Objective: To describe a microsurgical technique for denervation of the spermatic cord and use of multiphoton microscopy (MPM) laser to identify and ablate residual nerves after microsurgical denervation. To evaluate structural and functional changes in the rat testis and vas deferens after denervation.
Materials And Methods: Nine Sprague-Dawley rats were divided into three experimental groups: sham, microsurgical denervation of the spermatic cord (MDSC), and MDSC immediately followed by laser ablation with MPM. At 2 months after surgery, we assessed testicular volume, functional circulation of the testicular artery with Doppler, patency of the vas deferens, and histology of the testis and vas deferens.
Results: There was a significant decrease in the median number of nerves remaining around the vas deferens with MDSC alone (3.5 nerves) or MDSC with MPM (1.5 nerves) compared with sham rats (15.5 nerves) (P = 0.003). Although, MDSC with MPM resulted in the fewest remaining nerves, this result was similar to MDSC alone (P = 0.29). No deleterious effects on spermatogenesis or vas patency were seen in the experimental groups when compared with the sham rats.
Conclusion: A microsurgical approach can be used to effectively and safely denervate the rat spermatic cord with minimal changes to structure and function of the testis and vas deferens. MPM can be used as an adjunct to identify and ablate residual nerves after MDSC.
Spermatic cord sarcomas (SCS) are a group of mesenchymal tumors whose rarity and anatomical location often lead to clinical misdiagnosis such as inguinal hernia, testicular tumor, or other conditions. Any inguinoscrotal mass with suspicious characteristics should prompt clinicians to perform imaging assessments (such as ultrasound or, in uncertain cases, magnetic resonance imaging (MRI)) and refer the patient promptly to a specialized center. Histological characterization of all suspicious masses via percutaneous biopsy is recommended, with staging completed through computed tomography (CT) scan for confirmed cases.
Duplication of the vas deferens is a rare congenital anomaly, with an incidence of ~0.05% in the general population. It is typically discovered incidentally during surgeries involving the spermatic cord, such as inguinal hernia repair.
Mesh plugs are commonly used in inguinal hernia repair due to their perceived efficacy in reducing recurrence rates. However, their use has been associated with significant complications, including mesh migration, chronic pain, infection, hernia recurrence, adhesions, and erosion into adjacent organs. This case series presents three patients who experienced complications from mesh plug migration post-hernia repair.
The third-trimester ultrasound diagnosis in two fetuses with isolated testicular torsion is described. Pregnancy courses were uneventful and routine second-trimester scans had shown no structural anomalies. Antenatal ultrasound performed at 32 + 3 and 33 + 0 weeks' gestation showed signs consistent with the diagnosis of isolated left spermatic cord torsion in both cases (absent flow across the testicular artery, hyperechogenic small rounded mass in the hemiscrotum representing the twisted testes, and hydrocele).
Background: Testicular yolk sac tumor (YST) is a rare neoplasm with limited practical guidance for preoperative diagnostic assessment. This study aims to conduct a retrospective analysis of the value of clinical profiles and MRI parameters in accurately diagnosing pediatric testicular YST while exploring characteristic indicators for these patients.
Methods: This retrospective study analyzed eighty patients with a testicular mass who underwent surgical treatment and preoperative MRI.
