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Background Material and methods Results and discussion Conclusions The escalating prevalence of fertility problems in the aging population necessitates a comprehensive exploration of contributing factors, extending beyond environmental concerns, work‐related stress, and unhealthy lifestyles. Among these, the rising incidence of testicular disorders emerges as a pivotal determinant of fertility issues. Current treatment challenges are underscored by the limitations of high‐dose and frequent drug administration, coupled with substantial side effects and irreversible trauma inflicted by surgical interventions on testicular tissue.The formidable barrier posed by the blood–testis barrier compounds the complexities of treating testicular diseases, presenting a significant therapeutic obstacle. The advent of nanocarriers, with their distinctive attributes, holds promise in overcoming this impediment. These nanocarriers exhibit exceptional biocompatibility, and membrane penetration capabilities, and can strategically target the blood–testis barrier through surface ligand modification, thereby augmenting drug bioavailability and enhancing therapeutic efficacy.This review concentrates on the transformative potential of nanocarriers in the delivery of therapeutic agents to testicular tissue. By summarizing key applications, we illuminate the strides made in utilizing nanocarriers as a novel avenue to effectively treat testicular diseases.Nanocarriers are critical in delivering therapeutic agents to testicular tissue. [ABSTRACT FROM AUTHOR]

ABSTRACT Purpose: The gubernaculum seems to be the most important anatomical structure in the testicular migration process. The objective of this paper is to review current literature regarding the role of gubernaculum testis nerves in testicular migration. We conducted a comprehensive literature review about the gubernaculum testis innervation. A PubMed database search was performed in April 2024, focusing on gubernaculum testis and cryptorchidism and genitofemoral nerve (GFN) and calcitonin gene-related peptide (CGRP) gene. The gubernaculum has its own nerve supply, the GFN, descending on the anteromedial surface of the psoas muscle from L1-L2 segments. The second phase of testicular descent is regulated by androgens and CGRP, released from the sensory nucleus of the GFN. The GFN doesn't directly play a role in testicular migration but there is a theory that shows a regulatory function of this nerve in hormonal action during this process. The gubernaculum testis has important structural alterations during the testicular migration and the genitofemoral nerve and CGRP gene are of great importance in this process. The genitofemoral nerve provides motor innervation to the cremaster muscle and gubernaculum, which helps regulate the position of the testes within the scrotum.

Introduction: Testicular cancer is among the most common malignancies in men under the age of 50 years. Most testicular symptoms are linked to benign diseases. Men's awareness of testicular diseases and testicular self-examination behaviours are suboptimal. In this pilot feasibility study and process evaluation we examine the feasibility of conducting a future definitive randomised controlled trial (RCT) to test the effect of the Enhancing Men's Awareness of Testicular Diseases using Virtual Reality intervention (E-MATVR) compared to the Enhancing Men's Awareness of Testicular Diseases using Electric information control (E-MATE). The study protocol is registered on ClinicalTrials.gov (NCT05146466). Methods: Male athletes, engaged in Gaelic games, and aged 18 to 50 years were included. Recruitment was via FacebookTM, XTM (formerly TwitterTM), and posters. Participants were individually randomised to either E-MATVR or E-MATE. Data were collected at baseline (T0), immediately post-test (T1), and three months post-test (T2) using surveys. Qualitative interviews were conducted with participants and researchers. Results: Data were collected from 74 participants. Of those, 66 were retained. All E-MATVR participants and most E-MATE participants (n = 33, 89.2%) agreed/strongly agreed that the device was easy to use and that they were engaged to learn by the device. Most E-MATVR participants (n = 34, 91.9%) and all E-MATE participants agreed/strongly agreed that the time it took them to complete the intervention was reasonable. All 74 participants were extremely satisfied/somewhat satisfied with their overall participation in the study. E-MATVR was described as interactive, easy, fun, and close to real life. Initial difficulty using VR equipment, nausea, and technical issues were identified as challenges to engaging with E-MATVR. Recommendations were made to make VR more accessible, shorten the survey, and incorporate more interactivity. Across all participants, mean testicular knowledge scores (range 0–1) increased from 0.4 (SD 0.2) at T0 to 0.8 (SD 0.2) at T1. At T2, overall mean scores for participants were 0.7 (SD 0.2). Mean knowledge scores did not differ by trial arm at any timepoint. At T2, all E-MATVR participants and 29/32 E-MATE participants (90.6%) reported purposefully examining their testes within the past three months. Conclusion: Findings are promising, highlighting the feasibility of using VR to promote young athletes' awareness of testicular diseases. Considering the strengths, limitations, and lessons learned from this study, some modifications are required prior to conducing an RCT. These include but are not limited to shortening survey questions, incorporating more interactivity and visual content, and targeting more heterogenous male-dominated environments. [ABSTRACT FROM AUTHOR]

Chemotherapeutic drugs have demonstrated effectiveness in treating various neoplastic conditions; however, they can also have detrimental effects on male gonadal function and fertility. Consequently, interest has grown in identifying novel approaches that can mitigate chemotherapy-induced testicular damage. Thymoquinone (TQ), the chief active component of the volatile oil of Nigella sativa (NS), has a wide range of therapeutic properties, including antioxidant, anti-inflammatory and anti-apoptotic effects. The aim of this systematic review was to identify experimental animal studies that have evaluated the protective effects of TQ against testicular complications associated with chemotherapy. In accordance with the preferred reporting items for systematic review and meta-analyses (PRISMA) guidelines, a thorough search was performed across several databases (PubMed, EBSCOhost, Sage and Scopus) to identify experimental studies published from 2010 to May 2022 that focused on rodent models and compared the effects of TQ versus other chemotherapeutic drugs. Eight studies met the inclusion criteria, comparing TQ with methotrexate (MTX), 6-mercaptopurine (6-MP), cyclophosphamide (CPA), bleomycin (BL), doxorubicin (DOX) or busulfan (BUS). The results of these studies consistently demonstrated that TQ significantly improved sperm parameters, the levels of oxidative stress (OS) markers, apoptosis markers, and hormones and testicular histopathology, indicating that TQ has protective effects against chemotherapy-induced damage. TQ mitigated chemotherapy-induced testicular toxicity by decreasing lipid peroxidation and enhancing the activity of antioxidant enzymes within chemotherapy-treated testes. These findings highlight the potential of TQ as a therapeutic agent that can ameliorate testicular complications associated with chemotherapy, thereby providing a basis for further research and potential therapeutic applications. [ABSTRACT FROM AUTHOR]

The transcription factor SALL4 is associated with embryonic pluripotency and has proposed as a novel immunohistochemistry (IHC) marker for diagnosing germ cell tumours. SALL4 comprises three isoforms, and SALL4-A being the full-length isoform. Studying its isoforms could revolutionize testicular cancer prognosis and subtype differentiation. The expression and clinical significance of isoform 'A' of SALL4 was evaluated in 124 testicular germ cell tumours (TGCTs) subtypes, adjacent 67 normal tissues and 22 benign tumours, using immunohistochemistry on tissue microarrays (TMA). A statistically significant higher expression of nuclear and cytoplasmic SALL4-A was detected in TGCTs histological subtypes and benign tumours compared to the normal tissues. Seminoma and yolk sac tumours had the highest nuclear and cytoplasmic expression of SALL4-A. A significant correlation was detected between the higher nuclear expression of SALL4-A and increased pT stages (P = 0.026) in seminomas. Whereas in embryonal carcinomas, cytoplasmic expression of SALL4-A was associated with the tumour recurrence (P = 0.04) and invasion of the epididymis (P = 0.011). SALL4-A isoform expression in the cytoplasm and nucleus of TGCTs may be associated with histological differentiation. In the seminoma subtype of TGCTs, higher expression of SALL4-A may be used as a predictive indicator of poorer outcomes and prognosis. [ABSTRACT FROM AUTHOR]

