Diagnostic ultrasound was a simple, rapid, harmless, and painless method to visualize ultrascrotal contents, it provided information that was difficult to obtain on clinical examination. We recently tested the effectiveness of diagnostic ultrasound in 41 men with scrotal masses. In general, ultrasound was highly effective in differentiating and characterizing testicular and extratesticular masses. The following results were obtained. 1. The ultrasonic examination revealed 37 extratesticular lesions, 3 testicular lesions and 1 indeterminate lesion. Of the extratesticular lesions 22 were believed to be cystic but represented 18 hydroceles and 4 spermatoceles. 15 lesions were thought to be solid that represented epididymitis. 2. The accuracy rate the scrotal ultrasound, given a complete clinical history, was 97% in this series. 3. The tumor showed decreased echogenicity within the testicle, which was enlarged. The characteristic appearance of hydrocele, spermatocele were sonolucent cystic mass. The epididymis was enlarged in 11 patients with epididymitis, the echogenicity within testicle was decreased in 5 patients with epididymitis.
Epididymis ; Epididymitis ; Humans ; Male ; Spermatocele ; Testis ; Ultrasonics ; Ultrasonography

PURPOSE: This study was made to evaluate the clinical characteristics of testicular microlithiasis which shows small diffuse hyperechoic nonshadowing foci throughout both testes on sonography. MATERIALS AND METHODS: Between July 1995 and May 1997, we had seen 15 Patients with dilateral diffuse microlithiasis of the testes on the sonography. Medical records were reviewed with respect to age at presentation, associated diseases, and sonographic and pathologic characteristics. RESULTS: The age of the patients ranged from 8 to 69 years. The testicular microlithiasis was coincidental to the presence of erectile dysfunction(n=5), epididymitis(n=5), varicocele(n=4), epididymal cyst(n=2), infertility(n=1), testicular teratoma(n=1) and diabetes mellitus(n=1). There were considerable variations in the numbers of echogenic foci on each sonography that examined the entire half of the scrotum(from 15 to more than 60 foci). The histological examinations were done in two patients and sbowed the lumina of seminiferous tubules filled with concentrically lamellated calcified concretions. CONCLUSIONS: The testicular microlithiasis showed a wide range of age at presentation and associated with diabetes mellitus and a variety of urological problems including erectile dysfunction, epididymitis, varicoce18, epididymal cyst, infertility and testicular teratoma. The clinical relevance remains unclear at this time. Further additional cases as well as a long-term follow-up would be necessary to assess the association between testicular microlithiasis and these coincidental conditions.
Diabetes Mellitus ; Epididymitis ; Erectile Dysfunction ; Humans ; Infertility ; Male ; Medical Records ; Seminiferous Tubules ; Spermatocele ; Teratoma ; Testis ; Ultrasonography

The sperm count in semen analysis after vasovasostomy is significantly higher in men with vasal fluid in the proximal vas during the operation than in those without fluid on one or both sides(P<0.05). On 8(38.1%) of 21 sides in 12 men without vasal efflux during vasovasostomy secondary epididymal obstructions were found on scrotal exploration. Bilateral ductal obstructions were found in 3 of 9 men without vasal efflux on both sides. The cause of obstruction included spermatocele, chronic epididymal inflammation. In epididymal histology the cause of obstruction was the interstitial sperm granulomas resulting from the rupture of the epididymal duct and chronic epididymitis. We concluded that epididymal exploration is necessary in case with no sperm from testicular end of the vas on both sides.
Epididymitis ; Granuloma ; Humans ; Inflammation ; Male ; Rupture ; Semen Analysis ; Sperm Count ; Spermatocele ; Spermatozoa ; Vasovasostomy*

