Genitourinary tuberculosis is the most common manifestation of an extrapulmonary tuberculous infection. The most common site of genital tuberculosis is the epididymis, but testicular tuberculosis is very rare. A 30 year old patient presented with a painless right testicular mass. Under the clinical diagnosis of a right testicular tumor, a right radical inguinal orchiectomy was performed. The pathological diagnosis revealed testicular tuberculosis, without involvement of the epididymis.
Adult ; Diagnosis ; Epididymis ; Humans ; Male ; Orchiectomy ; Orchitis ; Tuberculosis* ; Tuberculosis, Male Genital

Female ; Gynecology ; methods ; Humans ; Infertility, Female ; complications ; diagnosis ; Male ; Pregnancy ; Tuberculosis, Female Genital ; complications ; diagnosis

OBJECTIVETo elevate the diagnosis and differential diagnosis levels of epididymal mass by sonography.

METHODSThis was a retrospective study of 179 cases of epididymal mass treated by surgery in our hospital between 1990 and 2005. The analysis was focused on pathological and sonographic features.

RESULTS179 patients with mean age of 51.4 +/- 14.7 were enrolled. The epididymal mass was classified into four groups: epididymal cyst (n = 98), nonspecific epididymitis (n = 27), tuberculous epididymitis (n = 33) , and epididymal tumor (n = 21). Epididymal cyst could be easily diagnosed by ultrasound, the diagnostic rate was 93.8%, but nonspecific epididymitis and tuberculous epididymitis were hard to differentiate, complicating with multiple organs lesions may distinguish tuberculous from nonspecific epididymitis. Tuberculous epididymitis could be easily diagnosed when cold abscess, calcification and sinus tract emerged. The majority epididymal tumors were benign, and malignant cases were rarely seen. Patient's history, physical examination and sonographic features were all essential to make a right diagnosis.

CONCLUSIONUltrasound features may be helpful to the differential diagnosis of epididymal mass and ultrasound should be the first choice of image detection in epididymal lesions.

Adolescent ; Adult ; Aged ; Diagnosis, Differential ; Epididymis ; Epididymitis ; diagnostic imaging ; Genital Neoplasms, Male ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tuberculosis, Male Genital ; diagnostic imaging ; Ultrasonography

OBJECTIVETo probe into and improve the diagnosis and treatment of tuberculosis (TB) in the male genital system.

METHODSFifteen patients with the male genital system TB established by microbiological and pathological examinations were retrospectively reviewed.

RESULTSThe male genital system TB was diagnosed by history, physical examination, semen analysis, TB culture and biopsy. Treatment consisted of antituberculous chemotherapy for all the patients before and/or after operation, including 5 cases of epididymectomy and 6 cases of orchi-epididymectomy.

CONCLUSIONThe male genital system TB tends to be atypical and semen polymerase chain reaction of TB (TB-PCR) may provide a new specific means for diagnosis in case of clinical suspicion. Surgical approaches should be cautiously adopted, especially for young patients.

Adult ; Aged ; Antitubercular Agents ; therapeutic use ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Retrospective Studies ; Tuberculosis, Male Genital ; diagnosis ; therapy

AIMThe effects of certain uropathogenic microorganisms (Neisseria gonorrhoeae, Staphylococcus aureus, Staphylococcus epidermidis and Mycobacterium tuberculosis) on human sperm motility characteristics were studied in vitro.

METHODSIn 10 healthy fertile men, ejaculates were aseptically obtained by masturbation and with a swim-up technique, a sperm suspension of high motility and purity was obtained. Several uropathogenic bacteria were obtained from outpatients with genitourinary tract infections. The sperm suspension was incubated with the pathogens at a bacteria: sperm ratio of 50:1 at 37deg. The sperm mobility parameters were estimated with a computer-assisted sperm analyzer (CASA) provided with a multiple-exposure photography system (Madi Corp., Zhejiang, China). Measurements were carried out at 0, 2 and 4 hours of incubation.

RESULTSStaphylococcus aureus significantly decreased the sperm motility and viability, but Staphylococcus epidermidis, Mycobacterium tuberculosis and Neisseria gonorrhoeae did not.

CONCLUSIONStaphylococcus aureus has an inhibitory effect on human sperm motility in vitro.

Gonorrhea ; pathology ; Humans ; In Vitro Techniques ; Male ; Mycobacterium tuberculosis ; Neisseria gonorrhoeae ; Sperm Motility ; Staphylococcal Infections ; pathology ; Staphylococcus aureus ; Staphylococcus epidermidis ; Tuberculosis, Male Genital ; pathology

OBJECTIVETo explore the potential application of IFN-gamma enzyme-linked immunospot (ELISPOT) assay in the diagnosis of tuberculous epididymitis (TE) by comparing ELISPOT assay with the traditional purified protein derivative (PPD) tuberculin skin test.

METHODSWe examined 13 TE patients using an in-house ELISPOT kit, another 11 TE patients by PPD skin testing, and 57 healthy male volunteers by parallel test with both the methods.

