We reported an 8-year-old boy with panscleritis in left eye and right epididymitis after falling on the ground. Etiologic diagnosis played a key role in this case. Systemic examinations ruled out systemic autoimmune diseases, tumors, and infections as the cause of scleritis and suggested that the disease was caused by a local delayed-type hypersensitivity (DTH) induced by ocular trauma and was non-infectious. Still, the right epididymitis was infectious. Both conditions were treated successfully using steroids and antibiotics, respectively. Thus, early etiologic diagnosis and reasonable treatment are crucial to prevent visual loss.
Male ; Humans ; Child ; Epididymitis/complications* ; Eye Injuries/complications* ; Wounds, Nonpenetrating/complications* ; Scleritis/etiology* ; Face

Abscess ; etiology ; Epididymitis ; complications ; Genital Diseases, Male ; etiology ; Humans ; Infant, Newborn ; Male ; Scrotum ; pathology

PURPOSE: The objective of this study was to retrospectively investigate postoperative infectious complications (PICs) in our early experience with holmium laser enucleation of the prostate (HoLEP) followed by mechanical morcellation for symptomatic benign prostatic hyperplasia. MATERIALS AND METHODS: A retrospective review was performed of the clinical data for 90 consecutive patients who underwent HoLEP at our institution between February 2008 and March 2011. All patients were evaluated for the emergence of PICs, including prophylactic antibiotic administration (PAA) and the influence of the kind or duration of PAA on PIC. The details of cases with PICs were also examined. RESULTS: The patients' mean age was 71 years (range, 50 to 95 years), and their mean prostate volume was 60 mL (range, 2 to 250 mL). There were 7 cases (7.78%) with PICs; in detail, 3 patients were diagnosed with prostatitis, 2 with pyelonephritis, and 2 with epididymitis. Three patients had positive urine cultures: 1 had Serratia marcescens/Proteus mirabilis, 1 had S. marcescens, and 1 had Klebsiella pneumonia; only one case had urological sepsis. Our statistical data showed no significant differences between 2 or fewer days and 3 or more days of PAA and PIC occurrence. There was also no significant effect on PIC occurrence of sulbactam/ampicillin compared with other antibiotics. CONCLUSIONS: The results of this retrospective study showed that PIC occurrence did not depend on the duration or the kind of PAA. Further prospective study is necessary for the evaluation and establishment of prophylactic measures for PICs.
Epididymitis ; Holmium ; Humans ; Klebsiella ; Lasers, Solid-State ; Male ; Mirabilis ; Postoperative Complications ; Prospective Studies ; Prostate ; Prostatectomy ; Prostatitis ; Pyelonephritis ; Retrospective Studies ; Sepsis ; Serratia

PURPOSE: To evaluate the usefulness and effectiveness of transurethral coagulation and incision of the ejaculatory duct for hematospermia caused by ejaculatory duct cyst and obstruction. MATERIALS AND METHODS: Twenty-six patients with hematospermia were enrolled. Ejaculatory duct cyst or obstruction was diagnosed by transrectal ultrasound or MRI, revealing seminal vesicle hypertrophy and cystic dilated ejaculatory ducts. One patient had hematospermia associated with infertility. The mean age of the patients and their duration of symptoms were 42.7 years (range, 25-67 years) and 16 months (range, 1-60 months), respectively. All patients underwent transurethral management for treatment of their ejaculatory duct obstruction in the form of incision and coagulation of the ejaculatory duct. We used a 9.5 Fr rigid ureteroscope (Stortz(R), Germany) and a Bugbee electrode. Patients were followed for more than 3 months after the procedure. RESULTS: All patients reported improvement of hematospermia and disappearance of midline cysts, except for one patient. The one case, ureteroscope failed to pass through verumontanum. A ejaculatory duct cyst was found in 18 cases. Calculi were present in the seminal vesicle and ejaculatory ducts in 7 patients and were removed with endoscopic instruments. One infertile patient regained reproductive ability after the procedure. Postoperative complications, such as epididymitis, orchitis, or retrograde ejaculation were not observed. CONCLUSIONS: Transurethral incision and coagulation was a safe and effective treatment option for hematospermia caused by ejaculatory duct obstruction and is considered to be a successful treatment option for infertility secondary to ejaculatory duct obstruction.
Calculi ; Ejaculation ; Ejaculatory Ducts ; Electrodes ; Endoscopy ; Epididymitis ; Hemospermia ; Humans ; Hypertrophy ; Infertility ; Male ; Orchitis ; Postoperative Complications ; Seminal Vesicles ; Ureteroscopes

AIMTo identify and define prostate and seminal vesicle abnormalities in patients with chronic male accessory gland infection (MAGI) who failed to respond to antibacterial treatment.

METHODSWe selected 67 consecutive patients with MAGI and persistently elevated bacteriospermia (=or>10(6) colony forming units [CFU]/mL) after three antibiotic courses. Fourteen infertile patients with initial chronic microbial (=or>10(6) CFU/mL) MAGI who responded to antibacterial treatment (<10(3) CFU/mL) served as a control group. All patients and controls underwent transrectal ultrasonography (TRUS) scans and semen analysis. Patients with low seminal plasma volume (<1.5 mL) underwent both pre-ejaculatory and post-ejaculatory TRUS examination.

