Acute Epididymitis Research Articles

A young patient with chronic epididymal-orchitis develops testicular ischemia: a serious complication of a common disorder

BACKGROUND AND AIM: Rare complications of acute epididymitis include ischemia and infarction of the testicles. Both clinically and radiologically, it is challenging to distinguish from testicular torsion. The project aims to increase the radiologist's digital picture library to facilitate a prompt and accurate differential diagnosis. This instance emphasizeshow crucial it is to perform a comprehensive radiological assessment and how a multidisciplinary approach is necessary to guarantee an accurate diagnosis. METHODS: A 24-year-old man experienced severe left testicular pain; he didnt come to the Emergency Department while the clinical situation was acute; but two weeks after he came to the Hospital, arrived at the Radiology Department, and reported that he had painful ejaculation, pain during intercourse (dyspareunia), redness/swelling at the scrotal level, genital inflammation, chills, swollen inguinal lymph nodes, dysuria and still today he has a few pains at scrotal region. All diagnostic procedures are done: first US and after MRI was required by the urologist. RESULTS: The results of the imaging show that he had left testicular ischemia, and a chronic orchid-epididymitis was suspected cause the clinic was positive. So, the young patient didnt have a leftorchidectomy but only medical therapy, cause the ischemia area was not too large. The patient has also a left varicocele. CONCLUSIONS: The images acquired with the different MRI sequences were carefully examined. Is important to consider that a rare instance of epididymal-orchitis, has been described as a potentially dangerouscomplication of epididymitis and needs to be considered if sudden, severe scrotal pain is experienced. This information can help with optimal patient management and help avoid needless interventions.

Diagnostic efficacy and value of ultrasound in children's scrotal testicular torsion: A retrospective analysis.

The purpose of this study is to explore the diagnostic efficacy and value of ultrasound detection for testicular torsion in children with scrotal and testicular diseases. A total of 120 children with acute scrotal swelling and pain who were treated in our hospital from August 2017 to August 2022 were selected for preliminary diagnosis through color Doppler ultrasound diagnostic instrument examination. The final diagnosis was made through surgical or conservative treatment. At the same time, 40 children with acute epididymitis during the same period were selected as the control group, and the clinical treatment of patients with testicular diseases was retrospectively analyzed. A total of 120 children were diagnosed with testicular torsion disease, with 57 cases affecting the left testicle and 63 cases affecting the right testicle. Ultrasound examinations revealed no blood flow signal in 78 cases, a significant reduction in blood flow in 38 cases, and no change in 4 cases. Among the pediatric patients who underwent manual reduction, 79 cases had a favorable prognosis. Surgical reduction was performed in 41 cases, with 35 cases successfully treated and 6 cases resulting in testicular removal. Follow-up examinations conducted 6 months to 1 year postoperatively showed testicular atrophy in 4 out of 35 cases with preserved testicles, while the 6 cases that underwent testicular resection had good outcomes. The non-active subgroup had a longer disease course and a greater degree of torsion (P < .05). There was no statistically significant difference in testicular volume and the ratio of healthy testicular volume between the 2 groups (P > .05). The sensitivity of ultrasound diagnosis was 95.24% (73/77), specificity was 78.57% (34/43), and accuracy was 89.29% (107/120). Ultrasound can effectively diagnose testicular torsion and evaluate the success rate of testicular reduction. Early treatment of patients with testicular torsion leads to better efficacy and higher survival rates.