Simple Summary: In our retrospective study at a tertiary centre, we reviewed the use of contrast-enhanced ultrasound (CEUS) and strain elastography (SE) as adjuncts to conventional greyscale and colour Doppler US (CDUS) for evaluating focal testicular abnormalities over a decade. This study highlights the potential of advanced ultrasound techniques to provide deeper insights into the characteristics of testicular abnormalities. In particular, we observed that contrast-enhanced ultrasound could detect vascular enhancement in all malignant cases, even those not identified by conventional CDUS, and more conclusively confirm benignity. While SE alone offered no distinctive advantage, incorporating a combination of CEUS and SE into the evaluation of focal testicular abnormalities improved diagnostic performance metrics over conventional CDUS. Our research underscores the enhanced performance achieved by utilising these advanced ultrasound techniques. The comprehensive diagnostic assessment provided by these techniques could facilitate a shift towards more conservative management of testicular lesions, supporting the preference for organ-preserving methods over more radical surgeries. Conventional ultrasonography (US), including greyscale imaging and colour Doppler US (CDUS), is pivotal for diagnosing scrotal pathologies, but it has limited specificity. Historically, solid focal testicular abnormalities often led to radical orchidectomy. This retrospective study evaluated the utilisation of contrast-enhanced ultrasound (CEUS) and strain elastography (SE) in investigating intratesticular focal abnormalities. A total of 124 cases were analysed. This study underscored the superior diagnostic capabilities of CEUS in detecting vascular enhancement in all malignant cases, even those with undetectable vascularity by CDUS. It also highlighted the potential of CEUS in identifying distinctive vascular patterns in benign vascular tumours. Definitive confirmation of benignity could be obtained when the absence of enhancement was demonstrated on CEUS. While SE alone offered no distinctive advantage in differentiating between benign and malignant pathologies, we demonstrated that incorporating a combination of CEUS and SE into the evaluation of focal testicular abnormalities could improve diagnostic performance metrics over conventional CDUS. Our findings underscore the role of advanced ultrasound techniques in enhancing the evaluation of focal testicular abnormalities in clinical practice and could aid a shift towards testis-sparing management strategies. [ABSTRACT FROM AUTHOR]

Introduction: Dirofilarial infestation has been reported as an extremely rare cause of pediatric acute scrotum. We aimed to evaluate clinical, radiological, and intraoperative findings of children who underwent surgical management for acute scrotum due to dirofilariasis in an endemic country. Materials and Methods: A retrospective study of patient records of children who underwent surgery for acute scrotum due to dirofilariasis between 2018 and 2022. Results: There were eight emergency presentations for acute scrotum due to dirofilariasis. Three presentations (37.5%) were not associated with scrotal pain. The median age at presentation was 59 (range: 19-100) months. Four patients (67.7%) underwent emergency scrotal exploration at the first presentation and another one during the second presentation. Recurrent episodes were seen in two patients who were initially managed nonsurgically with antibiotics alone. Ultrasonography was performed in all six patients and revealed a parasitic nodule in three (50%). Conclusions: Dirofilariasis causing acute scrotum may cause significant diagnostic dilemma for clinicians. It may resemble idiopathic scrotal edema since it predominantly affects boys under 6 years of age and is painless in a significant proportion. However, left unoperated, it appears to have a high recurrence rate. [ABSTRACT FROM AUTHOR]

Copyright of Osmangazi Journal of Medicine / Osmangazi Tip Dergisi is the property of Eskisehir Osmangazi University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective(s): Renal and testicular disorders are primarily associated with oxidative damage and inflammation. Here, alpha-pinene (a type of monoterpene) was investigated for its effect on oxidative/nitrosative stress and the expression of inflammatory and apoptotic factors in the kidneys and testes of rats treated with CCl4. Materials and Methods: CCl4 was injected intraperitoneally (IP) at a dose of 2 ml/kg (twice a week for six weeks). Alpha-pinene (50 mg/kg/day, IP) was also treated during the same period. Results: CCl4 increased the level of malondialdehyde (P<0.01 in the kidney and P<0.001 in the testis) and nitric oxide (P<0.001 in the kidney and P<0.01 in the testis) and decreased the levels of glutathione (P<0.05) in the kidneys and testicles of rats. CCl4 also reduced the catalase enzyme activity in the kidneys (P<0.05) but did not affect its activity in the testis. In addition, CCl4 enhanced the mRNA expression of TNF-α (P<0.01), nuclear factor-κB (P<0.05), and Bax (P<0.05 in the kidney and P<0.01 in the testis) and decreased the expression of Bcl-2 (P<0.05) in both organs. Alphapinene prevented all the mentioned changes, but it did not influence the expression of Bcl-2 in the kidneys of rats receiving CCl4. Conclusion: Alpha-pinene may have the potential to prevent renal and testicular diseases by strengthening the antioxidant system in the kidneys and testis, and inhibiting oxidative/nitrosative stress, inflammation, and apoptosis caused by CCl4. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Despite being a commonly encountered urologic condition, there remains a paucity of understanding and literature on the management and natural history of isolated epididymal pain. Typically, patients who do not respond to conservative management undergo an epididymectomy; however, the literature on its efficacy is also scarce, with success rates varying from 10-90%. Our goal was to better describe the etiology and natural history of isolated epididymal pain and to describe the rates of success associated with epididymectomy. METHODS: A retrospective, case-control study was conducted at the Manitoba Men's Health Clinic, with the approval of the University of Manitoba Research Ethics Board. All patients presenting with chronic epididymitis, defined as discomfort or pain localized to the epididymis for at least three months, were identified. Information regarding patient demographics, past medical and surgical history, duration of pain, localization of pain, findings on previous ultrasounds, prior conservative therapies trialed, and response rates, as well as response rates to surgical therapy were collected. RESULTS: From April 2022 to April 2023, a total of 275 patients with chronic orchialgia were identified; among them, 74 patients presented with chronic isolated epididymal pain. On average, 22.9% of patients experienced symptoms for 3-6 months, 10% for 6-12 months, and 67.1% for over 12 months; 13.5% (n=10) had associated ejaculatory pain, 8.1% (n=6) had lower urinary tract symptoms, and 4.1% (n=3) had erectile dysfunction. Ultrasound findings were observed in 68.9% of patients, with 31.1% having an epididymal cyst, 27.1% having a varicocele, 5.4% having a spermatocele, and 4.1% having a hydrocele. Among those who underwent conservative therapy, only 36.2% of patients reported a positive response. Surgical intervention was performed on 23 patients, including 16 who underwent epididymectomy, three who underwent cord denervation, and two who underwent vasovasostomy and spermatocelectomy each. Most (81.3%, n=13) patients who underwent epididymectomy had a positive response to the surgical intervention, defined as no pain on followup, while all patients undergoing other surgical interventions experienced a positive response. CONCLUSIONS: Chronic epididymal pain is a condition with limited data surrounding its management. Prior to referral, a large proportion of patients did not undergo any conservative treatment, and of those that did, there was limited response. For those who underwent surgical intervention, all were pain-free on followup, except three patients who underwent epididymectomy. [ABSTRACT FROM AUTHOR]

Introduction: Increased awareness of testicular diseases can lead to early diagnosis. Evidence suggests that men's awareness of testicular diseases is low, with many expressing their willingness to delay help‐seeking for symptoms of concern. The risk of testicular diseases is higher in gender and sexual minority groups. In this study, we discuss the codesign, refinement and launch of 'On the Ball', an inclusive community‐based 'testicular awareness' campaign. Methods: The World Café participatory research methodology was used. Individuals from Lesbian, Gay, Bisexual, Transgender and Queer+ friendly organisations, testicular cancer survivors, policymakers, media/marketing experts and graphic designers were recruited. Participants were handed a brief for 'On the Ball', which was designed based on feedback from a previous World Café workshop. They were assigned to three tables. Participants rotated tables at random for three 20‐min rounds of conversations. Each table had a facilitator who focussed on one element of the campaign brief. Data were collected using audio recorders and in writing and were analysed thematically. Results: Thirteen individuals participated in the workshop. The following themes emerged from the data: (i) campaign identity, (ii) campaign delivery and (iii) campaign impact. Participants recommended enhancements to the campaign logo, slogan, social media posts and poster. They suggested delivering the campaign online via social media and offline using various print and broadcast media. Participants recommended targeting areas with a large number of men such as workplaces. To help measure the impact of the campaign, participants proposed capturing social media analytics and tracking statistics relating to testicular diseases. Recommendations were used to refine the 'On the Ball' campaign and launch it in a university. In total, 411 students engaged with the various elements of the campaign during the soft launch. Conclusions: 'On the Ball' campaign visuals ought to be inclusive. Online and offline campaign delivery is warranted to reach out to a wider cohort. Campaign impact can be captured using social media analytics as well as measuring clinical outcomes relating to testicular diseases. Future research is needed to implement the campaign online and offline, explore its impact and evaluate its feasibility, acceptability, cost and effect on promoting testicular awareness. Patient or Public Contribution: The 'On the Ball' campaign was codesigned and refined with members of Lesbian, Gay, Bisexual, Transgender and Queer+ friendly organisations, testicular cancer survivors, health policymakers, media and marketing experts and graphic designers using the World Café participatory research methodology. [ABSTRACT FROM AUTHOR]