RESULTSTRUS revealed multiple abnormalities indicative of: (i) bilaterally extended prostato-vesiculitis (group A: 52 cases, 77.6%) (nine of these patients also had micro-emphysematous prostate abscess); and (ii) prostato-vesiculitis with unilateral or bilateral sub-obstruction of the ejaculatory ducts (group B: 15 cases, 22.4%). Mean sperm concentration, total sperm number, ejaculate volume and pH value were significantly higher in group A than in group B. In addition, sperm forward motility and the percentage of normal forms were significantly worse than in controls, whereas leukocyte concentration was significantly higher in group A. Group B patients had all sperm parameters, but their pH values, significantly different from those of controls.

CONCLUSIONAlthough antibiotic therapy is considered suitable when microbial MAGI is suspected, it is impossible to account for a poor response to antibiotics merely on the basis of conventional criteria (clinical history, physical and ejaculate signs). Thus, TRUS may be helpful in the follow-up of these patients.

Adult ; Anti-Bacterial Agents ; therapeutic use ; Bacterial Infections ; complications ; drug therapy ; Epididymis ; diagnostic imaging ; microbiology ; Epididymitis ; complications ; diagnostic imaging ; Follow-Up Studies ; Humans ; Infertility, Male ; diagnostic imaging ; microbiology ; Male ; Prostate ; diagnostic imaging ; microbiology ; Prostatitis ; complications ; diagnostic imaging ; Rectum ; diagnostic imaging ; Seminal Vesicles ; diagnostic imaging ; microbiology ; Ultrasonography ; methods

OBJECTIVETo study the effect of Qingre Yulin Decoction (QYD) on male infertility caused by accessory gland infection (AGI) with randomized controlled trial (RCT).

METHODSSixty infertility outpatients were equally divided into two groups randomly, the QYD group treated with modified QYD and the control group with antibiotic plus vitamin E, both for 3 months with another 6 months' follow-up. Pregnant rates, routine test of sperm and expressed prostatic secretion (EPS) were determined.

RESULTSThe healed rate was 26.7% (8 cases), the markedly effective rate was 43.3% (13 cases), the effective rate was 16.7% (5 cases), and the total effective rate was 86.7% in the QYD group, while in the control group it was 6.7% (2), 30.0% (9), 40.0% (12) and 76.7% respectively, showing higher healed rate and total effective rate in the former than those in the latter. Sperm quality of infertility patients with AGI decreased obviously, manifesting short ened average liquefaction time, reduced concentration, survival rate and vitality of sperm. These abnormal changes were improved after treatment in both groups, and the efficacy was better in the QYD group than that in the control group.

CONCLUSIONInfertility patients with AGI were manifested as oligospermatism and asthenospermia, which may not be the definite outcome of AGI. QYD is able to improve sperm quality, especially sperm vitality in infertility patients with AGI and therefore increase pregnant rate of their wives.

Adult ; Bacterial Infections ; complications ; Drugs, Chinese Herbal ; therapeutic use ; Epididymitis ; complications ; Female ; Humans ; Infertility, Male ; drug therapy ; etiology ; Male ; Phytotherapy ; Prostate ; drug effects ; pathology ; secretion ; Prostatitis ; complications ; Sperm Motility ; drug effects ; Treatment Outcome

PURPOSE: The twenty-six F sized continuous running irrigation transurethral resection (TUR) system has showed a relatively high risk for inducing postoperative urethral stricture in Korean men. We evaluated the efficacy and safety of recently available 22F continuous running irrigation TUR system for treating benign prostatic hyperplasia (BPH) patients. MATERIALS AND METHODS: A total of seventy patients with severe symptomatic BPH underwent transurethral prostatectomy (TURP). The 26F system was used in 31 cases and the 22F system was used in 39 patients. The total resection weight, the resection rate, and the intraoperative and immediate postoperative complication rates were compared between the 2 groups. The patients were followed for 2 weeks, 4 weeks and 3 months postoperatively to check for the development of urethral stricture. RESULTS: The total resection weight was 14.8+/-9.5gm in the 22F group and 11.2+/-10.2gm in the 26F group (p>0.05). The resection rates were 0.24+/-0.10gm/min and 0.19+/-0.11gm/min, respectively. The rate of urethral stricture requiring any type of management was 15.4% (6/39) in the 22F group and 38.7% (12/31) in the 26F group (p<0.05). Visual internal urethrotomy was performed in 2.6% (1/39) and 9.7% (3/31) of the patients, respectively. Other complications were 1 capsular perforation, 1 TUR syndrome, 1 epididymitis and 1 delayed bleeding in the 22F group, and 1 intraoperative fever and 1 epididymitis in the 26F group. CONCLUSIONS: TURP using the 22F continuous running irrigation system enabled the surgeon to resect prostate adenoma with a similar speed and effectiveness as compared with the 26F system, and it significantly reduced the risk of urethral stricture. Performing TURP with using this system can be considered as a first line therapy for the BPH patients who require surgery.
Adenoma ; Epididymitis ; Fever ; Hemorrhage ; Humans ; Male ; Postoperative Complications ; Prostate ; Prostatic Hyperplasia ; Running* ; Transurethral Resection of Prostate* ; Urethral Stricture