A Histopathological Study on the Changes in the Central Nervous System of Dead Cats With Neurological Symptoms

Background: Neurological conditions constitute approximately 10% of feline cases referred to veterinary clinics. Such cases often present manifestations of central nervous system (CNS) damage, including inflammatory lesions, neoplastic growth and structural and cellular transformations. Objectives: This study aimed at identifying histopathological changes in the CNS of cats that had succumbed to neurological symptoms. Methods: Microscopic evaluation of different sections within the CNS was conducted on 20 cats that had either died naturally or were euthanized due to neurological signs. After performing a necropsy, we examined the CNS tissues and conducted PCR testing to screen for possible viral infections, including feline infectious peritonitis (FIP), feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV). Results: The majority of cases showed characteristic histopathologic lesions, notably mononuclear and suppurative meningoencephalitis, perivascular cuffing, disseminated intravascular coagulation (DIC), granulomatous meningoencephalitis, acute neuronal necrosis, liquefactive necrosis, epididymitis, thrombosis and demyelination. Among the 20 cats studied, 12 tested positive for FIP by PCR analysis, while 5 cats exhibited positive results for FIV. Also, FeLV PCR tests displayed positive results in 4 cats. No evidence of feline spongiform encephalopathy (FSE) was observed. Conclusion: This study is the first of its kind conducted in Iran. Based on the results, the most prevalent viral agents infecting cats’ CNS were FIP, FIV and FeLV. The investigation revealed no evidence of FSE in cats with neurological signs.

It is not the best option to perform transurethral enucleation of the prostate immediately after biopsy in patients with histological inflammation.

This study seeks to investigate the impact of histopathological evidence of histological prostatic inflammation (PI) on the surgical outcomes of patients with benign prostatic hyperplasia (BPH) undergoing transurethral bipolar enucleation of the prostate (BiLEP) after biopsy. We conducted a prospective study in which data were collected from 112 patients with BPH who underwent BiLEP immediately after prostate biopsy at the Department of Urology in our hospital between October 2020 and October 2023. This cohort included 52 patients with histopathological prostatic inflammation (BPH + PI group) and 60 patients with simple BPH (BPH group). Baseline characteristics, surgical details, International Prostate Symptom Score (IPSS), quality of life (QoL), post-void residual volume (PVR), maximum flow rate (Qmax), International Index of Erectile Function-5 (IIEF-5), postoperative pathology results, and surgical complications were compared between the two groups. The study findings indicate that in patients with BPH who underwent BiLEP, various parameters in the BPH + PI group including operation time, intraoperative flushing volume, hemoglobin drop value, postoperative white blood cells, postoperative C-reactive protein, and average pain score at 3 days postoperatively were significantly higher compared to those in the BPH group (p < 0.01). In addition, the IPSS and IIEF-5 scores of the BPH + PI group were significantly worse before surgery and at 2 weeks postoperatively compared to the BPH group (p < 0.01); however, no significant differences were observed between the two groups at 1 and 3 months postoperatively (p > 0.05). At 2 weeks postoperatively, the BPH + PI group exhibited significantly worse outcomes in terms of QoL, PVR, and Qmax compared to the BPH group (p < 0.01). However, there were no statistically significant differences between the two groups at 1 and 3 months postoperatively (p > 0.05). The incidence rates of postoperative complications, such as fever, prostatic capsule perforation, urinary tract irritation, bladder spasm, acute epididymitis, urinary tract infection, and urethral stricture, were higher in the BPH + PI group compared to the BPH group (p < 0.05). Nevertheless, there was no significant difference in the overall complication rates between the two groups (p > 0.05). There were no statistically significant differences observed between the two groups in postoperative irrigation volume, extubation time, hospitalization time, proportion of secondary operations, proportion of bladder injury, and proportion of urinary incontinence (p > 0.05). However, the proportion of reported prostate cancer after surgery in the BPH + PI group was significantly higher than that in the BPH group (p < 0.05). Histopathological prostatic inflammation does not have a significant impact on the long-term efficacy of BiLEP surgery immediately after biopsy. However, it does prolong surgery time, increase surgery-related complications, and influence short-term surgical outcomes and patient treatment experience. Therefore, it may be advisable to administer a course of anti-inflammatory treatment before performing BiLEP in such patients. Nevertheless, further high-quality studies are necessary to validate this approach.

Symptomatic Intraparenchymal Epididymal Cysts: Description of 11 cases.

