Atypical testicular pain

Bedi, Nishant; Rahimi, Muhammad Naim Che; Menzies, Sarah; Kalsi, Jas

doi:10.1136/bcr-2018-226697

Cited by 6 publications

(10 citation statements)

References 8 publications

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“…However, suspicion of concomitant TB outside the urogenital tract should arise when these constitutional symptoms are present, such as pulmonary TB [ 13 ]. Compared with other reports in the literature, the average duration between onset of the symptoms and the definite diagnosis (mean 6.42 ± 7.0 months, range 0.3–36 months) in our study was longer, probably due to the insidious and asymptomatic onset of TBEO [ 5 , 14 – 16 ].…”

Section: Discussioncontrasting

confidence: 77%

“…In this situation, radical surgery is often unavoidable, which can be used for resection of the lesions and histopathological examination [ 4 , 6 , 13 , 20 ]. However, it is worth noting that Bedi et al has successfully treated a 38-year-old patient with TBEO by standard anti-tuberculous medications [ 14 ]. Besides, Abraham et al also reported an Ecuadorian man with TBEO who was cured with 6 months of drug therapy and no surgery was required [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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Surgical management of tuberculous epididymo-orchitis: a retrospective study of 81 cases with long-term follow-up

et al. 2021

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Background Nowadays, most studies of tuberculous epididymo-orchitis (TBEO) are case reports or small sample cohort series. Our study is aimed to present the largest series of TBEO with our management experiences and long-term follow-up outcomes. Methods Patients diagnosed with TBEO after surgical procedures at Department of Urology, West China Hospital from 2008 to 2019 were included. All clinical features, auxiliary examination results, treatment and histopathological findings were extracted if available. Results Eighty-one patients (mean age 50.77 ± 16.1 years) were included. Scrotal swelling (N = 47, 58.0%) and pain (N = 29, 35.8%) were the most common presenting complaint. Pyuria and microscopic hematuria were observed in twenty-two (27.2%) and eight patients (9.9%), respectively. Urine acid fast bacilli cultures were available in 16 patients and all were negative. The mean duration between the onset of symptoms and the definite diagnosis was 6.42 ± 7.0 months. TBEO was considered in 30 (37.0%), tumors in 28 (34.6%) and nonspecific bacterial epididymo-orchitis in 23 (28.4%) patients. All patients received triple therapy of chemotherapy-surgery-pharmacotherapy and definite diagnosis was confirmed through histopathology of surgical specimens. Fifty-five patients were followed up regularly (mean follow-up 82.35 ± 36.6 months). One patient (1.2%) died from liver cirrhosis and no recurrence was observed. Postoperative complications included erectile dysfunction in 4 patients (4.9%), premature ejaculation in 5 patients (6.2%) and sterility in 7 patients (8.6%). Conclusions We recommend patients with advanced TBEO to receive triple therapy of chemotherapy-surgery-pharmacotherapy. Physicians should pay more attention to patients’ sexual function and fertility during follow up after treatment completed.

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Surgical management of tuberculous epididymo-orchitis: a retrospective study of 81 cases with long-term follow-up

et al. 2021

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“…The symptoms can mimic epididymo-orchitis as well as testicular cancer. Surgical intervention is avoidable if diagnosed in time, since GUTB responds well to standard TB treatment 9. This fits well with the regression of testicular symptoms from the remaining left testicle after initiation of treatment in our case.…”

Section: Discussionsupporting

confidence: 88%

Contribution to differential diagnosis of sarcoidosis and disseminated tuberculosis

2019

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A previously healthy 54-year-old ethnically Danish man was referred to the Department of Infectious Diseases at Aarhus University Hospital after an unexpected detection of Mycobacterium tuberculosis DNA in his lungs. Further examination revealed widespread dissemination of the tuberculosis (TB) to brain, mastoid, urinary and gastrointestinal tract. Thirteen months earlier, the patient was orchiectomised due to recurring inflammation of the right testicle. Three and a half months prior to admission to our department the patient started immunosuppressive therapy with steroids due to radiological and histological findings in the lungs that were interpreted as sarcoidosis (SA). This treatment is likely to be co-responsible for the pronounced dissemination of the TB. The patient was Bacillus Calmette-Guérin (BCG)-vaccinated as a child and had no apparent risk factors for TB apart from travelling in TB-endemic countries until 10 years before falling ill. Screening for latent TB was not performed prior to starting steroid treatment.