Background: This study investigated the effect of curcumin nanomicelle (CUR-n) on the structure of testis tissue, the process of spermatogenesis, LH, FSH, testosterone, and oxidative stress in a model of multiple sclerosis. Methods: Twenty-four male mice C57BL/6 were randomly allocated into 4 groups of 6 (1: group receiving 2% CPZ diet, 2: group receiving the diet of 2% CPZ + CUR-n with a dose of 50 mg/kg, 3: group receiving the diet of 2% CPZ + CUR-n with a dose of 100 mg/kg). The concentration of hormones (testosterone, LH and FSH), was measured by the special hormone assay ELISA kits. Measuring total antioxidant capacity (TAC) and Malondialdehyde (MDA) levels was done by spectrophotometry and calorimetric methods, respectively. Stereological analysis was done in order to explore the number of spermatogenesis cells, testis and sperm properties. Results: The results indicated that CUR-n (100 mg/kg) significantly enhanced the concentration of LH, FSH, testosterone, and TAC but reduced MDA levels. It also notably increased the quantity of spermatogonia, spermatocyte, round spermatids, long spermatids and LCs, augmented testis weight and volume, and germinal epithelium volume, improved sperm count, morphology, viability, and motility. In addition, a considerable decrease in the amount of wrinkling and disruption of the germinal epithelium was observed after intervention with CUR-n (100 mg/kg). Furthermore, a significant increase in the number of germ cells compared to the group receiving CPZ was detected. Conclusion: This study proposes that CUR-n could be a therapeutic agent for decreasing the adverse effects of MS on testis. [ABSTRACT FROM AUTHOR]

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Cell phone and Ultra-High Frequency (UHF) waves produce oxidative stress and cause testicular toxicity. This investigation was directed to evaluate the effectiveness of Rosmarinic Acid (RA) against oxidative stress caused by UHF radiation in rats. Methods: Forty-two male Wistar rats were divided into six groups. The control received 5 mL normal saline (0.9% NaCl) by gavage, the cell phone group received 915 MHz, the UHF waves group just received 2450 MHz, the RA/cell phone group received RA plus 915 MHz, RA/UHF waves group received RA plus 2450 MHz, and RA just received RA (20 mg/kg). After 30 days of consecutive radiation, the biochemical and histopathological parameters of their testes were measured. Statistical comparison was made using one-way ANOVA followed by Tukey's post hoc test. Results: Cell phone and UHF wave radiation significantly diminished the activity of antioxidant enzymes such as superoxide dismutase, catalase, and glutathione peroxidase, and glutathione content (P<0.001). On the opposite, UHF significantly increased oxidative stress indices including malondialdehyde level, nitric oxide level, and protein carbonyl content (P<0.001). UHF also significantly reduced the number of Sertoli cells, spermatogonia, primary spermatocyte, epithelial height, and seminiferous tubular and luminal diameters (P<0.001). RA, as an effective antioxidant, reverses the above-mentioned harms and moderates the adverse effects of UHF on the testes of rats by significantly diminishing the oxidative stress indices and antioxidant enzyme rise and improving the histological parameters (P<0.001). Conclusion: RA can protect the testes of rats from UHF- induced toxicity by reducing oxidative stress. RA as a food supplement might be useful for protecting humans exposed to UHF environmental contamination. [ABSTRACT FROM AUTHOR]

Objective: This research focuses on the interaction between the circadian clock and the damage caused to testicular tissue by x-ray ionizing radiation. By examining the links between circadian rhythms and radiation-induced testicular damage, a deeper understanding of the underlying mechanisms may emerge, potentially leading to new strategies to mitigate or prevent such damage and its subsequent consequences. Methods: Twenty-four Sprague-Dawley rats were divided into 3 groups. Rats in group 1 (control group) did not undergo any procedures. Rats in group 2 (day) received 6 Gy total body external x-ray radiation in a single fraction between the hours 05:00 and 06:00. Rats in group 3 (night) received 6 Gy total body external x-ray radiation in a single fraction between the hours 19:00 and 20:00. Results: The day group was compared with the control group, and a decrease in spermatogenetic cells and edematous areas was observed. In addition, there was vacuolar accumulation in the cytoplasm of spermatids in the germinal epithelium and necrotic Leydig cells in the intertubular spaces. In the night group, we observed that the changes observed in group 2 were significantly restored. In terminal deoxynucleotide transferase dUTP nick end labeling and 8-hyd roxy- 2’-de oxygu anosi ne immunohistochemical analyses, we observed significantly increased immunopositivity in group 2 compared to the control group and group 3. Conclusion: In conclusion, it reveals that the circadian clock protects against testicular damage caused by x-ray ionizing radiation. By regulating DNA repair processes, antioxidant defense mechanisms, and other important pathways, the circadian clock appears to increase the resistance of testicular tissues to radiation stress. [ABSTRACT FROM AUTHOR]

Background: The clinical management of malignant melanoma (MM) has undergone a significant revolution with the implementation of immune checkpoint inhibitors (ICIs). While these therapeutic agents stimulate the host immune system against cancer, they may also lead to immune-related adverse events (IrAEs). Positron emission computed tomography (PET/CT) with 2-deoxy-2-[18F]fluoro-d-glucose ([18F]FDG) has proven successful in detecting IrAEs in cancer patients undergoing ICI. In our case, we report a rare occurrence of ICIs-induced concomitant thyroiditis and orchitis detected on [18F]FDG PET/CT. Case presentation: We present a case involving a 61-year-old man referred to our hospital due to MM. Following surgical excision and sentinel lymph node mapping, he underwent an initial [18F]FDG PET/CT, which yielded negative results. However, a follow-up PET/CT after 9 months revealed metastases in the lungs and lymph nodes. Subsequently, he initiated an ICI-based therapeutic regimen. After 3 months, he reported progressively worsening fatigue and the onset of testicular pain. A testicular ultrasound showed heterogeneous echotexture in both testicles with mildly increased vascularity. A subsequent PET/CT demonstrated complete regression of previously described pathological lesions in the lungs and metastatic lymph nodes. However, diffusely increased tracer uptake was observed in both the thyroid gland and testicles, findings absent in the pre-ICI examination. These were interpreted as IrAEs and promptly treated with corticosteroids, resulting in complete resolution of symptoms. Conclusions: [18F]FDG PET/CT plays a crucial role in staging and monitoring treatment response in cancer patients. When assessing subjects undergoing ICI-based therapies, particular emphasis should be given to detecting unusual IrAEs, as exemplified in our case. [ABSTRACT FROM AUTHOR]