Epididymal cysts are benign cystic formations of the epididymis that usually appear in adolescence or early adulthood. Their frequency doubles after the age of 14-15. Obstruction in the epididymal efferent ductules with subsequent prostenotic dilatation of them, as well as dysgenesis due to hormonal disorders during fetal or postnatal life, are possible. At the 1st Department of Pediatric Surgery of A.U.Th. we treated 11 cases of boys at the age of 11-16 who presented with acute scrotum because of an epididymal cyst. The diagnosis was confirmed by ultrasound scanning . Due to persistent symptomatology, patients underwent surgical exploration and removal of the cyst. The postoperative care of the patients was uncomplicated with immediate remission of symptoms. In one case, ipsilateral acute epididymitis occurred after 10 days, which was successfully treated with antibiotic therapy. It is reported that approximately 50% of epididymal cysts involute within an average of 17 months. In conclusion, using the data obtained from the review, of the small in number of international bibliography studies, it is proposed conservative treatment of asymptomatic cysts with diameter smaller than 1 cm and surgical excision [1] of large asymptomatic cysts with diameter greater than 1 cm, which do not regress after a follow-up of 24-48 months, cysts, regardless of their diameter, responsible for persistent symptoms and in the manifestation of acute scrotal symptoms due to inflammation, intravesical bleeding or secondarily torsion of the epididymis.

Regional modulation of toll-like receptor signaling pathway genes in acute epididymitis in mice.

Region-specific immune environments in the epididymis influence the immune responses to uropathogenic Escherichia coli (UPEC) infection, a relevant cause of epididymitis in men. Toll-like receptors (TLRs) are essential to orchestrate immune responses against bacterial infections. The epididymis displays region-specific inflammatory responses to bacterial-derived TLR agonists, such as lipopolysaccharide (LPS; TLR4 agonist) and lipoteichoic acid (LTA; TLR2/TLR6 agonist), suggesting that TLR-associated signaling pathways could influence the magnitude of inflammatory responses in epididymitis. To investigate the expression and regulation of key genes associated with TLR4 and TLR2/TLR6 signaling pathways during epididymitis induced by UPEC, LPS, and LTA in mice. Epididymitis was induced in mice using UPEC, ultrapure LPS, or LTA, injected into the interstitial space of the initial segment or the lumen of the vas deferens close to the cauda epididymidis. Samples were harvested after 1, 5, and 10 days for UPEC-treated animals and 6 and 24h for LPS-/LTA-treated animals. Ex vivo epididymitis was induced by incubating epididymal regions from naive mice with LPS or LTA. RT-qPCR and Western blot assays were conducted. UPEC infection up-regulated Tlr2, Tlr4, and Tlr6 transcripts and their associated signaling molecules Cd14, Ticam1, and Traf6 in the cauda epididymidis but not in the initial segment. In these epididymal regions, LPS and LTA differentially modulated Tlr2, Tlr4, Tlr6, Cd14, Myd88, Ticam1, Traf3, and Traf6 expression levels. NFKB and AP1 activation was required for LPS- and LTA-induced up-regulation of TLR-associated signaling transcripts in the cauda epididymidis and initial segment, respectively. The dynamic modulation of TLR4 and TLR2/TLR6 signaling pathways gene expression during epididymitis indicates bacterial-derived antigens elicit an increased tissue sensitivity to combat microbial infection in a spatial manner in the epididymis. Differential activation of TLR-associated signaling pathways may contribute to fine-tuning inflammatory responses along the epididymis.