RESULTSTwelve (92.3%) of the 13 TE cases were positive on ELISPOT assay, and 10 (90.9%) of the 11 TE cases positive on PPD skin test, with no statistically significant differences between the two groups (P > 0.05). Among the 57 healthy male volunteers, 8 (14.0%) were positive on ELISPOT, and 28 (49.1%) positive on PPD test, the latter significantly higher than the former (P < 0.001).

CONCLUSIONIn terms of sensitivity, ELISPOT assay is similar to PPD test in the examination of tuberculous epididymitis. As for specificity, ELISPOT assay seems better than PPD test in differentiating tuberculous epididymitis patients from healthy males.

Adult ; Case-Control Studies ; Enzyme-Linked Immunosorbent Assay ; Epididymitis ; diagnosis ; Humans ; Interferon-gamma ; Male ; Tuberculin ; Tuberculin Test ; Tuberculosis, Male Genital ; diagnosis

OBJECTIVETo analyse sonographical features of epididymis tuberculosis with caseous necrosis and improve the accuracy of ultrasonic diagnosis.

METHODSUltrasonic features of 12 cases with epididymis tuberculosis with caseous necrosis, confirmed by surgical pathology, was retrospectively analysed: size, location, echogenicity, degree of blood flow in the lesion.

RESULTSIn all 12 patients, the number of purified protein derivative test (PPD) presenting the positive reached to 67%, while cases with the pulmonary tuberculosis was 42%. The epididymal tuberculosis with caseous necrosis could present images of the whole or focal epididymal enlargement and abnormal shape. The lesions internal echoes were irregular, inhomogeneous increased isoechoic echogenicity or hypoechoic, including bad-defined, irregular, homogeneous hypoechoic or anechoic. In lesional location, 4 out of 12 patients (33%) possessed richly color blood flow in Color Doppler Power Imaging(CDPI). The testicular enlargement with increased internal echoes and the testicular hydroceles were partly (58%, 7/12) observed by ultrasound. There was no varicocele, scrotal wall thickening and inguinal lymph node enlargement.

CONCLUSIONThe High Frequency Color Doppler images is helpful for the diagnosis and differential diagnosis of epididymis tuberculosis with caseous necrosis.

Adult ; Diagnosis, Differential ; Epididymitis ; diagnostic imaging ; pathology ; Humans ; Male ; Middle Aged ; Necrosis ; Retrospective Studies ; Tuberculosis, Male Genital ; diagnostic imaging ; pathology ; Ultrasonography, Doppler, Color

OBJECTIVETo improve the diagnosis and the treatment of tuberculous epididymitis.

METHODSRetrospective studies were made of 20 cases of isolated epididymal tuberculosis defined as "tuberculosis infection affecting the epididymis without evidence of renal involvement as documented by the absence of acid fast bacilli in the urine sample and on imaging" among 35 patients with epididymal tuberculosis. Two weeks after the intensified anti-TB treatment by the combined therapy of Isoniazid + Rifampicin + Streptomycin or Ethambutol, all the patients underwent surgical removal of the tuberculous lesion, followed again by the combined therapy for 6-9 months.

RESULTSOf the 20 cases, 16 experienced no recurrence and complications within 0.5-5 years after the surgery, 3 were found with urinary tuberculosis at 3, 3.5 and 5 years, and 1 developed tuberculous epididymitis of the other side at 3.5 years.

CONCLUSIONIsolated tuberculous epididymitis may be the sole or the initial presentation of genitourinary tuberculosis, for which timely surgery is the best option and has a good prognosis.

Adolescent ; Adult ; Aged ; Epididymis ; microbiology ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tuberculosis, Male Genital ; drug therapy ; surgery ; therapy

OBJECTIVETo study the causes of orchiectomy in different age groups.

METHODSWe retrospectively reviewed the clinical data about 291 cases of orchiectomy performed between March 1993 and October 2014 and analyzed the causes of surgery and their distribution in different age groups.

RESULTSThe main causes of orchiectomy were testicular torsion (45.8%), cryptorchidism (32.5%) and testicular tumor (16.9%) in the patients aged 0-25 years, testicular tumor (42.4%), cryptorchidism (25.9%) and tuberculosis (10.6%) in those aged 26-50 years. Prostate cancer was the leading cause in those aged 51-75 years (77.6%) or older (84.0%)), and testicular tumor was another cause in the 51-75 years old men (10.2%). Prostate cancer, testicular tumor, cryptorchidism, and testicular torsion were the first four causes of orchiectomy between 1993 and 2009. From 2010 to 2014, however, testicular tumor rose to the top while prostate cancer dropped to the fourth place.

CONCLUSIONThe causes of orchiectomy vary in different age groups. The proportion of castration for prostate cancer patients significantly reduced in the past five years, which might be attributed to the improvement of comprehensive health care service.

Adolescent ; Adult ; Age Factors ; Aged ; Causality ; Child ; Child, Preschool ; Cryptorchidism ; surgery ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Orchiectomy ; statistics & numerical data ; Prostatic Neoplasms ; surgery ; Retrospective Studies ; Spermatic Cord Torsion ; surgery ; Testicular Neoplasms ; surgery ; Tuberculosis, Male Genital ; surgery ; Young Adult