We present a case of a 17‐year‐old male with a testicular tumour diagnosed after trauma. A 17‐year‐old male patient came to our clinic with swelling in the right hemiscrotum. The patient had a history of right scrotal blunt trauma 3 weeks before the admission and had no history of urological surgery or chronic disease. The patient doesn't use tobacco, alcohol, or illicit drugs. Genitourinary system examination revealed swelling and tenderness on palpation in the right hemiscrotum. The right testicle was not palpable. The left hemiscrotum was normal. The left testicle had a normal size and shape. Testicular tumour markers were high (AFP:196 μg/L (N: 0–8 μg/L), b‐HCG: 916 mIU/mL (N: <10 mIU/mL), LDH: 364 U/L (N: 0–265 U/L). Scrotal ultrasonography and magnetic resonance imaging revealed that there were areas of 9 × 9 × 11 cm in size of the right scrotal region without viable testis tissue, hematoma area, and areas compatible with necrosis. These findings were related to intratesticular rupture due to trauma. Abdominal tomography revealed lymphadenopathies of approximately 6 × 3 cm in the anterior paracaval area and approximately 4 × 3 cm in the anterior aspect of the psoas muscle. We performed right radical inguinal orchiectomy on the patient. Testicular tumour markers were still high on the 8th postoperative day (AFP:120 μg/L (N: 0–8 μg/L), bHCG: 680 mIU/mL (N: <10 mIU/mL), LDH: 200 U/L (N: 0–265 U/L)). The testicular tumour was diagnosed as mixed germ cell tumour (50% Yolk Sac, 30% Embryonal Carcinoma, 20% Teratoma). The tumour diameter was 9 cm, surgical margins were intact, there was rete testis invasion, and no tumour was detected in the tunica vaginalis. No tumour invasion was seen in the soft tissue around the spermatic cord (pT2). The patient received 3 cycles of chemotherapy with bleomycin, etoposide, and cisplatin. We suggest that patients presenting with scrotal trauma should be carefully evaluated for testicular malignancy, and if malignancy is suspected, radical inguinal orchiectomy should be preferred for the operation. [ABSTRACT FROM AUTHOR]

There are limited data regarding the significance of multifocality in testicular cancer patients. This study evaluated the relationship between multifocality and clinicopathological features determined at the time of radical orchiectomy. The study involved 280 consecutive patients who underwent radical orchiectomy between 2018 and 2023. Multifocality was defined as a distinct tumor focus characterized by a group of malignant cells > 1 mm, clearly differentiated from the primary tumor mass. Uni- and multivariate logistic regression analyses were employed to investigate the association between multifocality and histopathological parameters along with potential risk factors for clinical stages II + III. Multifocality was identified in 44 (15.7%) patients. Significantly smaller primary tumors were observed in subjects with multifocality (20.0 mm vs. 30.0 mm, p = 0.0001), while those exhibiting monofocality presented a markedly elevated rate of tumors exceeding 4 cm (40.3% vs. 18.2%, p = 0.005). Furthermore, multifocality was associated with a significantly higher rate of primary tumors < 2 cm (52.3% vs. 29.2%, p = 0.003). Univariate logistic regression analysis revealed a substantial decrease in the likelihood of multifocality occurrence in seminoma patients with tumors > 4 cm (OR = 0.38, p = 0.017). Meanwhile, in multivariate logistic regression, multifocality did not emerge as a significant risk factor for clinical stages II + III in either seminoma (p = 0.381) or non-seminoma (p = 0.672) cases. Our study suggests that multifocality holds no substantial prognostic relevance for clinically advanced disease in testicular cancer patients. The findings indicate that multifocality is associated with smaller primary tumors, particularly those measuring less than 2 cm. [ABSTRACT FROM AUTHOR]

Introduction: Testicular cancer is the most common cancer in men aged 15–44 years in many countries. Most men with testicular cancer present with a lump. Testicular symptoms are more likely to occur secondary to benign diseases like epididymo‐orchitis, a common sexually transmitted infection. Gender and sexual minorities are at an increased risk of testicular diseases and health disparities. The aim of this study was to co‐design an inclusive community‐based campaign to promote testicular awareness. Methods: This study uses the World Café methodology. Participation was sought from Lesbian, Gay, Bisexual, Transgender and Queer+ friendly organisations, testicular cancer survivors, health policy makers, media and marketing experts and graphic designers. Participants engaged in three rounds of conversations to co‐design the campaign. Data were collected using drawing sheets, artefact cards, sticky notes, coloured markers and a voice recorder. Deductive thematic analysis was conducted. Results: Seventeen individuals participated in the study. Six themes emerged from the analysis as follows: (i) online communication; (ii) offline communication; (iii) behavioural targeting and education; (iv) campaign frequency and reach; (v) demographic segmentation; and (vi) campaign identity. The use of social media for campaign delivery featured strongly in all conversations. Participants also recommended offline communication using posters and radio/television advertisements to scale up the campaign and achieve wider reach. Advertisements to overcome embarrassment surrounding testicular health were particularly recommended. Participants emphasised that campaign delivery must be dynamic whilst ensuring that the health‐promoting messages are not diluted or lost. They stressed the importance of being inclusive and tailoring the campaign to different age groups, gender identities and sexual orientations. Conclusions: Study recommendations will be used to design and deliver the campaign. Future research will be needed to evaluate the feasibility, acceptability, cost and effect of the campaign on promoting testicular awareness and early detection of testicular diseases. Patient or Public Contribution: A participatory research approach was used to co‐design the campaign with members of Lesbian, Gay, Bisexual, Transgender and Queer+ (LGBTQ+) friendly organisations, LGBTQ+ student bodies, LGBTQ+ staff networks, LGBTQ+ sports clubs, men's health organisations, testicular cancer survivors, health policy makers, media and marketing experts and graphic designers. [ABSTRACT FROM AUTHOR]

Angiomyolipoma (AML) is a benign mesenchymal tumor, that is composed of thick-walled blood vessels, smooth muscle cells and adipose tissue. They are commonly seen in kidneys, testicles are not a typical location for AML's; many solid testicular tumors are germ cell malignancies. Here we report the sixth testicular AML case in the literature, to our knowledge. An 80-year-old male undergone bilateral orchiectomy with the diagnosis of local invasive prostate cancer, without any testicular symptoms. Pathological analysis demonstrated a tumor, involving nearly the whole left testicle, composed of muscle cells, vessels and fat tissue, diagnosed as testicular AML. In this article our case is reported and we also make a literature review about testicular AML's. [ABSTRACT FROM AUTHOR]

Testicular and scrotal abnormalities can occur in children, adolescents, and adults. The lesions, often accompanied by pain and swelling/enlargement of the scrotum, can cause anxiety in patients and their parents. Regardless of age, proper diagnosis is based on adequate anamnesis and physical examination. Color Doppler ultrasound is the first-line test in the differential process of testicular and scrotal diseases. Testicular and scrotal lesions require differentiation for benign and malignant processes as well as therapeutic management, including urgent surgical intervention. The aim of this paper is to present the most common causes of testicular and scrotal abnormalities in pediatric and adult patients and to outline the symptoms and diagnostic and therapeutic management. [ABSTRACT FROM AUTHOR]

Testis is considered the main organ of the male reproductive system. Dogs are used as a suitable experimental model of testicular diseases in humans. From the veterinary aspect, several disorders have been reported to affect the testis in dogs. Thus, the objective of the present study was to investigate the morphometrical features of the dog testis using design‐based stereology. The testes of six male dogs were used. Isotropic, uniform random sections were obtained and processed for light microscopy. Testicular total volume and the fractional volume of the seminiferous tubules, interstitial tissue and germinal epithelium were measured using the Cavalieri's estimator and the point counting system. Germinal epithelial surface area was estimated using test lines, and total length of seminiferous tubules was analysed using the counting frames. The total volume of testis was calculated 13.64 ± 1.94 cm3. The relative volume fractions of the seminiferous tubules, interstitial tissue and germinal layer expressed as a percentage of total testicular volume were found to be 75.87 ± 6.11%, 23.68 ± 5.15% and 64.15 ± 4.82%, respectively. The surface area of the germinal layer was 915.25 ± 150.48 cm2. The thickness of germinal layer was estimated to be 96.18 ± 10.72 μm. The total length of seminiferous tubules measured 290.8 ± 35.86 m. No statistical difference in investigated parameters was found between the left and right testes (p > 0.05). Our data might contribute to the male reproductive knowledge, help develop experimental studies in this field and possibly lead to advancement in the diagnosis and treatment of testicular diseases in the dog. [ABSTRACT FROM AUTHOR]

