hemiscrotum, while Bell Clapper Deformity was found in 9 patients. Fixation of the suffering testis to the mesoscrotal diaphragm with 3 separate sutures by using non-absorbable suture followed. By the same surgical approach, the contralateral hemiscrotum was also investigated. Bilateral high adhesion of the tunica vaginalis was found in 8 out of 9 patients, in whom preventive unilateral orchidopexy was performed. All the patients are followed-up on a 6-month basis, without report of a similar, transient episode of acute scrotal pain. TTT should always be included in differential diagnosis in cases of acute scrotal pain in the past, with transverse orientation of the suffering testis. Prompt diagnosis and early treatment of the subject anatomic deformity (Bell Clapper Deformity) prevents the ischemic consequences on testicular parenchyma due to either recurrent episode of TTT or as a consequence of intravaginal testicular torsion.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171111
[Lr] Last revision date:171111
[St] Status:In-Data-Review

  10 / 2429 MEDLINE  
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[PMID]: 29072248
[Au] Autor:Oluyemi OY
[Ad] Address:Department of Surgery, Ben Carson (SNR) School of Medicice/Babcock University Teaching Hospital, Ilisan Remo, Ogun State, Nigeria.
[Ti] Title:Torsion of the spermatic cord: An exemplary early presentation.
[So] Source:Niger J Clin Pract;20(9):1206-1209, 2017 Sep.
[Is] ISSN:1119-3077
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:Torsion of the spermatic cord may lead to loss of the testis when presentation is delayed. In our environment, a high premium is placed on the male child and his ability to procreate. Hence, torsion of the spermatic cord is a true surgical emergency. Here, we report a case of torsion of the spermatic cord in a 19-year-old student that exemplifies early presentation and short presentation-detorsion time. Immediately after the operation, the clinical information in the patient's case file was summarized. A literature search was conducted on the subject matter, and the findings were compared with those of the present patient. The determinants of outcome include presentation time and the time between presentation and operation. Unfortunately, in many series, late presentation is still the norm. In the index patient, the presentation time was very short. In our environment, patients with torsion of the spermatic cord can present early and be operated promptly if we can provide public health education, mobile phones, commercial taxis, and good road networks.
[Pt] Publication type:CASE REPORTS
[Em] Entry month:1710
[Cu] Class update date: 171026
[Lr] Last revision date:171026
[St] Status:In-Process
[do] DOI:10.4103/njcp.njcp_358_16


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