Abstract | PURPOSE: We evaluated the clinical and histological significance of incidental ultrasonographic focal testicular lesions and assessed whether a conservative surgical approach may put the patient at higher oncological risk due to insufficient surgical eradication. MATERIALS AND METHODS: From October 2000 to May 2002 all patients with infertility, scrotal swelling, scrotal pain, varicocele, scrotal trauma or erectile dysfunction underwent scrotal ultrasonography. A total of 1,320 patients were investigated. Focal testicular lesions were found in 27 patients (2%), palpable nodules were present in 17 (63%) and nonpalpable incidental lesions were diagnosed in 10. Nodule diameter was 3 to 24 mm. All patients underwent explorative surgery via inguinotomy and preventive clamping of the spermatic cord. The nodules were completely removed with biopsy of the resection margins. Nonpalpable lesions were removed under ultrasonographic guidance. The testicle was only preserved when frozen section revealed a benign lesion and margins were negative. RESULTS: CONCLUSIONS: The incidental diagnosis of testicular ultrasound alterations is increasing and 80% show a benign histology. In these cases a conservative surgical approach is the best option and it does not expose the patient to the risk of relapse.
|
Authors | Luca Carmignani, Franco Gadda, Giacomo Gazzano, Franco Nerva, Mario Mancini, Mario Ferruti, Gaetano Bulfamante, Silvano Bosari, Guido Coggi, Francesco Rocco, Giovanni Maria Colpi |
Journal | The Journal of urology
(J Urol)
Vol. 170
Issue 5
Pg. 1783-6
(Nov 2003)
ISSN: 0022-5347 [Print] United States |
PMID | 14532776
(Publication Type: Evaluation Study, Journal Article)
|
Topics |
- Abscess
(diagnostic imaging, pathology, surgery)
- Adenomatoid Tumor
(diagnostic imaging, pathology, surgery)
- Adolescent
- Adult
- Aged
- Biopsy
- Carcinoma, Embryonal
(diagnostic imaging, pathology, surgery)
- Child
- Child, Preschool
- Diagnosis, Differential
- Frozen Sections
- Humans
- Hyperplasia
- Incidental Findings
- Leydig Cell Tumor
(diagnostic imaging, pathology, surgery)
- Leydig Cells
(pathology)
- Male
- Middle Aged
- Orchiectomy
- Risk
- Seminoma
(diagnostic imaging, pathology, surgery)
- Testicular Neoplasms
(diagnostic imaging, pathology, surgery)
- Testis
(diagnostic imaging, pathology, surgery)
- Ultrasonography
|