MyMedR

Spontaneous neonatal scrotal haematoma: an early manifestation of severe haemophilia

Lee JS, Chieng CH, Martin M, Toh TH

BMJ Case Rep, 2021 Apr 28;14(4).

PMID: 33910804 DOI: 10.1136/bcr-2020-241482

We report a term newborn who presented on day 3 of life with unilateral, tender scrotal swelling with skin discolouration, which was subsequently diagnosed as haemophilia A at about 6 months of age. He received intramuscular vitamin K and hepatitis B vaccine at birth uneventfully. The scrotal swelling was treated as an infected hydrocoele, considering the absence of a family history of bleeding disorder and other risks of bleeding tendency, as well as the ultrasonographic features. He also had congenital pneumonia requiring venepuncture, non-invasive oxygen supplementation and intravenous antibiotics, without any complication. The swelling slowly improved over 2 months. He later developed post-trial vaccine injection haematoma at 4 months of age, and multiple non-traumatic bruises when he was 6 months old, leading to the diagnosis. This case demonstrates an uncommon, but a possible, early manifestation of haemophilia A at birth with a unilateral scrotal haematoma.

Matched MeSH terms: Genital Diseases, Male*

Fournier's gangrene: its aetiology and management

Thambi Dorai CR, Kandasami P

Aust N Z J Surg, 1991 May;61(5):370-2.

PMID: 2025192

The clinical features and management of 12 patients with Fournier's gangrene are described. The patients differed from the usual description of Fournier's gangrene in that they were older, the disease had a less abrupt onset and a definite predisposing factor was identified in 10 of the 12 patients. The importance of early diagnosis and excision of necrotic tissue is emphasized.

Matched MeSH terms: Genital Diseases, Male/etiology; Genital Diseases, Male/pathology; Genital Diseases, Male/surgery

Painful oral and genital ulcers

Ch'ng CC, Wong SM, Lee YY

Cutis, 2017 Jan;99(1):E1-E3.

PMID: 28207013

Matched MeSH terms: Genital Diseases, Male/diagnosis*; Genital Diseases, Male/pathology

Fulltext A rare case of ambiguous genitalia

Ng SF, Boo NY, Wu LL, Shuib S

Singapore Med J, 2007 Sep;48(9):858-61.

PMID: 17728969

Genes on the Y chromosome are essential for normal sex determination and sex differentiation of male genitalia. However, genes on the X chromosome and other autosomes have been shown to be anti-testes and have a detrimental effect on this process. Addition of X chromosomes to the 46,XY karyotype results in seminiferous tubules dysgenesis, hypogonadism and malformed genitalia. We report a term male newborn with 49,XXXXY syndrome presenting with ambiguous genitalia, multiple extra-gonadal anomalies, facial dysmorphism, and radioulnar synostosis.

Matched MeSH terms: Genital Diseases, Male/etiology; Genital Diseases, Male/pathology*

Fulltext Subcutaneous leiomyosarcoma of the scrotum mimickering testicular cancer. A case report and literature review

Singh S, Hassan A

Urol Case Rep, 2021 Jan;34:101487.

PMID: 33318933 DOI: 10.1016/j.eucr.2020.101487

Leiomyosarcoma of the scrotum is a rare tumor. Johnson H Jr in 1987 reported first case. Only 39 cases been reported in the literature. A 74 years old Indian gentleman presented with progressive painless right testicular swelling for 3 months. On examination, a firm right testicular mass. We proceeded with right scrotal exploration with excision of the right scrotal mass. Histopathology showed scrotum leiomyosarcoma. We would like to discuss the rarity of presentation, dilemma of diagnosis and managing in a district hospital. We advocate wide local excision with clear margin of 2 cm which give good overall survival benefits.

Matched MeSH terms: Genital Diseases, Male

Fulltext Laparoscopic transabdominal approach and its modified technique for incarcerated scrotal hernias

Siow SL, Mahendran HA, Hardin M, Chea CH, Nik Azim NA

Asian J Surg, 2013 Apr;36(2):64-8.

PMID: 23522757 DOI: 10.1016/j.asjsur.2012.11.004

Using laparoscopic methods for incarcerated scrotal hernias is controversial because of the perceived technical difficulties in treating such hernias. Herein, we present our experience with laparoscopic repair of such hernias.

