Electrophysiologic evaluation of cremasteric reflex in experimental orchitis

Soyer, Tutku; İnal, Elem; Boybeyi, Özlem; Balcı, Mahi; Aslan, Mustafa; Aydın, Gülümser

doi:10.1016/j.jpurol.2013.03.014

Cited by 2 publications

(9 citation statements)

References 10 publications

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“…All of them agreed on irritating, rubbing or provoking the upper inner thigh (Schliack, 1958;Caesar and Kaplan, 1994;Sugiyama et al, 1994;Okuda et al, 2000;Bingol-Kologlu et al, 2001;Bademkiran et al, 2005;Ertekin et al, 2005;Shafik et al, 2006;Ertekin et al, 2007;Soyer et al, 2007Soyer et al, , 2013Kayalioglu et al, 2008;Ozdemirkiran and Ertekin, 2011). All of them agreed on irritating, rubbing or provoking the upper inner thigh (Schliack, 1958;Caesar and Kaplan, 1994;Sugiyama et al, 1994;Okuda et al, 2000;Bingol-Kologlu et al, 2001;Bademkiran et al, 2005;Ertekin et al, 2005;Shafik et al, 2006;Ertekin et al, 2007;Soyer et al, 2007Soyer et al, , 2013Kayalioglu et al, 2008;Ozdemirkiran and Ertekin, 2011).…”

Section: Resultsmentioning

confidence: 98%

“…The studies and textbooks investigated show that both terms are used in different combinations, such as cremaster muscle (Starling and Harms, 1989;Caesar and Kaplan, 1994;Sugiyama et al, 1994;Bing € ol-Kologlu et al, 1999Tanyel et al, 2000;Tanyel et al, 2001;Bademkiran et al, 2005;Soyer et al, 2007Soyer et al, , 2008Kayalioglu et al, 2008;Ozdemirkiran and Ertekin, 2011), cremasteric muscle (Shafik, 1973;Oelrich and Moosman, 1977;Redman, 1996;Ducic and Dellon, 2004;Bademkiran et al, 2005;Ertekin et al, 2005;Sasaoka et al, 2005;Shafik et al, 2006;Ertekin et al, 2007;Soyer et al, 2013), cremaster reflex (Tanyel et al, 2000), and cremasteric reflex (Starling and Harms, 1989;Caesar and Kaplan, 1994;Sugiyama et al, 1994;Bing € ol-Kologlu et al, 1999Shafik et al, 2006;Ertekin et al, 2007;Soyer et al, 2007Soyer et al, , 2008Soyer et al, , 2013Kayalioglu et al, 2008;Ozdemirkiran and Ertekin, 2011). The studies and textbooks investigated show that both terms are used in different combinations, such as cremaster muscle (Starling and Harms, 1989;Caesar and Kaplan, 1994;Sugiyama et al, 1994;…”

Section: Discussionmentioning

confidence: 99%

“…With one exception they all agreed on spinal nerves L1 and L2 (Oelrich and Moosman, 1977;Starling and Harms, 1989;Bing € ol-Kologlu et al, 1999Al-Dabbagh, 2002;Liu et al, 2002;Ertekin et al, 2005;Shafik et al, 2006;Soyer et al, 2007Soyer et al, , 2013Anloague and Huijbregts, 2009;Tagliafico et al, 2015). With one exception they all agreed on spinal nerves L1 and L2 (Oelrich and Moosman, 1977;Starling and Harms, 1989;Bing € ol-Kologlu et al, 1999Al-Dabbagh, 2002;Liu et al, 2002;Ertekin et al, 2005;Shafik et al, 2006;Soyer et al, 2007Soyer et al, , 2013Anloague and Huijbregts, 2009;Tagliafico et al, 2015).…”

Section: Lumbar Roots Of the Genitofemoral Nervementioning

confidence: 96%

“…According to modern textbooks the innervation of the inguinal region is similar among all humans, which (Schliack, 1958;Caesar and Kaplan, 1994;Sugiyama et al, 1994;Okuda et al, 2000;Bingol-Kologlu et al, 2001;Bademkiran et al, 2005;Ertekin et al, 2005Ertekin et al, , 2007Soyer et al, 2007Soyer et al, , 2013Shafik et al, 2006;Kayalioglu et al, 2008;Ozdemirkiran and Ertekin, 2011) Ten textbooks 8: three via the femoral branch (Moll and Moll, 2006;Fangh € anel et al, 2009;Anderhuber et al, 2012), one via the ilioinguinal nerve (Moore et al, 2013), and one via femoral branch and ilioinguinal nerve (Drake et al, 2013) 2 (Lang et al, 2003;Moore et al, 2011): both via femoral branch Table 3). Ducic and Dellon (2004) dissected ten human specimens and followed the genital and femoral branches of the genitofemoral nerve.…”