Copyright of Revista Cientifica de la Facultade de Veterinaria is the property of Universidad del Zulia, Facultad de Ciencias Veterinarias and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Van Health Sciences Journal / Van Sağlık Bilimleri Dergisi is the property of Van Yuzuncu Yil University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The main functions of the testis, steroidogenesis and spermatogenesis, depend on the endocrine axis and systemic and local tolerance mechanisms. Infectious or non-infectious diseases may disturb testicular immune regulation causing infertility. Literature has illustrated that bacterial and viral infections lead to autoimmune infertility: either sperm antibodies or autoimmune epidydimoorchitis. However, little is known about the association between non-infectious testicular pathologic diseases and autoimmunity. Here we review the novel aspect of varicocele and testicular cord torsion pathology linked to inflammation and discuss how immune factors could contribute to or modulate autoimmunity in ipsi- and contralateral testis. [ABSTRACT FROM AUTHOR]

Copyright of Environnement, Risques & Santé is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: For early diagnosis, testicular self-examination (TSE) is crucial. Videos of TSE have increased on social media platforms. In this study, we assessed the reliability of TSE videos on YouTube. Materials and Methods: The keywords including "testicular self-examination", and "testis mass" were used for searching on YouTube (http://www.youtube.com). A total of 1311 videos were investigated, and a total of 207 videos were included in the study. Shorter videos (below 1.30 minutes) and irrelevant videos were not included in the study. Results: The median number of views was 1846 (interquartile range: 406-30310). Most of the videos were uploaded by profit organizations (57.5%). The DISCERN score and Global Quality Score (GQS) were significantly higher in the health professional group (p=0.003, and p<0.001, respectively). In addition, the degree of information was generally low in both groups. However, misinformation was statistically lower in the health professional group. Conclusion: YouTube is a popular platform for promoting videos about TSE. In particular, not checking health-related videos while uploading causes poor quality videos to be uploaded. Videos of TSE have a low degree of misinformation. However, the DISCERN and GQS were also low. [ABSTRACT FROM AUTHOR]

Objective: Multiple sclerosis is an autoimmune disease of central nervous system (CNS). There are a few articles studying the risk factors of developing MS in men. Male infertility can stem from a range of etiological factors such as genetics or environment. In the context of MS, research suggests a potential link, possibly due to shared immunological and inflammatory mechanisms. Therefore, we designed this study to evaluate the relationship between male infertility and MS development. Materials and methods: We systematically searched PubMed, Embase, Scopus, web of science, Google scholar and gray literature including references of the references as well as conference papers which were published up to June 2021. The search strategy in PubMed was ("Infertility, Male"[Mesh] OR [Male Infertility] OR [Sterility, Male] OR [Male Sterility] OR [Subfertility, Male] OR [Male Subfertility] OR [SubFertility, Male] OR [Male Sub-Fertility] OR [Sub Fertility, Male]) AND ("Multiple Sclerosis"[Mesh] OR [Sclerosis, Multiple] OR [Sclerosis, disseminated] OR [Disseminated Sclerosis] OR [MS] OR [Multiple Sclerosis, Acute Fulminating]) AND ("Testicular Diseases"[Mesh] OR [Disease, Testicular] OR [Diseases, Testicular] OR [Testicular Disease]) AND ("Multiple Sclerosis"[Mesh] OR [Sclerosis, Multiple] OR [Sclerosis, disseminated] OR [Disseminated Sclerosis] OR [Multiple Sclerosis, Acute Fulminating] OR [MS]). Results: The literature search revealed 197 articles, after deleting duplicates 109 remained. For the meta-analysis, 3 studies were included. Totally, 2090 MS cases as well as 3895562 healthy subjects were enrolled. One hundred and fourteen infertile men were in MS group and 139716 infertile men were in controls. The pooled OR for male factor infertility and odds of developing MS was1.87 (95% CI: 0.89-3.94) (I2=86.1%, P=0.001). Conclusion: The results of this systematic review and meta-analysis show that there is no relationship between male factor infertility and risk of MS. [ABSTRACT FROM AUTHOR]

Simple Summary: In andrology, ultrasound provides important information on the patient's state of health. In dogs, as in humans and other mammals, many reproductive pathologies can affect the male's general and reproductive health. In today's society, the dog represents a full member of the family unit, thus early and timely diagnosis represents an important step in the treatment and resolution of the testicular pathological process, improving both reproductive and general health. Ultrasound represents a noninvasive diagnostic technique and is well tolerated by patients. Several new ultrasound-based technologies developed in recent years have expanded the tools available to the andrologist. The present review aims to describe all ultrasound techniques applied to canine testis evaluation, including the well-known basic B-Mode ultrasonography and colour Doppler, and new and advanced technologies, such as contrast-enhanced ultrasonography (CEUS) and ultrasound elastography. The principles of the different technologies, their applications, and the relevant findings in normal and abnormal testicular conditions, often completed by images, are described and discussed. Thus, the present review, describing the ultrasound-based tools available to canine andrologists, promotes the diffusion of advanced technologies for the rapid identification of canine testicular disease, promoting the chances of a resolution and restoration of reproductive function. Ultrasonography is a valuable diagnostic tool extensively used in the andrology of human and domestic animals, including dogs. This review aims to provide an overview of various technologies based on ultrasound, from the basic B-Mode ultrasonography to the more recent advancements, such as contrast-enhanced ultrasonography (CEUS) and ultrasound elastography (UEl), all of which are utilized in the evaluation of canine testicles. The review outlines the principles behind each of these technologies and discusses their application in assessing normal and abnormal testicular conditions. B-mode canine testicular ultrasonography primarily focuses on detecting focal lesions but has limitations in terms of objectivity. Other technologies, including Doppler ultrasonography, B-Flow, and CEUS, allow for the characterization of vascular patterns, which could be further measured using specific applications like spectral Doppler or quantitative CEUS. Additionally, ultrasound elastography enables the assessment of parenchyma stiffness both qualitatively and quantitatively. These ultrasound-based technologies play a crucial role in andrology by providing valuable information for evaluating testicular function and integrity, aiding in the identification of pathological conditions that may impact the health and quality of life of male dogs. [ABSTRACT FROM AUTHOR]

Introduction/Purpose: Percutaneous core‐needle biopsy of the testicle has been shown to be a safe and effective method of obtaining tissue for histological analysis and can be considered in specific clinical scenarios. While the use of spermatic cord block has been shown to be effective in pain relief in the emergent setting and as an anaesthetic option for inguinal surgery, its use in percutaneous core‐needle biopsy has not been well described. Through this case series, we present our experience and technique of ultrasound‐guided percutaneous core‐needle biopsy using spermatic cord block in the setting of indeterminant testicular masses. Methods: Our departmental biopsy database was reviewed to identify patients who underwent percutaneous core‐needle biopsy of the testicle from March 2010 to July 2022 and who also received spermatic cord block during the procedure. Results: Three patients were identified who met the search criteria. All three patients presented for the evaluation of indeterminant testicular mass and had a known non‐testicular primary cancer diagnosis at the time of biopsy. All three biopsies were performed using a combination of spermatic cord block, moderate sedation, and local anaesthetic. Biopsies were obtained using an 18‐gauge spring‐loaded device with 4‐5 core samples obtained during each procedure. All biopsies were well tolerated without significant pain or post‐procedure complications. Discussion: Ultrasound‐guided percutaneous core‐needle testicular biopsy using spermatic cord block is a safe and effective option in sampling indeterminate testicular masses while maintaining patient comfort. Conclusion: The inclusion of a spermatic cord block in combination with local anaesthetic and moderate sedation has become standard practice in our institution, as we believe this maximises patient comfort and safety resulting in a better patient experience. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to compare the immediate and long-term outcomes after high spermatic vessel ligation (HSVL) and low spermatic vessel ligation (LSVL) in a high undescended testis (UDT) model in rats. Materials and Methods: A prospective randomized controlled study was conducted on 24 male Wistar rats. The rats were randomly divided into three groups. Group A underwent a sham laparotomy and acted as the control. Group B underwent HSVL of both testicular vessels. Group C underwent LSVL of both testicular vessels. Each group was again subdivided into two subgroups. One sub-group underwent blood collection and testicular biopsy of both testes 24 h after the procedure to demonstrate immediate changes. Other subgroups underwent blood sample collection and testicular biopsy of both testes on day 50 following the procedure for hormonal changes and long-term changes. Results: All the testes in HSVL showed atrophy (100%) in the long term, whereas LSVL showed atrophy in 12.5% of testes, even though both groups showed adequate neovascularization. Testes in HSVL showed poor bleeding on incision at both 24 h and day 50. On histology, 75% of testes in HSVL showed complete necrosis, and 50% in LSVL showed partial necrosis at 24 h. On day 50, all the testes in HSVL (100%) showed complete necrosis with dystrophic calcification, whereas all the testes in LSVL showed normal histology with good maturation of seminiferous tubules. There was no significant difference in testosterone levels between both groups. Conclusions: Both immediate and long-term changes following LSVL showed an increase in blood flow to the testis after ligation through collaterals and reverses early ischemic changes to the testis. Given the higher testicular atrophic rate after HSVL, LSVL or at least low ligation can be preferred for the management of high intra-abdominal UDT. [ABSTRACT FROM AUTHOR]