No-scalpel vasectomy — a new approach to male surgical contraception: a single center experience

BACKGROUND: No-scalpel vasectomy is a modern approach to performing vasectomy, in which access to the vas deferens is achieved through a puncture of the scrotum.&#x0D; AIM: To analyze of own experience in the use of no-scalpel vasectomy.&#x0D; MATERIALS AND METHODS: During the period from April 2017 to December 2022, 32 men underwent non-scalpel vasectomy at the Mother and Child Clinic Yaroslavl. Three operations were performed under intravenous anesthesia, 29 under local anesthesia. Occlusion of the vas deferens was achieved by excision of the fragment, coagulation of the lumen, ligation of the ends of the duct and fascial interposition.&#x0D; RESULTS: The average age of the patients was 39 years (range 35 to 62 years). All patients were married. The mean number of children in patients undergoing vasectomy was 2.3 0.4. In all cases, the reason for performing a vasectomy was cited by patients as dissatisfaction with other methods of contraception. The average operation time was 19.0 4.0 minutes. The average size of the scrotal skin puncture was 9.3 1.3 mm (range 7 to 11 mm). The severity of pain during surgery, as assessed on a visual analogue scale (VAS), varied from 1 to 3 points, with an average of 2.3 0.5 points. In the postoperative period, one patient developed acute epididymitis (3.1%), and one patient (3.1%) developed a small hematoma (up to 1 cm) in the area of the surgical wound. A week after surgery, 15 patients (46.8%) reported the presence of pain with a visual analogue scale score of 1 to 3 points, with an average of 2.2 0.7 points. One month after the operation, no pain was noted in any patient. The results of the study of the ejaculate 3 months after the operation showed the presence of azoospermia in 27 (84.4%) patients and the presence of single immobile spermatozoa (less than 100,000/ml) in 5 (15.6%) patients, which allowed us to state 100% occlusive effectiveness of vasectomy.&#x0D; CONCLUSIONS: No-scalpel vasectomy is a less traumatic and safe method of male surgical contraception. The operation under local anesthesia is associated with minimal discomfort for the patient. Maximum success rates can be achieved using the technique of vas deferens occlusion through excision of the fragment, coagulation of the lumen, ligation of the ends of the duct, and fascial interposition.

Acute cytomegalovirus proctitis and epididymitis acquired via sexual transmission in an immunocompetent patient: a case report

BackgroundWe present a case report of an immunocompetent host with presumed sexually transmitted cytomegalovirus proctitis and epididymitis, where there currently is a sparsity of published data.Case presentationA 21-year-old previously healthy Caucasian individual was admitted for severe rectal and testicular pain in the setting of proctitis and epididymitis. Serology and rectal pathology confirmed acute primary cytomegalovirus infection.ConclusionsThis report details his diagnostic workup and highlights cytomegalovirus as a rare cause of sexually transmitted disease among immunocompetent persons.

Sero-Prevalence, Epidemiology, and Public Health Significance of Small Ruminant Brucellosis

Brucellosis is a widespread zoonosis mainly transmitted from cattle, sheep, goats, pigs, and camels through direct contact with blood, placenta fetuses, or uterine secretion or through consumption of the contaminated raw animal product (especially unpasteurized milk and soft cheeses) in endemic areas. Therefore, the objective of this paper are to explain the Current Epidemiological Aspects of Brucellosis and the Importance of Small ruminant Brucellosis for Public Health and briefly illustrate the Economic Importance of Small ruminant Brucellosis. Sources of infection include aborted fetuses, fetal membranes, vaginal discharges and milk from infected sheep and goat. Brucellosis is caused by facultative, intracellular and Gram- negative bacteria called Brucella. Small ruminant brucellosis is caused by B. ovis (for sheep) and B. melitensis (mainly for goats), the latter one is the most virulent species of the Brucella genus. The disease in naturally infected sheep and goats is characterized by abortion in the last trimester of pregnancy, stillbirth and birth of weak offspring in females, and acute orchitis and epididymitis in males. Brucellosis occurs worldwide in domestic animals such as cattle, sheep, goats, camels and pigs and creates a high economic problem for both the intensive and extensive livestock production system in the tropics and a threat to public health. Diagnostic tests fall into two categories: those that demonstrate the presence of the organisms and those that detect an immune response to its antigens. As a general rule, treatment of infected livestock is not attempted because of the high treatment failure rate, cost, and potential problems related to maintaining infected animals in the face of ongoing eradication programs. To control the disease in human, prevention of the disease in reservoir host is important, so test and slaughter followed by proper disposal of seropositive animals to decrease the incidence of infection and effective vaccination and hygienic practices would reduce the disease spreading in/from endemic regions and to lessen the economic and zoonotic effects of brucellosis, the government, public health officials, and veterinarians must collaborate.