Section: Innervation Of the Inguinal Region (Seementioning

confidence: 99%

“…, the cremasteric reflex has since been described as a helpful sign in detecting testicular torsion (Nelson et al, 2003;Soyer et al, 2007), orchitis (Soyer et al, 2013), varicocele (Shafik, 1973), and undescended testis (Bing € ol-Kologlu et al, 1999;Tanyel et al, 2000Tanyel et al, , 2001, and even for successful spinal anesthesia (Okuda et al, 2000). With 100% sensitivity and 60% specificity for diagnosing problems with the testes (Rabinowitz, 1984), for example, testicular torsion, such problems are seldom associated with an intact cremasteric reflex (Feldstein, 1985;Nelson et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

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The cremasteric reflex and its muscle – a paragon of ongoing scientific discussion: A systematic review

Schwarz

Hirtler

2017

Clinical Anatomy

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The technique of triggering the cremasteric reflex and its respective signaling pathway is not described uniformly throughout the literature. As this reflex is a useful sign in diagnosing testicular torsion, orchitis, varicocele, and undescended testis, it seems desirable to identify and define the correct mechanism. Our aim was to investigate how the cremasteric reflex and its signaling pathway are described in the current literature and how the variability of the innervation of the inguinal region could affect the frequency of this reflex. Thirty-five original articles and 18 current textbooks were included after searching PubMed (MEDLINE) and Scopus for the terms "cremaster muscle," "cremasteric reflex," and "genitofemoral nerve" and after applying all exclusion criteria. This systematic review was performed according to the PRISMA Statement Rules. Eliciting the cremasteric reflex was defined either as "rubbing of the upper inner thigh" or "rubbing of the skin under the inguinal ligament." Four different afferent pathways among studies and three different pathways among textbooks were described and the frequency of an intact reflex ranged between 42.7 and 92.5% in newborns and between 61.7 and 100% in boys between 24 months and 12 years. Owing to the huge differences among the studies investigated and the lack of convincing results, it is not possible to define the correct way to elicit the cremasteric reflex. Four hypotheses about the afferent pathway are proposed on the basis of the literature. Further studies should be performed, concentrating on the afferent pathway(s) with respect to the individual innervation of the inguinal region. Clin. Anat. 30:498-507, 2017. © 2017 Wiley Periodicals, Inc.

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Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Lumbar Roots Of the Genitofemoral Nervementioning

confidence: 96%

Section: Innervation Of the Inguinal Region (Seementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The cremasteric reflex and its muscle – a paragon of ongoing scientific discussion: A systematic review

Schwarz

Hirtler

2017

Clinical Anatomy

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Diagnostic Accuracy of Doppler Ultrasound Compared to Surgical Exploration in Torsion Testis

Thekeveetil¹,

Krishnadas²,

Vishwambharan³

2021

jemds

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BACKGROUND Twisting of the spermatic cord resulting in ischemia of the testicles known as testicular torsion is a surgical emergency. Delay in diagnosis or surgery results in loss of testicles. Doppler ultrasound of scrotum is used in evaluating acute scrotum to support or rule out a diagnosis of torsion testis. Our study compares Doppler results with findings at exploration to finding out the accuracy of Doppler diagnosis in this scenario. METHODS This was a record based observational cross-sectional study. Out of all cases of acute scrotum presented to a tertiary care hospital over 14 months time, those patients with Doppler evaluation done were identified (n = 52) and their surgical findings were compared to the Doppler findings. Diagnostic accuracy of Doppler in diagnosing torsion testis was measured using sensitivity, specificity, accuracy, and predictive values. RESULTS Out of these 52 cases, 44 (84.6 %) were testicular torsion on exploration while remaining cases were epididymo-orchitis four (7.7 %) and testicular appendage torsion four (7.7 %). Among 44 cases of torsion testis, 31 (70.5 %) patients underwent orchiectomy (70.45 %) and in remaining 13 (29.5 %) orchiopexy was done. Sensitivity of Doppler to diagnose testicular torsion was 86.4 %, specificity was 87.5 % and accuracy was 86.54 %. Positive predictive value (PPV) was 97.4 % and negative predictive value (NPV) was 53.8 %. CONCLUSIONS Doppler ultrasound can be used as an adjunct to clinical findings in acute scrotum. High positive predictive value suggest that all Doppler diagnosed torsion should undergo emergency exploration as it will be correct in 97.5 % cases. If performing a Doppler study delays the definitive management, and if clinical findings are highly suggestive of testicular torsion, treating doctor can proceed to surgery without Doppler evaluation. KEY WORDS Doppler, Torsion Testis, Scrotum

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Electrophysiologic evaluation of cremasteric reflex in experimental orchitis

Cited by 2 publications

References 10 publications

The cremasteric reflex and its muscle – a paragon of ongoing scientific discussion: A systematic review

The cremasteric reflex and its muscle – a paragon of ongoing scientific discussion: A systematic review

Diagnostic Accuracy of Doppler Ultrasound Compared to Surgical Exploration in Torsion Testis

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