Introduction: A hydrocele is an abnormal collection of serous fluid in a part of the processes vaginalis and the tunica vaginalis. Acquired hydroceles are primary or it is idiopathic, or it is secondary to epididymal or testicular diseases. The aim of this study is to compare post operative complications, hospital stay and duration of surgical procedure between hydrocele window vs jaboulay procedure in a tertiary care hospital named SCB MEDICAL COLLEGE AND HOSPITAL CUTTACK, ODISHA. Patients and Methods: • Type-prospective observational study • Time period of study: March 2021-October 2022. • Place of study: Department of General Surgery S.C.B. medical college & Hospital, Cuttack. • Sample size: Convenient sample Results:- those who underwent the hydrocele window operation was 17.34 SD 1.81 minutes with a range of 15 to 20 minutes as compared to conventional hydrocelectomy i.e was 31.58 SD 2.05 minutes. The mean time of hospital stay among the patients who underwent conventional hydrocelectomy (jaboulay's) was 71.82 SD 10.76 hours with a range of 48 to 88 hours and those who underwent window operation was 44.04 SD 13.59 hours with a range of 24 to 79 hours. Overall complication rate was less compared to conventional hydrocelectomy. Conclusion: From the present study, the post operative complications, hospital stay and duration of surgery is less in hydrocele window procedure with comparision to the Jaboulay's procedure. [ABSTRACT FROM AUTHOR]

Abstract Introduction Testicular cancer is the most common cancer in men aged 15–44 years in many countries. Most men with testicular cancer present with a lump. Testicular symptoms are more likely to occur secondary to benign diseases like epididymo‐orchitis, a common sexually transmitted infection. Gender and sexual minorities are at an increased risk of testicular diseases and health disparities. The aim of this study was to co‐design an inclusive community‐based campaign to promote testicular awareness. Methods This study uses the World Café methodology. Participation was sought from Lesbian, Gay, Bisexual, Transgender and Queer+ friendly organisations, testicular cancer survivors, health policy makers, media and marketing experts and graphic designers. Participants engaged in three rounds of conversations to co‐design the campaign. Data were collected using drawing sheets, artefact cards, sticky notes, coloured markers and a voice recorder. Deductive thematic analysis was conducted. Results Seventeen individuals participated in the study. Six themes emerged from the analysis as follows: (i) online communication; (ii) offline communication; (iii) behavioural targeting and education; (iv) campaign frequency and reach; (v) demographic segmentation; and (vi) campaign identity. The use of social media for campaign delivery featured strongly in all conversations. Participants also recommended offline communication using posters and radio/television advertisements to scale up the campaign and achieve wider reach. Advertisements to overcome embarrassment surrounding testicular health were particularly recommended. Participants emphasised that campaign delivery must be dynamic whilst ensuring that the health‐promoting messages are not diluted or lost. They stressed the importance of being inclusive and tailoring the campaign to different age groups, gender identities and sexual orientations. Conclusions Study recommendations will be used to design and deliver the campaign. Future research will be needed to evaluate the feasibility, acceptability, cost and effect of the campaign on promoting testicular awareness and early detection of testicular diseases. Patient or Public Contribution A participatory research approach was used to co‐design the campaign with members of Lesbian, Gay, Bisexual, Transgender and Queer+ (LGBTQ+) friendly organisations, LGBTQ+ student bodies, LGBTQ+ staff networks, LGBTQ+ sports clubs, men's health organisations, testicular cancer survivors, health policy makers, media and marketing experts and graphic designers.

Background: Splenogonadal fusion (SGF) is a rare developmental choristoma in which ectopic splenic tissue is aberrantly attached to the gonads, mostly in the scrotum. It is a great clinical masquerader, and accurate preoperative diagnosis is often difficult due to the rarity of this entity. Many patients tend to undergo unnecessary surgical explorations and also orchiectomy. Accordingly, this article aims to review the latest literature regarding SGF and a description of the radiological features of this rare entity. Multiple systematic methods were used to find the latest publications on splenogonadal fusion by searching the Scopus, PubMed, and Google Scholar databases online since 2013. The latest comprehensive review of this rare entity was of 61 cases by Malik et al. in 2013. We reviewed all the cases of SGF reported in the literature in the last 10 years between 2013 and 2022 with an emphasis on diverse clinical presentations and radiologic findings. Along with this, a surgical and pathological proved case of SGF will be presented with emphasis on imaging findings. Splenogondal fusion is an uncommon differential diagnosis in patients with scrotal swelling. The current literature review showed the discontinuous type (63%) of SGF to be more common than the continuous (37%) type in contradiction to the previous literature review. Orchiectomy was done in 36% of cases as compared to 24% as described in the latest review by Malik et al. Conclusions: Knowledge of this entity along with familiarization with its imaging features among radiologists is essential for surgical prognostication and avoiding unnecessary orchiectomy. We suggest that the addition of colour Doppler and elastography to routine grey-scale ultrasound can increase diagnostic confidence. Subsequent cross-sectional imaging with magnetic resonance imaging (MRI) helps categorize the subtype and pre-operative planning. [ABSTRACT FROM AUTHOR]