PURPOSE: To evaluate the usefulness and effectiveness of endoscopic management for recurrent hematospermia, we performed transurethral endoscopy of the seminal vesicles in patients with recurrent hematospermia, despite the administration of oral medication. MATERIALS AND METHODS: Sixteen patients were enrolled this study. Initially, all patients were treated with oral antibiotics for 6-8 weeks. Transrectal ultrasound (TRUS) and/or MRI were performed to find the anatomic abnormality and its relation with pelvic organs. The mean patient age and duration of symptoms were 43.9 years (range 24-64 years) and 21.3 months (range 1-108), respectively. We used a 6.5Fr. rigid ureteroscope and/or 14Fr. endoureterotomy instruments for the seminal vesiculoscopic examination. Patients were followed for more than 12 months after the procedures. RESULTS: An endoscopic seminal vesicle examination was able to be successfully performed in all patients. A midline cyst was found at 10 cases, which were fulgurated. Endoscopic incisions or dilation of the ejaculatory duct were performed in all patients. An ejaculatory duct stone was found at 5 cases, and removed endoscopically. All patients reported improvement of hematospermia after the procedure, and 3 with perineal discomfort became symptom free. Postoperative complications, such as epididymitis, orchitis and ejaculatory abnormalities, were not observed in any patient. CONCLUSIONS: Transurethral endoscopic interventions of the seminal vesicles can be performed easily with a conventional 6.5Fr. rigid ureteroscope and/or 14Fr. endoureterotomy instruments. Transurethral endoscopic managements were effective and safe treatment options in recurrent hematospermia patients.
Anti-Bacterial Agents ; Ejaculatory Ducts ; Endoscopy ; Epididymitis ; Hemorrhage ; Hemospermia* ; Humans ; Magnetic Resonance Imaging ; Male ; Orchitis ; Postoperative Complications ; Semen ; Seminal Vesicles ; Ultrasonography ; Ureteroscopes

PURPOSE: To evaluate the etiology and treatment of options in patients with hematospermia, we performed endoscopy of the seminal vesicles in 37 patients with hematospermia. MATERIALS AND METHODS: The patients were evaluated with either transrectal ultrasound (TRUS) or endorectal MRI. Mean age was 47.1 years (range 28-68 years) with duration of infliction being 37 months (range 3 months to 10 years). When the patients who had the definite abnormalities on the imaging studies and did not improve by medications for more than 3 months, transutricular seminal-vesiculoscopy using 6Fr or 9Fr rigid ureteroscope was performed. Patients were followed for more than 3 months after the endoscopic treatment. RESULTS: Hemorrhage was found in the seminal vesicles and the ejaculatory ducts in 23 (62.2%) and 3 (8.1%), respectively. Calculi were present in the seminal vesicles and the ejaculatory ducts in 6 (16.2%) and 2 (5.4%), respectively. Prostatitis was present in 9 (24.3%) patients. All patients except one reported improvement of hematospermia. Postoperative complications including epididymitis or retrograde ejaculation were not observed. CONCLUSIONS: Our series is the first large-scale experience of the seminal vesicle endoscopy in vivo. Transutricular seminal vesiculoscopy can be performed easily with conventional endoscopic equipment. The endoscopic evaluation and management of the hematospermia is a viable clinical option.
Calculi ; Ejaculation ; Ejaculatory Ducts ; Endoscopy ; Epididymitis ; Hemorrhage ; Hemospermia* ; Humans ; Magnetic Resonance Imaging ; Male ; Postoperative Complications ; Prostatitis ; Seminal Vesicles ; Ultrasonography ; Ureteroscopes

Schoenlein-Henoch syndrome (SHS), one of the manifestations of systemic vasculitis, usually involves the skin, gastrointestinal tract, joints and kidney. Since the involvement of male genitalia is very rare and there is little mention of it in textbooks, doctors have a tendency to neglect this finding in SHS. Unless there is a confirming diagnosis, it is easily mistaken for testicular torsion and the patients undergo unnecessary operations because they complain of unbearable scrotal pain. SHS is not uncommon in Korea, but hardly any cases of scrotal involvement are found. We have experienced 7 cases of acute scrotum associated with SHS admitted to Severance Hospital, Yonsei University College of Medicine during the last 20 years; 2 underwent operation and 5 received conservative treatment only.
Acute Disease ; Case Report ; Child ; Child, Preschool ; Edema/etiology* ; Epididymitis/etiology* ; Human ; Male ; Purpura, Schoenlein-Henoch/complications* ; Scrotum* ; Spermatic Cord Torsion/therapy ; Spermatic Cord Torsion/etiology*