[New WSES-AAST guidelines on trauma of the urogenital tract-Summary and comments].

Different perspectives exist among the various specialist disciplines on the treatment of trauma patients with injuries of the urogenital tract. The multidisciplinary consensus guidelines of the World Society of Emergency Surgery (WSES) and the American Association for the Surgery of Trauma (AAST), which appeared in autumn 2019, are summarized in this article. They should constitute an aid to making decisions on the optimal treatment of trauma patients with urogenital injuries.

Prospective evaluation of scrotal ultrasound and intratesticular perfusion by color-coded duplex sonography (CCDS) in TESE patients with azoospermia.

Purpose: The objective of this study was to assess whether CCDS might improve the outcome of testicular sperm retrieval in patients with azoospermia. Furthermore, we evaluated potential sonographic alterations of the testis before and after trifocal and Micro-TESE.

Methods: 78 patients were enrolled prospectively: 24 with obstructive azoospermia (OA) and 54 with non-obstructive azoospermia (NOA).

[Renal carbuncle and perirenal abscess in children and adolescents].

Renal abscesses are rare in childhood. The diagnosis is often complicated by non-specific symptoms and the typical signs of urinary tract infections are frequently absent. The currently available imaging methods are necessary and helpful for a differentiated therapeutic approach; nevertheless, cases are continuously being found in which a renal abscess is only diagnosed intraoperatively.

[Biopsies of the kidney, prostate and urinary bladder].

Background: Biopsies of the kidney, prostate and urinary bladder are amongst the most frequent interventions in urology. A correct indication, preparation and performance are important to achieve good results and low complication rates.

Objectives: In this review complication management in biopsies of the kidney, prostate and urinary bladder are discussed.

Acute epididymitis in ultrasound: results of a prospective study with baseline and follow-up investigations in 134 patients.

Objectives: To perform a comprehensive follow-up analysis of ultrasonographic scrotal features and associated signs in patients with acute epididymitis.

Methods: Between 2007 and 2012, 134 adults (median age 54 years) with acute epididymitis underwent scrotal ultrasonography and palpation at first presentation and after 2 weeks and 3 months.

Results: At first presentation, 61 patients (45.

[Acute urinary retention in children: initial manifestation of caudal regression syndrome].

Caudal regression syndrome is a rare and sporadic congenital developmental defect of the lower spinal segments and the neural tube. Movement disorders and sensory neurological deficits of the lower extremities in conjunction with impaired bladder and bowel control are the major symptoms. Abnormal visual aspects of the sacral region in combination with maternal gestational diabetes are further diagnostic indications.

Detection of normal intratesticular perfusion using color coded duplex sonography obviates need for scrotal exploration in patients with suspected testicular torsion.

Purpose: Although color coded duplex sonography is useful for visualizing testicular perfusion in patients with clinical suspicion of testicular torsion, fear of overlooking the condition itself remains. Thus, routine scrotal exploration in every patient with acute scrotal pain is common at many centers. We assessed the efficacy of color coded duplex sonography in predicting the need for scrotal exploration in patients with clinical suspicion of testicular torsion.

Congenital phimosis in patients with and without lichen sclerosus: distinct expression patterns of tissue remodeling associated genes.

Purpose: Lichen sclerosus is a potentially important factor in the ongoing debate concerning the pathology of persistent congenital phimosis. We assessed the molecular differences of congenital phimosis in boys with and without lichen sclerosus compared to age matched boys with fully retractable foreskins to gain more insight into the pathogenesis of fibrotic remodeling of the prepuce.

Materials And Methods: A total of 150 boys were circumcised in a prospective study between 2007 and 2009.

Reference values for testicular volume, epididymal head size and peak systolic velocity of the testicular artery in adult males measured by ultrasonography.

Purpose: To obtain ultrasonography-based reference values for testicular volume, epididymal head size and peak systolic velocity (PSV) of the testicular artery in adult males of all ages.

Materials And Methods: Between 2009 and 2011, 306 Caucasian adult males (median age: 51 years; range: 18-88 years) without scrotal pathology underwent prospective scrotal ultrasonography. The testicular volume was calculated from the length (L), width (W), and height (H) using three formulas: a) 0.

Role of human papillomaviruses in persistent and glucocorticoid-resistant juvenile phimosis.

Background: In adults, human papillomaviruses (HPV), lichen sclerosus et atrophicus (LSA) and phimosis are considered to be major risk factors for penile cancer. In boys, a possible association between phimosis, LSA and HPV has been suggested.