STUDY QUESTION What is the long-term outcome of individuals born with bilateral testicular regression (BTR) in relation to its underlying etiology? SUMMARY ANSWER Statural growth and pubertal development are adequate with incremental doses of testosterone replacement therapy (TRT); however, penile growth is often suboptimal, especially in those with a suspected genetic etiology (i.e. heterozygous DHX37 variants) or a micropenis at birth. WHAT IS KNOWN ALREADY BTR is a rare and poorly understood condition. Although a vascular origin has been postulated, heterozygous missense variants in DHX37 have been attributed to the phenotype as well. How these various etiologies impact the clinical phenotype, gonadal histology and outcome of BTR remains unclear. STUDY DESIGN, SIZE, DURATION For this cross-sectional study, individuals with BTR were recruited in eight Belgian pediatric endocrinology departments, between December 2019 and December 2022. A physical exam was performed cross-sectionally in all 17 end-pubertal participants and a quality of care questionnaire was completed by 11 of them. Exome-based panel testing of 241 genes involved in gonadal development and spermatogenesis was performed along with a retrospective analysis of presentation and management. A centralized histological review of gonadal rests was done for 10 participants. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 35 participants (33 with male, 1 with female, and 1 with non-binary gender identity) were recruited at a mean age of 15.0 ± 5.7 years. MAIN RESULTS AND THE ROLE OF CHANCE The median age at presentation was 1.2 years [0–14 years]. Maternal gestational complications were common (38.2%), with a notably high incidence of monozygotic twin pregnancies (8.8%). Heterozygous (likely) pathogenic missense variants in DHX37 (p.Arg334Trp and p.Arg308Gln) were found in three participants. No other (likely) pathogenic variants were found. All three participants with a DHX37 variant had a microphallus at birth (leading to female sex assignment in one), while only six of the remaining 31 participants without a DHX37 variant (19.4%) had a microphallus at birth (information regarding one participant was missing). Testosterone therapy during infancy to increase penile growth was more effective in those without versus those with a DHX37 variant. The three participants with a DHX37 variant developed a male, female, and non-binary gender identity, respectively; all other participants identified as males. TRT in incremental doses had been initiated in 25 participants (median age at start was 12.4 years). Final height was within the target height range in all end-pubertal participants; however, 5 out of 11 participants (45.5%), for whom stretched penile length (SPL) was measured, had a micropenis (mean adult SPL: 9.6 ± 2.5). Of the 11 participants who completed the questionnaire, five (45.5%) reported suboptimal understanding of the goals and effects of TRT at the time of puberty induction. Furthermore, only 6 (54.5%) and 5 (45.5%) of these 11 participants indicated that they were well informed about the risks and potential side effects of TRT, respectively. Histological analysis of two participants with DHX37 variants suggested early disruption of gonadal development due to the presence of Müllerian remnants in both and undifferentiated gonadal tissue in one. In eight other analyzed participants, no gonadal remnants were found, in line with the BTR diagnosis. LIMITATIONS, REASONS FOR CAUTION The limitations of this study include the relatively small sample size (n = 35) and the few individuals with DHX37 variants (n = 3). Furthermore, data on the SPL were often missing, due to this being undocumented or refused by participants. WIDER IMPLICATIONS OF THE FINDINGS TRT provides adequate statural growth, even when initiated in late adolescence, thus providing time for physicians to explore the patients' gender identity if needed. However, sufficient and understandable information regarding the effects and side effects of TRT is required throughout the management of these patients. SPL remains suboptimal in many individuals and could be improved by TRT during infancy to mimic the physiological mini-puberty. An environmental origin in some participants is supported by the high incidence of gestational complications (38.2%) and by the three monozygotic twin pregnancies discordant for the BTR phenotype. Individuals with a heterozygous DHX37 variant have a more severe phenotype with severely restricted penile growth until adulthood. Histological analysis confirmed DHX37 as a gonadal development, rather than a BTR-related, gene. STUDY FUNDING/COMPETING INTEREST(S) Funding was provided by the Belgian Society for Pediatric Endocrinology and Diabetology (BESPEED) and by Ghent University Hospital under the NucleUZ Grant (E.D.B.). M.C. and E.D.B. are supported by an FWO senior clinical investigator grant (1801018N and 1802220N, respectively). The authors report no conflicts of interest. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Purpose: To reveal the underlying roles that pyroptosis-related genes (PRGs) played in human spermatogenic dysfunction. Methods: One discovery set and three validation sets were employed to inspect the previously reported 33 PRGs in the human testis with different status of spermatogenesis. PRGs that differentially expressed in all sets were considered as key differentially expressed pyroptosis-related genes (PR-DEGs). The relationships between key PR-DEGs and samples' clinicopathological, therapeutic, and immune patterns were respectively studied. Single-cell RNA sequencing (scRNS-seq) analyses were conducted to show the expression changes and related mechanisms of key PR-DEGs at a single-cell resolution. Results: CASP4 and GPX4 were identified as two key PR-DEGs. These two genes were significantly dysregulated in spermatogenic dysfunctional samples, but with opposite tendency. CASP4 was negatively correlated with Johnsen scores but positively correlated with follicle-stimulating hormone (FSH) levels (all p < 0.05), while GPX4 exhibited significant positive correlations with Johnsen scores and negative relevance with FSH. For treatments, both molecules showed a prospective value of being predictors for sperm retrieval surgeries. Moreover, CASP4 and GPX4 were potential immunoregulators in the testicular immune microenvironment and showed significant correlations to testicular macrophages and mast cell infiltration. In scRNA-seq analyses, GPX4 was highly expressed in germ cells, which therefore suffered a sharp reduction with the loss of germ cells in spermatogenic dysfunction. On the other hand, CASP4 were basically somatic cell–derived, and the proportion of CASP4-positive Leydig cells significantly increased in disease testes (p = 0.0001). Conclusion: In all, we revealed two key PRGs of human testes that might be functional in spermatogenic dysfunction. [ABSTRACT FROM AUTHOR]

Background: The aim of this prospective study was to determine the relationship between testicular shear wave elastography (SWE) and sperm count in infertile male patients and to evaluate diagnostic performance. Materials and Methods: The study was carried out with 113 patients over 18 years of age who were diagnosed as infertility.All patients underwent US examination and virtual touch tissue imaging measurement (VTIQ) SWE examination. A total of 6 measurements were made in each testis. Volume measurements of testes were calculated with US examination. Patients were evaluated for varicocele using color Doppler ultrasonography Results: Right and left testis volume values in azoospermia patients found statistically different and lower than other groups(p=0,001).The mean SWE values in all zones were significantly higher in azoospermia patients compared to the other groups (p=0.001).Moderate positive correlation was found between sperm count and mean volume (r =0.545, p =0.001).Negative correlation was found between sperm count and mean SWE (r =-0.429, p = 0.001).There was a moderate negative relationship between mean volume and mean SWE (r =-0.590, p =0.001). Using ROC analysis between normal sperm and azospermia patients, the cut-off value was 2.06 m/sec.sensitivity 72% specificity was measured 87.88% (p<0,001; AUC=0,837; Sensitivity= 72,00% (95% GA 46,5-85,1); Specifity= 87,88% (95% GA 81,5-95,2). Using ROC analysis between the azoospermia patient group and the oligospermia patient group, the cut-off point was 2.04m/sec. For differentiating azoospermia and oligospermia patients groups, the sensitivity (sensitivity) was 72% and the specifity was 83.33% (p<0,001; AUC=0,789; Sensitivity= 72,00% (95% GA 46,5-85,1); Specifity=83,33% (95% GA 81,5-95). Conclusions: SWE is a noninvasive method for the evaluation of testicular parenchyma in male patients whohave infertility and may provide helpful information in addition to gray scale and RDUS. [ABSTRACT FROM AUTHOR]

Copyright of Kocatepe Veterinary Journal / Kocatepe Veteriner Dergisi is the property of Afyon Kocatepe University, Faculty of Veterinary Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Testicular adrenal rest tumors (TARTs) are a common complication in male patients with congenital adrenal hyperplasia (CAH). The aim of our cross-sectional cohort study is to estimate the frequency of TARTs with the correlation of genotype and disease control on tumor development. Thirty-five male patients, aged 14–26 years, were included in the study, all followed by the same center of pediatric endocrinology in Bologna. We studied genotypes, hormonal profiles at different time intervals and testicular ultrasound. A logistic regression model with multivariant analysis was developed for the statistical analysis. TARTs were detected in 31.4% of the cases, 90.9% of them had a classic form with salt wasting, while 9.1% had a non-classic form. Additionally, a significant correlation between the incidence of TARTs and severity of genotype was detected. Patients with TARTs had markedly worse metabolic control on average (p = 0.027), reflected by high ACTH, 17OH progesterone, and overall delta4-androstenedione. In conclusion, a screening tool is mandatory, especially (but not exclusively) in patients with the most severe forms of CAH and poor endocrine control of the disease. [ABSTRACT FROM AUTHOR]

Testicular compartment syndrome (TCS) impedes the microcirculation in the testicle, resulting from increased venous resistance or an extraluminal compression that might lead to a cascade of hypoxia, ischemia, and gangrene. We report a case of fulminant necrotizing orchitis occurring in a 45‑year‑old immunocompetent patient in the form of TCS. The patient underwent imaging, which suggested extensive localized right testicular abscess formation, for which the patient underwent guided drainage from the abscess. Subsequently, the patient was started on culture‑sensitive intravenous antibiotics. Due to the failure of conservative treatment and symptomatic deterioration, we planned scrotal exploration. Intraoperatively, we found that the testicular tissue was necrotic and completely replaced by frank pus, with an already ruptured tunica, due to higher compartmental pressure. The patient underwent a right orchidectomy. The postoperative course in the hospital was uneventful. We report that this case as TCS is rare, and all surgeons should be aware of such possibility of occurrence. [ABSTRACT FROM AUTHOR]