Comprehensive evaluation of hematospermia in patients with acute epididymitis compared to patients with isolated hematospermia.

Among the most commonly known causes of hematospermia are infections in the genitourinary tract, but no study exists that has comprehensively investigated hematospermia in patients with acute epididymitis. To assess the impact of hematospermia in patients with acute epididymitis and its association with clinical, microbiological, and semen parameters. Since May 2007, a total of 324 sexually active patients with acute epididymitis were recruited in a prospective cohort study. Patients received a comprehensive medical and sexual history, and clinical, sonographic, laboratory, and microbiological diagnostics. Antibiotic therapy was given according to European Association of Urology guidelines. Semen analysis was offered 14 days after the first presentation and initiation of therapy. Since 2013, a separate control group of 56 patients presenting with isolated hematospermia (=no other urogenital symptoms) was prospectively recruited, and differences between the groups were statistically evaluated. Of 324 patients with acute epididymitis, 50 patients (15%) had self-reported hematospermia. This occurred with a median of 24h before the onset of scrotal symptoms and was associated with significantly elevated prostate-specific antigen levels compared to 274 patients without hematospermia (3.1vs. 1.8ng/ml, p<0.01). The two most common etiological pathogens were Escherichia coli and Chlamydia trachomatis, and the bacterial spectrum was comparable in both epididymitis subgroups (p=0.859). Semen analysis at 14 days still showed hematospermia in 24% of patients associated with massive leukocytospermia. Compared to the hematospermia control group, the two epididymitis subgroups showed significantly increased inflammation markers (pH, leukocytes, and elastase), reduced sperm concentration, and reduced levels of alpha-glucosidase and zinc (always p<0.01). In sexually active patients who develop acute epididymitis, self-reported hematospermia is evident in 15% of patients as early as one day before the onset of scrotal symptoms. Conversely, none of the 56 patients presenting with isolated hematospermia developed epididymitis within the next 4 weeks.

Acute orchitis deciphered: Coxsackievirus B strains are the main etiology and their presence in semen is associated with acute inflammation and risk of persistent oligozoospermia.

Although various viruses are considered to be the clinical cause for acute orchitis, it is completely unclear to what extent and which viruses are etiologically involved in acute orchitis and what the clinic and course of these patients are like. Therefore, a prospective study was set up to decipher acute isolated orchitis. Between July 2007 and February 2023, a total of 26 patients with isolated orchitis were recruited and compared with 530 patients with acute epididymitis. We were able to show for isolated orchitis, that (1) orchitis is usually of viral origin (20/26, 77%) and enteroviruses with coxsackievirus B strains (16/26, 62%) are predominant, (2) virus isolates could be received from semen indicating the presence of replication-competent virus particles, (3) a polymerase chain reaction (PCR) for enteroviruses should be conducted using semen provided at the onset of disease, because the virus is not detectable in serum/urine, (4) there is a circannual occurrence with the maximum in summer, (5) orchitis is associated with a characteristic inflammatory cytokine panel in the semen and systemic inflammation, (6) orchitis is usually rapidly self-limiting, and (7) about 30% of patients (6/20) suffer ongoing oligozoospermia. These seven emerging aspects are likely to fundamentally change thinking and clinical practice regarding acute isolated orchitis.

Testicular ischemia secondary to acute epididymitis: A case report.