Matched MeSH terms: Genital Diseases, Male/surgery*

Spermatic cord metastasis from a medulloblastoma

Thambi dorai CR, Azmi A, Rahman AJ, Subathra S, Hayati AR, Zulfiqar A

Pediatr Surg Int, 2001 Nov;17(8):654-6.

PMID: 11727063

A 4-year-old boy presented with metastases in the spermatic cord and ribs 2 years after treatment for a primary medulloblastoma (MB). The testis was free of tumor. A MB presenting with a metastasis to the spermatic cord has not been reported to date. The role of a ventriculo-peritoneal shunt in promoting such spread should be considered in planning management.

Matched MeSH terms: Genital Diseases, Male/etiology*

Genital infections with chlamydia trachomatis

Ngeow YF, Ong SB, Thong ML, Teoh SK, Omar R, Low BT

Med J Malaysia, 1979 Sep;34(1):65-70.

PMID: 542157

Matched MeSH terms: Genital Diseases, Male/diagnosis*

Fulltext Case report of bilateral testicular infarction due to severe bilateral epididymo-orchitis: A catastrophic complication causing castration

Ong Lay Keat W, Lechmiannandan S, Manoharan D, Lee SB, Nagalingam P

Int J Surg Case Rep, 2020;73:161-163.

PMID: 32688238 DOI: 10.1016/j.ijscr.2020.07.013

INTRODUCTION: Testicular infarction as a result of severe epididymo-orchitis is an uncommon urological emergency, with only a handful of reported cases in literature. We report an even rarer case of bilateral epididymo-orchitis complicated with testicular infarction, resulting in bilateral orchidectomy.

PRESENTATION OF CASE: 49 year old gentleman presented with fever, persistent, unresolving pain and scrotal swelling of two weeks duration. Despite close clinical monitoring, timely ultrasounds of the testis and antibiotics there was an inexorable progression to bilateral testicular ischemia.

DISCUSSION: This is only the second reported case of this nature in published literature. Epididymo-orchitis usually responds well to appropriate antibiotic therapy, although progression to testicular infarction is possible.

CONCLUSION: Clinical presentation of persistent scrotal pain and oedema in cases of epididymo-orchitis should raise strong suspicion of testicular ischemia or infarction. Despite all efforts, progression to bilateral testicular infarction resulting in castration is a possible catastrophic outcome.

Matched MeSH terms: Genital Diseases, Male

Giant urinary bladder with left scrotal swelling: An unusual presentation of chronic urinary retention

Nur Bazlaah B, Nabiha F, Khairuzi S, Amerdad D, Mohd Firdaus H, Ismayudin I

Med J Malaysia, 2020 11;75(6):736-737.

PMID: 33219187

Chronic Urinary Retention (CUR) can be either asymptomatic or associated with lower urinary tract symptoms. There has been no report of case of CUR presented with unilateral scrotal swelling. In the present report, a 69-year-old man came with an abdominal distension and left scrotal swelling. He was initially diagnosed with ascites secondary to a possible malignancy. A diagnosis was established after a computed tomography (CT) scan was done that revealed a giant bladder distension with volume of 10.1 litres. The left scrotal swelling was resolved after catheterization was carried out. There was a possibility that the patient had inferior vena cava obstruction secondary to the huge bladder.

Matched MeSH terms: Genital Diseases, Male

Correlation of ultrasonography and surgical outcome in patients with testicular torsion

Burud IAS, Alsagoff SMI, Ganesin R, Selvam ST, Zakaria NAB, Tata MD

Pan Afr Med J, 2020;36:45.

PMID: 32774621 DOI: 10.11604/pamj.2020.36.45.21824

Introduction: Testicular torsion is a surgical emergency that is caused by twisting of the spermatic cord and its content. This condition causes irreversible changes after 6 hours. Early recognition and management of testicular torsion is important for testicular salvage and preservation of fertility.

Methods: This is a retrospective study done on all patients who presented with acute scrotal pain from January 2013 to December 2017. The data collected included the patient's age, symptoms, the time duration between the onset, ultrasound, and surgery, ultrasound findings with Doppler and the surgical intervention. Statistical analysis was performed using SPSS 25.0. Data are presented as mean (SD) values. Differences between groups and predictive values were calculated using Chi-square, t-test and Mann-Whitney U-test and are expressed by value with 95% CI.