Background: Testicular cancer (TC) is the most common malignancy in men under 50 years. Athletes are particularly at risk of testicular trauma and diseases. Experiencing negative testicular symptoms does not necessarily imply that men seek help. Men’s awareness of testicular diseases is often lacking and their intention to seek help for testicular symptoms is sub-optimal. The use of virtual reality (VR) may be effective in promoting men’s awareness of testicular diseases. The Enhancing Men's Awareness of Testicular diseases (E-MAT) feasibility trial aims to test the effect of E-MATVR (intervention; interactive experience using virtual reality [VR]) compared to information delivered Electronically E-MATE (control; same information as E-MATVR delivered as plain text and images) on testicular knowledge, and testicular self-examination among male athletes affiliated with a national sports organisation. The overall aim of this mixed method process evaluation will be to describe (i) the experiences of participants and key stakeholders (e.g., researchers); (ii) the perceived effectiveness of intervention components; (iii) acceptability of the feasibility trial and intervention procedures; (iv) the relationship between implementation, mechanisms, and context; and (v) the barriers and facilitators to support effective conduct of a future definitive trial. Methods: This mixed method process evaluation will use a descriptive realist evaluation. Quantitative data will be gathered using a usability and satisfaction survey, in addition to fidelity checks during intervention delivery. Quantitative data will be analysed using descriptive and inferential statistics. Qualitative data will be gathered from semi-structured interviews and focus groups with participants and key stakeholders to investigate their experiences of E-MATVR and E-MATE, and explore areas for improvement. Thematic analysis of transcripts will be conducted. Conclusions: This process evaluation will provide an in-depth understanding of how the interventions worked within this cohort and lessons for a future definitive trial.

ABSTRACT Objective To report the effects of a tunica vagina flap on testicular compartment syndrome. Methods This single-arm clinical trial was conducted from September 2020 to October 2021. Consecutive patients with suspected testicular torsion within 24 hours of pain onset were included. Patients with past testicular torsion, bilateral torsion, or previous atrophy were excluded. The tunica vaginalis was opened, and the intratesticular pressure was measured before testicular retrieval from the scrotum and detorsion (P1), after detorsion (P2), and after transverse incision (P3). A tunica vaginalis flap was performed and a new intratesticular pressure was recorded (P4). The contralateral testicular pressure was recorded before fixation (Pc). The minimum follow-up period was 6 months. Results Fifteen patients were recruited from September 2020 to October 2021. Nine patients completed the follow-up. The median age (range) was 15 years (9-19). The mean P1, P2, P3, P4, and Pc (range) were 43, 60, 23, 20, and 14mmHg, respectively. The atrophy rate was 66.3% and the viability was 88.9%. No major complications were observed. Conclusion The modified tunica vaginalis flap in acute testicular torsion decreased intratesticular pressure. Furthermore, normal testicular pressure can improve testicular preservation. It can also decrease testicular pressure to normal levels and preserve the testicular parenchyma.

BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) are a component of firefighting foams used at military installations. Although high PFAS exposures have been related to cancer risks among civilian populations, the effects for military personnel are unclear. OBJECTIVES: We investigated associations between serum PFAS concentrations and testicular germ cell tumors (TGCT) among U.S. Air Force servicemen. METHODS: This nested case–control study involved active-duty Air Force servicemen with sera from the Department of Defense Serum Repository. We selected 530 cases and 530 controls individually matched on birth date, race and ethnicity, year entered the service, and year of sample collection, with prediagnostic serum samples collected between 1988 and 2017. A second prediagnostic sample, collected a median of 4 y after the first, was selected for 187 case–control pairs. Seven PFAS were quantified using isotope-dilution tandem mass spectrometry. Odds ratios (ORs) and 95% confidence intervals (CIs) from conditional logistic regression adjusting for military grade, number of deployments, and, in some models, other PFAS, estimated associations between PFAS concentrations (categorized using quartiles among controls) and TGCT. RESULTS: Elevated concentrations of some PFAS were observed for military employment in firefighting [perfluorooctanesulfonic acid (PFOS), perfluorohexanesulfonic acid (PFHxS), perfluorooctanoic acid] and service at a base with high PFAS concentrations in drinking water (PFHxS). Elevated PFOS concentrations in the second sample were positively associated with TGCT [OR for fourth vs. first quartile (ORQ4)=2.6, 95% CI: 1.1, 6.4; 푝trend =0.02], including after adjustment for other PFAS (ORQ4 =4.6, 95% CI: 1.4, 15.1; 푝trend =0.009). Associations with PFOS in the first/only samples were weak and not statistically significant. Elevated concentrations of perfluorononanoic acid were inversely associated with TGCT, whereas results were null for other PFAS. DISCUSSION: We identified service-related predictors of PFAS concentrations and increased TGCT relative risks with elevated PFOS concentrations among Air Force servicemen. These findings warrant further investigation in other populations and military service branches. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the etiologic agent of the coronavirus disease 2019 (COVID-19), which caused one of the pandemics with the highest mortalities with millions of deaths and hundreds of millions of cases to date. Due to its potential for airborne transmission, many studies have focused on SARS-CoV-2 primarily as a respiratory disease. However, the spread of SARS-CoV-2 to non-respiratory organs has been experimentally demonstrated and clinically observed. During autopsy studies, histopathological lesions, and disruption of the blood-testes barrier (BTB) have been observed in the male reproductive tract. Here, we review findings from both autopsy cases and animal models that demonstrate testicular disease due to COVID-19 and present an overview of the pathological alterations that occur in the testes resulting from SARS-CoV-2 infection and explore its potential mechanisms. [ABSTRACT FROM AUTHOR]

Nonobstructive azoospermia (NOA) is one of the most important causes of male infertility, accounting for 10–15% of infertile men worldwide. Among these, more than 70% of cases are idiopathic NOA (iNOA), whose pathogenesis and molecular basis remain unknown. This work profiles 3696 human testicular single‐cell transcriptomes from 17 iNOA patients, which are classified into four classes with different arrest periods and variable cell proportions based on the gene expression patterns and pathological features. Genes related to the cell cycle, energy production, and gamete generation show obvious abnormalities in iNOA germ cells. This work identifies several candidate causal genes for iNOA, including CD164, LELP1, and TEX38, which are significantly downregulated in iNOA germ cells. Notably, CD164 knockdown promotes apoptosis in spermatogonia. Cellular communications between spermatogonial stem cells and Sertoli cells are disturbed in iNOA patients. Moreover, BOD1L2, C1orf194, and KRTCAP2 are found to indicate testicular spermatogenic capacity in a variety of testicular diseases, such as Y‐chromosome microdeletions and Klinefelter syndrome. In general, this study analyzes the pathogenesis of iNOA from the perspective of germ cell development, transcription factor (TF) regulatory networks, as well as germ cell and somatic cell interactions, which provides new ideas for clinical diagnosis. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the protective effects of ellagic acid on testicular ischemia/reperfusion injury in rats. Materials and Methods: Twenty-one Sprague-Dawley rats were randomly divided into three groups: sham, ischemia/reperfusion (I/R), I/R + ellagic acid (EA). All animals underwent left scrotal exploration. In all groups except the sham group, the left testes were rotated 720 degrees clockwise for 3 h and 3 h reperfusion. 10 mg/kg ellagic acid was administered intraperitoneally to the I/R+E group before reperfusion. Then, the left orchiectomy was performed. The testes underwent biochemical and histological examination. Results: There was a significant difference between the sham and the I/R, I/R+EA groups according to the Cosentino system (p<0.001, p=0.036), and there was no difference between the I/R and IR+EA groups (p=0.319). A significant difference was found between sham and I/R groups according to Johnsen spermatogenesis score (p<0.001), but there was no significant difference between sham and I/R+EA groups (p=0.063). Superoxide dismutase, catalase, malondialdehyde, total oxidant status values were statistically different between I/R and I/R+EA groups (p=0.001, 0.002, 0.002, 0.001 respectively). Conclusion: Ellagic acid has a protective effect against testicular ischemia/reperfusion injury in rats. [ABSTRACT FROM AUTHOR]