Rare side effects of acute epididymitis include testicular infarction and ischemia. Distinguishing them from testicular torsion is challenging, both clinically and radiologically. However, only a few such cases have been reported to date. A 12-year-old child presented with persistent right testicular pain for 3 days. It developed after trauma and was accompanied by gradual swelling and enlargement of the right scrotum, with nausea and vomiting. Scrotal color Doppler ultrasonography demonstrated right epididymitis, right scrotal wall swelling, and right testicular torsion. Routine blood tests revealed leukocyte and neutrophil counts were both above normal. Scrotal exploration revealed edema and adhesions in all layers of the scrotal wall. The right testicle was pale. The patient was diagnosed with testicular ischemia secondary to acute epididymitis. The patient underwent simultaneous lower spermatic cord sheath dissection and decompression, testicular sheath reversal, and right testicular fixation. Blood flow to the testicles gradually recovered after decompression, as did the color. Postoperatively, the patient's scrotal swelling and pain improved significantly. Despite the rarity of this condition, it is a potentially serious consequence of epididymitis and should be considered when patients experience sudden scrotal pain.

Coronavirus Disease Patients with Acute Testicular Infection: Ultrasound Imaging Findings

Introduction: Objectives: Coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic, raising widespread public health concerns. Our team treated hospitalized patients with COVID-19 in SAIMS Indore, where the outbreak first began, and we suspected that SARS-CoV-2 may cause testicular infection in male patients. We conducted this study to explore that observation. Methods: We enrolled male patients with a confirmed diagnosis of COVID-19 and performed a bedside ultrasound (US) examination of the scrotum, focused on findings of acute inflammation such as tunica albuginea thickening, enlargement and heterogeneous echogenicity of the testis, epididymis, or both, an abscess, scrotal wall edema, and hydrocele. Then we compared the proportions of observed epididymo-orchitis in patients from different age groups and COVID-19 severity groups. Results: A total of 150 patients with COVID-19 were enrolled in our study, and 32 (22.5%) patients had acute orchitis, epididymitis, or epididymo-orchitis on scrotal US imaging, according to the diagnosis criteria. The observed risk of acute scrotal infection increased with age, with the incidence reaching 53.3% in men older than 80 years. We also observed that men with severe COVID-19 had a significantly higher possibility of epididymo-orchitis compared to the non- severe COVID-19 group (P = .037). Conclusions: This study shows US imaging evidence that SARS-CoV-2 may cause infection of the testis or epididymis, and the risk is worthy of the attention of clinicians.

Percutaneous Nephrolithotomy Combined with B-Mode Ultrasound-Guided Renal Access in the Lateral Decubitus Flank Position for Complex Renal Calculi.

Percutaneous nephrolithotomy (PCNL) has been widely used in the clinical practice of urinary calculi. The prone positioning for PCNL is generally adopted, while it is associated with a certain risk when repositioning the patient into the prone position after anesthesia. This approach is more difficult for obese or elderly patients with respiratory diseases. The application of PCNL combined with B-mode ultrasound-guided renal access in the lateral decubitus flank position for complex renal calculi has been poorly investigated. This study aimed to evaluate the efficacy and safety of PCNL combined with B-mode ultrasound-guided renal access in the lateral decubitus flank position for complex renal calculi. From June 2012 to August 2020, 660 patients with renal stones (>20 mm) were enrolled. All patients were diagnosed by ultrasonography, kidney-ureter-bladder (KUB) plain X-ray imaging, intravenous urography (IVU), or computed tomographic urography (CTU). All the enrolled subjects underwent PCNL combined with B-mode ultrasound-guided renal access in the lateral decubitus flank position. Successful access was achieved in 660 patients (100%). Micro-channel PCNL and PCNL were performed on 503 and 157 patients, respectively. The stone-free rate was 85.30% (563/660). A dual-channel access was required for phase I PCNL in 92 cases, and reconstruction of channel was required for 33 cases for phase II PCNL. The stone-free rate of phase I PCNL was 85.30% (563/660). Totally, 45 patients had stones that were cleared during phase II PCNL, while 5 patients became stone-free after phase III PCNL. Besides, 12 cases became stone-free after undergoing PCNL combined with extracorporeal shock wave lithotripsy. The mean operation time was 66 (range, 38 to 155) min, and the mean length of hospital stay was 16 (range, 8 to 33) days. One case developed heavy bleeding 6 days after the removal of kidney fistula, and one case developed acute left epididymitis during urethral catheter retention. No visceral injuries and other complications occurred. PCNL combined with B-mode ultrasound-guided renal access in the lateral decubitus flank position is safe and convenient, preventing the surgical team and patients from exposure to harmful radiations.

