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Varicocele
varicocele is an abnormal enlargement of the pampiniform venous plexus in the scrotum. This plexus of veins drains blood from the testicles back to the heart. The vessels originate in the abdomen and course down through the inguinal canal as part of the spermatic cord on their way to the testis. Varicoceles occur in around 15% to 20% of all men. The incidence of varicocele increase with age. Signs and symptoms Varicocele might be noticed as soft lumps, usually above the testicle and mostly on the left side of the scrotum. Right-sided and bilateral varicocele does also occur. Men with varicocele can feel symptoms of pain or heaviness in their scrotum. Large varicoceles present as plexus of veins and may be described as a "bag of worms". Varicocele is sometimes discovered when investigating the cause of male infertility. Cause There are three main theories as to the anatomical cause; the first has to do with the geometry of the veins, wherein the vein on the left side connec ...
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Scrotal Ultrasound
Scrotal (or transscrotal) ultrasound is a medical ultrasound examination of the scrotum. It is used in the evaluation of testicular pain, and can help identify solid masses. Indications Although the development of new imaging modalities such as computerized tomography and magnetic resonance imaging have opened a new era for medical imaging, high-resolution sonography remains as the initial imaging modality of choice for evaluation of scrotal disease. Many of the disease processes, such as testicular torsion, epididymo-orchitis, and intratesticular tumor, produce the common symptom of pain at presentation, and differentiation of these conditions and disorders is important for determining the appropriate treatment. High-resolution ultrasound helps in better characterize some of the intrascrotal lesions, and suggest a more specific diagnosis, resulting in more appropriate treatments and avoiding unnecessary operation for some of the diseases. Imaging technique For any scrotal examina ...
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Spermatic Cord
The spermatic cord is the cord-like structure in males formed by the vas deferens (''ductus deferens'') and surrounding tissue that runs from the deep inguinal ring down to each testicle. Its serosal covering, the tunica vaginalis, is an extension of the peritoneum that passes through the transversalis fascia. Each testicle develops in the lower thoracic and upper lumbar region and migrates into the scrotum. During its descent it carries along with it the vas deferens, its vessels, nerves etc. There is one on each side. Structure The spermatic cord is ensheathed in three layers of tissue: * ''external spermatic fascia'', an extension of the innominate fascia that overlies the aponeurosis of the external oblique muscle. * '' cremasteric muscle and fascia'', formed from a continuation of the internal oblique muscle and its fascia. * '' internal spermatic fascia'', continuous with the transversalis fascia. The normal diameter of the spermatic cord is about 16 mm (range 11 ...
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Male Infertility
Male infertility refers to a sexually mature male's inability to impregnate a fertile female. In humans it accounts for 40–50% of infertility. It affects approximately 7% of all men. Male infertility is commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity. More recently, advance sperm analyses that examine intracellular sperm components are being developed. Age considerations There is a decrease in sperm concentration as men age: 90% of seminiferous tubules in men in their 20s and 30s contain spermatids, whereas men in their 40s and 50s have spermatids in 50% of their seminiferous tubules, and only 10% of seminiferous tubules from men aged > 80 years contain spermatids. In a random international sample of 11,548 men confirmed to be biological fathers by DNA paternity testing, the oldest father was found to be 66 years old at the birth of his child; the ratio of DNA-confirmed versus DNA-rejected paternity tests around tha ...
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Nutcracker Syndrome
The nutcracker syndrome (NCS) results most commonly from the compression of the left renal vein (LRV) between the abdominal aorta (AA) and superior mesenteric artery (SMA), although other variants exist. The name derives from the fact that, in the sagittal plane and/or transverse plane, the SMA and AA (with some imagination) appear to be a nutcracker crushing a nut (the renal vein). Furthermore, the venous return from the left gonadal vein returning to the left renal vein is blocked, thus causing testicular pain (colloquially referred to as "nut pain"). There is a wide spectrum of clinical presentations and diagnostic criteria are not well defined, which frequently results in delayed or incorrect diagnosis. The first clinical report of Nutcracker phenomenon appeared in 1950. This condition is not to be confused with superior mesenteric artery syndrome, which is the compression of the third portion of the duodenum by the SMA and the AA. Signs and symptoms The signs and symptoms of ...
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Pampiniform Venous Plexus
The pampiniform plexus (from Latin ''pampinus'', a tendril, + ''forma'', form) is a venous plexus – a network of many small veins found in the human male spermatic cord, and the suspensory ligament of the ovary. In the male, it is formed by the union of multiple testicular veins from the back of the testis and tributaries from the epididymis. In the male The veins of the plexus ascend along the spermatic cord in front of the vas deferens. Below the superficial inguinal ring they unite to form three or four veins, which pass along the inguinal canal, and, entering the abdomen through the deep inguinal ring, coalesce to form two veins. These again unite to form a single vein, the testicular vein, which opens on the right side into the inferior vena cava, at an acute angle, and on the left side into the left renal vein, at a right angle. The pampiniform plexus forms the chief mass of the cord. In addition to its function in venous return from the testes, the pampiniform plexu ...