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“…Диагностика УГТ, как правило, запаздывает, что может вести к фатальным последствиям. Одни из основных причин -низкая настороженность в отношении туберкулеза, неумение распознать его среди других урологических заболеваний, под которые УГТ удачно маскируется [14][15][16][17][18][19][20][21][22][23].…”

Section: Introductionunclassified

“…Низкий уровень настороженности в отношении внелегочных локализаций туберкулеза и недостаточный уровень знаний приводят к поздней диагностике, когда терапевтические возможности исчерпаны и хирургическое вмешательство неизбежно [12]. Неэффективность антибактериальной терапии урогенитальных инфекций объясняют резистентностью патогена, в то время как это может иметь место туберкулез мочеполовой системы, протекающий под маской неспецифических заболеваний [17][18][19][20].…”

Section: Introductionunclassified

Dynamics of the structure of renal tuberculosis over 20 years

Kulchavenya

Kholtobin

2022

Terapevticheskii arkhiv

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Background. Tuberculosis is a serious medical and social problem that does not lose its importance, despite all the advances in pharmacology and surgery. Diagnosis of urogenital tuberculosis (UGTB), as a rule, is delayed due to low index of suspicion to tuberculosis and the absence of pathognomonic symptoms. Aim. Determining the change in the ratio of clinical forms of renal tuberculosis from 1999 to 2020. Materials and methods. A retrospective cohort comparative non-interventional study on the spectrum of the incidence of extrapulmonary tuberculosis (EPTB) was carried out. Among all 13852 extrapulmonary tuberculosis patients which were diagnosed from 1999 to 2020, patients with renal tuberculosis were selected, and the spectrum of their clinical forms in three periods was analyzed: 1st period 19992004 (1155 patients), second period 20052014 (2657 patients), and the third period 20152020 (671 patients). The clinical features of nephrotuberculosis in 88 patients was also estimated. Results. Over the 20 years of the analyzed period, the number of patients with UGTB decreased by 80.6%; for the year of the COVID-19 pandemic, this figure fell by another third. In the first period, destructive complicated forms of nephrotuberculosis prevailed (922 patients 79.8%), while the so-called "minor forms" were diagnosed in 233 patients (20.2%). In the second period, the situation was statistically significantly more favorable: the proportion of destructive and complicated forms of renal tuberculosis decreased to 43.8% (1124 patients), "small forms" were diagnosed in 1443 patients (56.2%). In the third period, destructive and complicated forms of nephrotuberculosis were diagnosed in 531 patients (77.6%), and the proportion of "small forms" in comparison with the previous period decreased by half, to 22.4%. Analysis of the clinical features of renal tuberculosis, depending on the prevalence of the destruction, showed that an asymptomatic course is possible, and pain, dysuria, intoxication and renal colic are present with different frequencies, and the clinical picture of tuberculosis of the renal parenchyma differs significantly from the clinical picture of tuberculous papillitis, cavernous nephrotuberculosis and symptoms of renal tuberculosis as whole. Conclusion. Currently, there is no screening on urogenital tuberculosis at all. Patients are diagnosed by referral, with a long history, after receiving multiple courses of antibacterial treatment; mainly through the pathomorphological examination of the operating material. Thus, a sharp decrease in the proportion of UGTB patients does not mean the disappearance of tuberculosis of this localization, but only states the tragic defects in timely diagnosis and low index of suspicion of medical doctors in relation to UGTB.

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Atypical testicular pain

Cited by 6 publications

References 8 publications

Surgical management of tuberculous epididymo-orchitis: a retrospective study of 81 cases with long-term follow-up

Surgical management of tuberculous epididymo-orchitis: a retrospective study of 81 cases with long-term follow-up

Contribution to differential diagnosis of sarcoidosis and disseminated tuberculosis

Dynamics of the structure of renal tuberculosis over 20 years

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