Out of 334 patients with obstructive azoospermia between Sep. 1983 and Aug. 1991. scrotal exploration for attempted epididymo-vasostomy showed vas agenesis in 60 of them(17.9%). The anatomical findings were classified into various groups of frequency. In the study of associated structural anomaly of seminal vesicle with transrectal ultrasonography, high incidence of anomalies was detected(8 out of 10). In bilateral vas agenesis, artificial insemination donor and artificial spermatocele were recommended for most of the patients and recently sperm aspiration from the epididymis was tried to unilateral agenesis, epididymo-vasostomies were carried out to ipsilateral (11) and contralateral(3) side. It is desirable to apply various operations with positive attitude. Further study including transrectal ultrasonography is expected to elucidate combined seminal vesicle anomalies.
Azoospermia ; Epididymis ; Humans ; Incidence ; Insemination, Artificial ; Male ; Seminal Vesicles ; Sperm Retrieval ; Spermatocele ; Tissue Donors ; Ultrasonography

The "bridge" alloplastic spermatocele, which connected the tails of the both epididymis and collected sperms from both testes, were constructed in 30 male Wistar rats, using Goretex cylinder. The artificial cylinder were aspirated postoperatively every week for 8 weeks, and the animals were then sacrificed and the epididymis connected with spermatoceles were examined histologically. The valid experimental results were not obtained because of the inflammation. However, the surgical procedure was relatively easy and a greater quantity of aspirate was obtained with easy execution of the single puncture. The number of sperms was markedly decreased from the 3rd weeks, and no sperms were survived at the first week in all the experimental rats. Therefore, it is recommended that the basic aspect of the spermatocele should be worked out experimentally before applying it to human patients.
Animals ; Epididymis ; Humans ; Inflammation ; Male ; Polytetrafluoroethylene ; Punctures ; Rats ; Rats, Wistar ; Spermatocele* ; Spermatozoa ; Testis

This article presents changes in the testis and epididymis after a vasectomy as well as illustrate the various vasectomy-related abnormalities on sonographic examination. In patients with scrotal pain after a recent vasectomy, the sonographic findings include enlargement of the epididymis with an ill-defined border and hematoma, or a hematocele surrounding the testis and epididymis. Vasectomy-related changes are likely attributable to post-vasectomy obstructive changes and increased intraluminal pressure in the efferent ducts, epididymides, and vas deferens. The typical sonographic changes after a vasectomy primarily include epididymal thickening and epididymal tubular ectasia with diminished blood flow in the epididymis. Spermatoceles display various sonographic findings, from multilocular cysts, to cystic lesions with low-echo levels, to a solid mass. Sperm granulomas appear as well-circumscribed heterogeneous masses on sonography and are commonly found at the epididymis or the ends of the severed vas deferens. The hydrocele, varicocele, epididymal cysts, and testicular cysts can also be associated; however, these findings are nonspecific. When radiologists encounter abnormalities of the scrotum, it would be useful to obtain a history of vasectomy to enable a correct diagnosis. Understanding of sonographic features of vasectomy-related changes and abnormalities is essential for correct diagnosis and proper management.
Dilatation, Pathologic ; Epididymis ; Granuloma ; Hematocele ; Hematoma ; Humans ; Male ; Scrotum ; Spermatocele ; Spermatozoa ; Testis ; Varicocele ; Vas Deferens ; Vasectomy

Ultrasound has been shown to be effective in the diagnosis of a variety of scrotal abnormalities. We performed ultrasound of the scrotum in 22 patients with conventional 3.75 MHz real time scanner. There were 6 intratesticular lesions-3 spermatic cord torsion, 1 malignant lymphoma,1 leukemic infiltration and l yolk sac tumor. Extratesticular abnormalities included acute epididymitis, chronic epididymitis, Tb epididymitis, epididymal cyst peritesticular abscess, spermatocele, hematocele and infected hydrocele. Sonography accurately distinguished between testicular and extratesticular masses in all cases and pathologic correlation were obtained for operated scrotal lesions. The results were as follows. l. Out of 22 patients, chief complaints of 9 were acute sctotum and 13 were scrotal mass. 2. Of 9 cases with acute scrotum, ultrasonography detected 5 cases with acute epididymitis, 3 cases with spermatic cord torsion and l case with hematocele. 3. Of 13 cases with scrotal mass, surgical exploration was done in 1O cases. 9 cases were confirmed same as post-operative finding (90% accuracy). One case with hematoma was confirmed to infected hydrocele after operation. 4. Ultrasound characteristics of 22 patients were classified as follows. 13 were hypoechoic, 4 were anechoic, 3 were mixed and 2 were hyperechoic.
Abscess ; Diagnosis ; Endodermal Sinus Tumor ; Epididymitis ; Hematocele ; Hematoma ; Humans ; Leukemic Infiltration ; Male ; Scrotum ; Spermatic Cord Torsion ; Spermatocele ; Ultrasonography