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Scrotum
The scrotum or scrotal sac is an anatomical male reproductive structure located at the base of the penis that consists of a suspended dual-chambered sac of skin and smooth muscle. It is present in most terrestrial male mammals. The scrotum contains the external spermatic fascia, testes, epididymis, and ductus deferens. It is a distention of the perineum and carries some abdominal tissues into its cavity including the testicular artery, testicular vein, and pampiniform plexus. The perineal raphe is a small, vertical, slightly raised ridge of scrotal skin under which is found the scrotal septum. It appears as a thin longitudinal line that runs front to back over the entire scrotum. In humans and some other mammals the scrotum becomes covered with pubic hair at puberty. The scrotum will usually tighten during penile erection and when exposed to cold temperatures. One testis is typically lower than the other to avoid compression in the event of an impact. The scrotum is biolo ...
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Wound After Microsurgical Varicocelectomy
A wound is a rapid onset of injury that involves lacerated or punctured skin (an ''open'' wound), or a contusion (a ''closed'' wound) from blunt force trauma or compression. In pathology, a ''wound'' is an acute injury that damages the epidermis of the skin. To heal a wound, the body undertakes a series of actions collectively known as the wound healing process. Classification According to level of contamination, a wound can be classified as: * Clean wound – made under sterile conditions where there are no organisms present, and the skin is likely to heal without complications. * Contaminated wound – usually resulting from accidental injury; there are pathogenic organisms and foreign bodies in the wound. * Infected wound – the wound has pathogenic organisms present and multiplying, exhibiting clinical signs of infection (yellow appearance, soreness, redness, oozing pus). * Colonized wound – a chronic situation, containing pathogenic organisms, difficult to heal (e.g. ...
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Retroperitoneal
The retroperitoneal space (retroperitoneum) is the anatomical space (sometimes a potential space) behind (''retro'') the peritoneum. It has no specific delineating anatomical structures. Organs are retroperitoneal if they have peritoneum on their anterior side only. Structures that are not suspended by mesentery in the abdominal cavity and that lie between the parietal peritoneum and abdominal wall are classified as retroperitoneal. This is different from organs that are not retroperitoneal, which have peritoneum on their posterior side and are suspended by mesentery in the abdominal cavity. The retroperitoneum can be further subdivided into the following: *Perirenal (or perinephric) space *Anterior pararenal (or paranephric) space *Posterior pararenal (or paranephric) space Retroperitoneal structures Structures that lie behind the peritoneum are termed "retroperitoneal". Organs that were once suspended within the abdominal cavity by mesentery but migrated posterior to the ...
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Laparoscopic Surgery
Laparoscopy () is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.MedlinePlus > Laparoscopy Update Date: 21 August 2009. Updated by: James Lee, MD // No longer valid Laparoscopic surgery, also called minimally invasive procedure, bandaid surgery, or keyhole surgery, is a modern surgical technique. There are a number of advantages to the patient with laparoscopic surgery versus an exploratory laparotomy. These include reduced pain due to smaller incisions, reduced hemorrhaging, and shorter recovery time. The key element is the use of a laparoscope, a long fiber optic cable system that allows viewing of the affected area by snaking the cable from a more distant, but more easily accessible location. Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery pe ...
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Urology
Urology (from Greek οὖρον ''ouron'' "urine" and '' -logia'' "study of"), also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary-tract system and the reproductive organs. Organs under the domain of urology include the kidneys, adrenal glands, ureters, urinary bladder, urethra, and the male reproductive organs (testes, epididymis, vas deferens, seminal vesicles, prostate, and penis). The urinary and reproductive tracts are closely linked, and disorders of one often affect the other. Thus a major spectrum of the conditions managed in urology exists under the domain of genitourinary disorders. Urology combines the management of medical (i.e., non-surgical) conditions, such as urinary-tract infections and benign prostatic hyperplasia, with the management of surgical conditions such as bladder or prostate cancer, kidney stones, congenital abnormalities, traumatic injury, and stress incontinence. U ...
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Groin
In human anatomy, the groin (the adjective is ''inguinal'', as in inguinal canal) is the junctional area (also known as the inguinal region) between the abdomen and the thigh on either side of the pubic bone. This is also known as the medial compartment of the thigh that consists of the adductor muscles of the hip or the groin muscles. A pulled groin muscle usually refers to a painful injury sustained by straining the hip adductor muscles. These hip adductor muscles that make up the groin consist of the adductor brevis, adductor longus, adductor magnus, gracilis, and pectineus. These groin muscles adduct the thigh (bring the femur and knee closer to the midline). The groin is innervated by the obturator nerve, with two exceptions: the pectineus muscle is innervated by the femoral nerve, and the hamstring portion of adductor magnus is innervated by the tibial nerve. In the groin, underneath the skin, there are three to five deep inguinal lymph nodes that play a role in ...
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Percutaneous
{{More citations needed, date=January 2021 In surgery, a percutaneous procedurei.e. Granger et al., 2012 is any medical procedure or method where access to inner organs or other tissue is done via needle-puncture of the skin, rather than by using an "open" approach where inner organs or tissue are exposed (typically with the use of a scalpel). The percutaneous approach is commonly used in vascular procedures such as angioplasty and stenting. This involves a needle catheter getting access to a blood vessel, followed by the introduction of a wire through the lumen (pathway) of the needle. It is over this wire that other catheters can be placed into the blood vessel. This technique is known as the modified Seldinger technique. More generally, "percutaneous", via its Latin roots means, 'by way of the skin'. An example would be percutaneous drug absorption from topical medications. More often, percutaneous is typically used in reference to placement of medical devices using a nee ...
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