The regional distribution of resident immune cells shapes distinct immunological environments along the murine epididymis.

The epididymis functions as transition zone for post-testicular sperm maturation and storage and faces contrasting immunological challenges, i.e. tolerance towards spermatozoa vs. reactivity against pathogens. Thus, normal organ function and integrity relies heavily on a tightly controlled immune balance. Previous studies described inflammation-associated tissue damage solely in the distal regions (corpus, cauda), but not in the proximal regions (initial segment, caput). To understand the observed region-specific immunity along the epididymal duct, we have used an acute bacterial epididymitis mouse model and analyzed the disease progression. Whole transcriptome analysis using RNAseq 10 days post infection showed a pro-inflammatory environment within the cauda, while the caput exhibited only minor transcriptional changes. High-dimensional flow cytometry analyses revealed drastic changes in the immune cell composition upon infection with uropathogenic Escherichia coli. A massive influx of neutrophils and monocytes was observed exclusively in distal regions and was associated with bacterial appearance and tissue alterations. In order to clarify the reasons for the region-specific differences in the intensity of immune responses, we investigated the heterogeneity of resident immune cell populations under physiological conditions by scRNASeq analysis of extravascular CD45+ cells. Twelve distinct immune cell subsets were identified, displaying substantial differences in distribution along the epididymis as further assessed by flow cytometry and immunofluorescence staining. Macrophages constituted the majority of resident immune cells and were further separated in distinct subgroups based on their transcriptional profile, tissue location and monocyte-dependence. Crucially, the proximal and distal regions showed striking differences in their immunological landscapes. These findings indicate that resident immune cells are strategically positioned along the epididymal duct, potentially providing different immunological environments required for addressing the contrasting immunological challenges and thus, preserving tissue integrity and organ function.

Sonographic findings of COVID-19 related acute scrotal infection and associations with clinical-laboratory data.

BackgroundDuring the Coronavirus Disease 2019 (COVID‐19) pandemic, patients present to hospitals with a wide range of symptoms. Some of these symptoms include acute orchitis and epididymitis. The goal of this research is to see if COVID‐19 infection and scrotal infection are associated.Materials and methodsPatients with a COVID‐19 (+) who agreed to a scrotal ultrasound (US) examination were studied prospectively in a tertiary care center between October 2021 and February 2022. The severity of the disease was used to divide patients into groups. Patients diagnosed with acute scrotal infection based on scrotal ultrasonography findings were compared in these groups, as were their age, comorbidities, and laboratory data.ResultsThe median age of the 213 participants was 61.7 ± 8.3. During the ultrasonographic examination of the patients, 15 (7%), 8 (3.7%), 17 (7.9%), and 40 (18.7%) were diagnosed with acute orchitis, acute epididymitis, acute epididymo‐orchitis, and scrotal infection, respectively. Acute scrotal infection was far more common in patients with a higher clinical severity of the disease. The patients' comorbidities were also assessed, and it was discovered that they were statistically more common in the same group.ConclusionsEven if there are no clinical symptoms, ultrasonography can help detect acute scrotal infection in COVID‐19 patients. Furthermore, in groups with higher clinical severity, this association is more likely to be seen. It is critical to understand this in order to avoid complications.