The authors presented a case of von Hippel-Lindau's disease. The patient was a 33-year-old man who visited to our hospital with visual disturbance on the right eye for a month and blind in the left eye for 10 years on the 4th May, 1973. On the eye examination, the left eye revealed ocular hypertension, deep chamber, and vitreous opacity which interfered with the visuality of the fundus. The right eye was normotensive and 0.1 incorrectable in visual acuity. The fundus revealed two angioma associated with large feeding vessels, scattered hemorrhages, and massive exudates along the engorged and tortuous vessels at the temporal retina. On general physical examination, no neurological signs were found, but multiple hard corn sized masses were palpated on the both sides of epididymal head. The masses were confirmed as epididymal cyst on microscopic examination. The x-ray findings were pulmonary tuberculosis far advanced on chest, an extrinsic pressure indentation in the floor of bladder on I.V.P., and abnormal intracranial vascularity, on right carotid angiogram. The blood chemistry showed an abnormal increase of amylase and lipase titers.
Adult ; Amylases ; Chemistry ; Exudates and Transudates ; Head ; Hemangioma ; Hemorrhage ; Humans ; Lipase ; Ocular Hypertension ; Physical Examination ; Retina ; Spermatocele ; Thorax ; Tuberculosis, Pulmonary ; Urinary Bladder ; Visual Acuity ; Zea mays

Patients with bilateral aplasia of the vas deferens have been considered sterile. In such patients many investigators have tried to create a successful sperm bank with various materials such as saphenous vein, tunica vaginalis, silicone prosthesis, monofilament knitted polypropylene and etc. and to offer hope for fertility. We performed to create an artificial spermatocele in a 32 year old male patient with bilateral vas aplasia by using a segment of great saphenous vein, anastomosed to the globus major to store spermatozoa. Aspirations of the venous cap of the patient at 2.3.4. and 5 months revealed numerous sperm with normal morphology and poor motility. Attempted insemination to his wife with this sperm was unsatisfactory.
Adult ; Aspirations (Psychology) ; Fertility ; Hope ; Humans ; Insemination ; Male ; Polypropylenes ; Prostheses and Implants ; Research Personnel ; Saphenous Vein ; Silicones ; Sperm Banks ; Spermatocele* ; Spermatozoa ; Spouses ; Vas Deferens*

OBJECTIVETo investigate the clinicopathologic features of epididymal cyst in von Hippel-Lindau (VHL) syndrome.

METHODSWe reviewed the clinical data of 3 epididymal cyst patients treated by surgery, and detected the expressions of HIF-1alpha, VEGF, alpha-SMA and CD34 in the epididymal tissue samples by the immunohistochemistry SP method.

RESULTSAll the 3 patients underwent surgical removal of the epididymal cyst. Immunohistochemistry of the epididymal tissues showed HIF-1alpha, VEGF, alpha-SMA and CD34 to be positive. All the 3 cases were confirmed to be VHL syndrome, 1 right after surgery, and the other 2 within 8 years postoperatively.

CONCLUSIONEpididymal cyst is a usual benign disease, which may occur independently of or be complicated by VHL syndrome. If immunohistochemistry of epididymal tissues shows HIF-1alpha, VEGF, alpha-SMA and CD34 to be positive, VHL syndrome should be considered, and further clinical examinations and post-operation follow-up are necessitated.

Actins ; metabolism ; Adult ; Epididymis ; pathology ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Male ; Middle Aged ; Spermatocele ; etiology ; metabolism ; pathology ; Vascular Endothelial Growth Factor A ; metabolism ; von Hippel-Lindau Disease ; complications ; metabolism ; pathology