Objective: To investigate the role of HPV in the persistence of phimosis in children.

Mixed testicular atrophy related to atherosclerosis: first lessons from the ApoE(-/-)/ LDL receptor(-/-) double knockout mouse model.

Age-related testicular changes are associated with declining spermatogenesis and testosterone levels. A relationship to atherosclerosis has never been investigated systematically. The ApoE(-/-)/LDL receptor(-/-) double knockout mouse model, providing a remarkable homology to human atherosclerosis, is an ideal tool to investigate spermatogenetic alterations in this context.

[New concepts for varicolele treatment in male infertility: the current situation].

There is no question that therapy for a varicocele in cases of male infertility improves the ejaculate quality. New data provide hints for an additional influence on the pregnancy rates in infertile partnerships.

Color Doppler ultrasound imaging in varicoceles: is the venous diameter sufficient for predicting clinical and subclinical varicocele?

Purpose: Investigating the diagnostic value of color Doppler ultrasound for defining the varicocele grade according to WHO criteria.

Methods: A total of 217 men (129 with clinical varicocele and 88 without clinical varicocele) were investigated by physical examination and color Doppler ultrasound and categorized according to WHO varicocele criteria (0, subclinical, I, II, and III). Diameter and reflux of the largest vein in the pampiniform plexus were measured bilaterally with the patient in the supine position in rest and during the Valsalva maneuver.

[Andrology: varicocele: an update].

Varicocele is a common finding in approximately 20% of adolescents and adult men and in about 40% of infertile patients. Although numerous theories addressing the deteriorating impact on the testis are known, the direct connection between varicocele and infertility is not clear. It is well known that after operative therapies an improvement in sperm quality is found.

[Diagnosis of erectile dysfunction].

Erectile dysfunction is a disorder with multifactorial causes. The pathophysiological origin can be severe general disease. Consequently each patient has to undergo a general diagnostic procedure so that severe disease is not missed.

Evaluation of penile perfusion by color-coded duplex sonography in the management of erectile dysfunction.

The etiology of erectile dysfunction is wide ranging. Penile vascular disorders may result in impaired erection or complete impotence. Almost 30% of erectile dysfunction is due to the presence of systemic disease which affects the blood supply to the penis.

Questionable efficacy of extracorporeal shock wave therapy for Peyronie's disease: results of a prospective approach.

Purpose: Extracorporeal shock wave therapy (ESWT) for Peyronie's disease is still a topic of debate. We evaluated the effects of ESWT in a large series of patients with Peyronie's disease via a prospective approach.

Materials And Methods: In a prospective study 114 patients with Peyronie's disease were treated with ESWT.

Seminoma in an intra-abdominal testis misdiagnosed as a kidney tumor and associated with ipsilateral renal agenesis.

We present a case of seminoma found in an intra-abdominal testis and associated with ipsilateral renal agenesis and absence of the ipsilateral seminal vesicle. Although malignant tumor degeneration in an undescended intra-abdominal testis is rare, understanding its radiologic appearance is important in order to confirm the diagnosis preoperatively and detect possible malformations of other organs.

Extracorporal shock wave therapy in the treatment of Peyronie's disease. First results of a case-controlled approach.

Objective: To test whether extracorporal shock wave therapy (ESWT) has an effect in the treatment of Peyronie's disease.

Methods: 22 patients with Peyronie's disease and previous unsuccessful oral drug therapy were treated with ESWT in a prospective design with a follow-up of at least 3 months; 23 age-matched patients without previous therapy received oral placebo drug for 6 months daily as control. The standard follow-up included palpation, ultrasound, autophotography and evaluation of symptomatology based on a symptom score.

Prostaglandin E1 long-term self-injection programme for treatment of erectile dysfunction--a follow-up of at least 5 years.

Prostaglandin E1 (PGE1) is currently the vasoactive drug of choice for intracavernous self-injection therapy in the treatment of erectile dysfunction. PGE1 is often said to have a low incidence of side-effects. However, real long-term follow-up reports are rare.

[Clinical aspects of hydatid torsion. Diagnosis and therapy in 104 consecutive patients].

At the department of the urology of the university hospital in Giessen we observed 104 hydatid torsions with acute scrotal pain between 1977 and 1998. The average age of the affected patients showed a peak in boys with 12 years of age. 33.

[Induratio penis plastica].

The symptoms of Peyronie's disease consist of fibrotic plaque formation, penile deviation and painful erection. The etiology is still unknown. During its progress the disease can cause erectile failure.