Community Associated Methicillin-Resistant Staphylococcus Aureus Causing Acute Urinary Tract Infection and Epididymo-Orchitis: A Case Report

Acute epididymitis is most commonly infectious in etiology, usually secondary to a urinary tract infection (UTI) or a sexually transmitted infections (like gonorrhea and chlamydia). Enteric gram-negative bacteria (like Escherichia coli) and coagulase-negative Staphylococcus saprophyticus are the most frequently encountered organisms associated with UTIs. Staphylococcus aureus, especially methicillin-resistant Staphylococcus aureus (MRSA), is an uncommon pathogen when considering community associated acute UTI and acute epididymitis. We present an unusual case of a 28-years-old immunocompetent male, who presented with a left scrotal swelling and was found to have acute epididymo-orchitis due to an acute MRSA UTI.

AB162. SOH22ABS173. Case report: unexpected unilateral testicular rupture

Background: Acute scrotal pain is a urological emergency. While clinical recommendations regarding testicular torsion and acute epididymitis are well known, little is known about the causes of the low incidence of acute scrotal pain. Our aim is to identify and characterize the rare differential diagnosis of acute scrotal pain in order to provide diagnostic and therapeutic recommendations. Testicular trauma can be categorized as blunt, penetrating. While every case of penetrating trauma is subject to surgical treatment, a decision must be made between surgery and conservative treatment for each blunt injury case. Here we present a case report.

HF02-14 HERMAN KRETSCHMER: FROM GENITOURINARY PATHOLOGY TO PRESIDENCY

You have accessJournal of UrologyCME1 May 2022HF02-14 HERMAN KRETSCHMER: FROM GENITOURINARY PATHOLOGY TO PRESIDENCY Alice Cheung Alice CheungAlice Cheung More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002540.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Herman Kretschmer (1879-1951) was a urologist who made significant contributions to genitourinary pathology and academic urology. METHODS: A thorough literature review was performed. RESULTS: Herman Kretschmer was born in Chicago, where he grew up and later graduated from the Northwestern University School of Pharmacy in 1900. He continued his studies at Northwestern University Medical School where he graduated magna cum laude in 1904. After graduation, he completed an internship at Alexian Brothers Hospital before traveling abroad to Vienna to study under Otto Zuckerkandl from 1906 to 1907. Kretschmer studied “essential hematuria” while in Vienna, and his work was eventually published in the first volume of the Zeitschrift for Urologie. Kretschmer made many contributions to pathology in the genitourinary tract and firmly believed that every urologist should be a close student of pathology. He had over 285 scientific publications under his name, many with a focus on genitourinary pathology. His publications included work on bladder leiomyoma, prostate cancer and diethylstilbestrol, acute and chronic epididymitis, and prostatic sarcoma. A strong dedication to academic medicine led Kretschmer to serve in a wide variety of academic societies, including holding the titles of Chairman of the Section of Urology of the American Medical Association, President of the American Board of Urology, and President of the American Urological Association. He earned himself several awards and honors throughout his career, while also finding time to give back to his community. The preservation of the Pasteur monument in Convalescent Park in Chicago was due in part to Kretschmer’s philanthropic efforts. He passed away in his Chicago home on September 23, 1951 and was commemorated fondly in an obituary published in JAMA. CONCLUSIONS: Herman Kretschmer devoted his life to the study of genitourinary pathology and was the exemplification of an interdisciplinary academic physician. His involvement and participation in academic urology helped shape the urologic societies present today. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e210 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alice Cheung More articles by this author Expand All Advertisement PDF DownloadLoading ...

Urinary diversion for acute epididymitis : Transurethral or suprapubic catheter?

Acute infective epididymitis is the most common cause for scrotal pain in adults. The severe course of the disease requires immediate antimicrobial management, comprised antibiotic treatment and supportive measures. Patients with chronic indwelling catheters and developing epididymitis show amore severe clinical course compared to patients without a catheter. Although it is common clinical practice to place acatheter for the treatment of asystemic infectious condition of the genitourinary tract, there is only limited evidence of support due to the absence of clinical trials.