Results: The total number of patients who presented with acute scrotal pain were 88. Testicular torsion was diagnosed in 55 (62.50%) of the patients, 17 (19.32%) had epididymis-orchitis, 5 (5.68%) had torsion of appendage/cyst, and 11 (12.50%) had normal testis. Ultrasound has a sensitivity and specificity of 88.24% and 68.40% respectively. It is a good tool to detect testicular torsion but it is operator dependent. Positive predictive value was 83.33% and negative predictive value was 76.47%. When ultrasound is combined with clinical findings the rate of negative exploration is reduced by 10%.

Conclusion: Good medical history, appropriate clinical evaluation and performing an ultrasound of the scrotum are important in testicular torsion. US evaluation in cases presented after 24 hours does not change the outcome.

Matched MeSH terms: Genital Diseases, Male

Fulltext Paratesticular aggressive angiomyxoma: A rare case

Ismail MI, Wong YP, Tan GH, Fam XI

Urol Ann, 2017 5 10;9(2):197-199.

PMID: 28479778 DOI: 10.4103/UA.UA_168_16

Aggressive angiomyxoma (AAM) particularly testicular origin is a rare benign mesenchymal myxoid tumor which is locally aggressive, blatant for local recurrence, and may metastasize. It occurs mostly in females of childbearing age and extremely rare in males. AMM particular testicular origin is not reported in literature yet. This is a 65-year-old man who had a right scrotal swelling. Ultrasound scrotum showed a soft tissue tumor of the right testis. The patient underwent radical right orchidectomy of which histopathologically confirmed to be a paratesticular AAM with clear resection margins. There were no signs of local recurrence or metastasis 2 years postsurgical resection.

Matched MeSH terms: Genital Diseases, Male

Fulltext A microbiological study of genital ulcers in Kuala Lumpur

Zainah S, Cheong YM, Sinniah M, Gan AT, Akbal K

Med J Malaysia, 1991 Sep;46(3):274-82.

PMID: 1839925

The microbial aetiology of genital ulcers was studied in 249 patients (241 men and 8 women) attending a Sexually Transmitted Disease Clinic in Kuala Lumpur, Malaysia. Herpes simplex virus type 2 was isolated in 48 (19.2%) patients, Haemophilus ducreyi from 22 (8.8%), Neisseria gonorrhoeae from seven (2.8%) and Chlamydia trachomatis from four (1.6%). Syphilis was diagnosed in 18 (7.2%) patients on the basis of dark field microscopy. Two (0.8%) patients were found to have both chancroid and syphilis and one (0.5%) had both gonorrhoea and syphilis. No organism was isolated in the remaining 151 (61.5%) patients. Overall, the accuracy of clinical diagnosis was 58% for single infection, 67% for herpes, 63% for syphilis, 47% for chancroid and 0% for lymphogranuloma venereum. Therefore, our study confirms the need for laboratory tests to diagnose accurately the aetiology of genital ulcer disease.

Matched MeSH terms: Genital Diseases, Male/microbiology*

Clinical epidemiology of filariasis due to Brugia malayi on a rubber estate in West Malaysia

Dondero TJ, Menon VV

Southeast Asian J Trop Med Public Health, 1972 Sep;3(3):355-65.

PMID: 4652465

Matched MeSH terms: Genital Diseases, Male/epidemiology

New Zealand Malayan war veterans' exposure to dibutylphthalate is associated with an increased incidence of cryptorchidism, hypospadias and breast cancer in their children

Carran M, Shaw IC

N Z Med J, 2012;125(1358):52-63.

PMID: 22864157

It is well known that the endocrine-disrupting chemical (EDC) dibutylphthalate (DBP) inhibits testosterone synthesis and can lead to feminisation in male laboratory animals. Moreover, it has long been speculated that human exposure would result in the similar effects, but this is difficult to study because specific human exposure cohorts are rare. We report increases in the incidences of hypospadias (p<0.05), cryptorchidism (p<0.05) and breast cancer (p<0.05) in the children of New Zealand soldiers who served in Malaya (1948-1960) and were exposed to DBP applied daily to their clothing as an acaricide to prevent tick-transmitted bush typhus. In addition, we modelled absorption of DBP from the soldiers' clothing and using published data for skin absorption, and calculated a large theoretical absorbed dose of 64 mg/kg body weight/day which is similar to DBP's lowest observed adverse effect level (LOAEL) of 50 mg/kg body weight/day and thus indicates a biological effect is possible. This is the first report of a multigenerational developmental effect following DBP exposure in human males.

Matched MeSH terms: Genital Diseases, Male/etiology; Genital Diseases, Male/epidemiology

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