Scrotal fistula from urethro-vasal reflux in paraplegia

Ahn, Jung Hwan; Reiter, Raymond; Farcon, Eduardo; Morales, Pablo

doi:10.1016/0090-4295(89)90448-2

Cited by 8 publications

(2 citation statements)

References 5 publications

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“…8 In tetraplegic patients with detrusor-external sphincter dyssynergia, high-pressure re¯ux of urine into the vas and scrotum is more likely to occur during dyssynergic voiding. (2) Indwelling urethral catheter drainage.…”

Section: Pathogenesis Of Xanthogranulomatous Epididymo-orchitis In Spmentioning

confidence: 99%

Xanthogranulomatous funiculitis and epididymo-orchitis in a tetraplegic patient

et al. 2000

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Study design: A case report of xanthogranulomatous funiculitis and epididymo-orchitis. Xanthogranulomatous in¯ammation is an uncommon, non-neoplastic process characterised by destruction of tissue, which is replaced by a striking cellular in®ltrate of lipid-laden macrophages. Case report: A 21-year male sustained complete tetraplegia at C-6 level, after a fall in 1998. The neuropathic bladder was managed with an indwelling urethral catheter. He had many unsuccessful trials of micturition. Sixteen months after the cervical injury, he noticed swelling of the left side of the scrotum following removal of a blocked catheter. He was prescribed antibacterial therapy. Four weeks later, physical examination revealed a hard and irregular swelling encompassing the testis, epididymis and spermatic cord. The clinical diagnosis was epididymo-orchitis progressing to pyocele. Through a scrotal incision, the swollen testis, epididymis and diseased segment of the spermatic cord were removed en masse. Histopathology showed extensive areas of necrosis, with xanthogranulomatous in¯ammation in the spermatic cord and to a lesser extent in the testis/epididymis. Conclusion: Repeated episodes of high-pressure urinary re¯ux along the vas deferens during dyssynergic voiding, and subsequent interstitial extravasation of urine together with chronic, low-grade, suppurative infection possibly led to development of xanthogranulomatous in¯ammation in the testis and the epididymis. Since tissue destruction is a feature of xanthogranulomatous in¯ammation, the de®nite and curative treatment is either complete (or, where applicable, partial) excision of the a ected organ in most of the cases. Spinal Cord (2000) 38, 769 ± 772

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Section: Pathogenesis Of Xanthogranulomatous Epididymo-orchitis In Spmentioning

confidence: 99%

Xanthogranulomatous funiculitis and epididymo-orchitis in a tetraplegic patient

et al. 2000

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“…In addition to urethral stricture, other causes of UEDR include urethral obstruction (stones, posterior urethral valves), voiding dysfunction [7] and functional disturbances of the bladder neck, inflammatory conditions, surgical interventions, or it may occur in otherwise normal individuals. Besides these, in children neurogenic bladder or imperforate anus with urological involvement [8] may lead to such reflux.…”

Section: Discussionmentioning

confidence: 99%

Urethro-Ejaculatory Duct Reflux, a Complication of Peno-Bulbar Urethral Stricture: Case Report with Review of the Literature

Goel¹,

Sankhwar²

2013

Urol Int

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Urethro-ejaculatory duct reflux (UEDR) is an uncommonly discussed entity that may result in devastating complications. We discuss the case of a young married male with obstructive voiding symptoms along with intermittent left scrotal pain for last the 2 years. On voiding cystourethrography, he had intravasation of contrast into the prostatic ducts, vas deferens and epididymal ducts suggestive of UEDR which might be the cause of his scrotal pain due to recurrent episodes of epididymitis. Complete resolution of voiding symptoms and recurrent scrotal pain occurred after management of urethral stricture. The possibility of UEDR should be kept in mind while dealing with men suffering from recurrent prostatitis, seminal vesiculitis, epididymitis or, less commonly, infertility.

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