<strong>Introduction:</strong> Trauma of the external male genital organs (TEMGO) is multifaceted and rare. The objective of this work was to provide an overview of these lesions by describing the epidemio...<strong>Introduction:</strong> Trauma of the external male genital organs (TEMGO) is multifaceted and rare. The objective of this work was to provide an overview of these lesions by describing the epidemiology, the diagnostic approach, their therapeutic and prognostic aspects. <strong>Materials and Methods:</strong> It was a retrospective study carried out over a ten-year period, from January 1, 2009 to December 31, 2018. It included male patients, admitted and treated in surgical emergencies and in the urology department of the Sylvanus Olympio Teaching Hospital in Lomé for trauma of male external genital organs. <strong>Results:</strong> Thirty-five cases had been collected. They had represented 1.5% of urological emergencies. The subjects were young with a mean age of 29.6 ± 3.1 years, with extremes of 18 and 60 years. Trauma to the penis was more frequent and found in 60% of cases, with the mechanism of coitus misstep in 54.3%, leading to a fracture of the penis. Testicular contusions were found in 22.9% of the cases. The ultrasound was performed in 6 patients. Four orchidectomies were performed for an unsustainable testicle found at scrototomy. The postoperative had been simple in all cases. Fifteen patients (42.8%) had been regularly followed on 18 months. Residual testicular pain and mode-rate erectile dysfunction was noted respectively in 3 and 2 patients. <strong>Conclusion:</strong> TEMGO, although rare, require perfect knowledge for adequate therapeutic decisions, as they can compromise the functional prognosis of concerned organs.展开更多
Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. Whe...Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. When present, these neoplasms often manifest with nonspecific signs and symptoms such as pain, itching, swelling, single-focus lesions, bleeding, and enlargement of inguinal lymph nodes, in addition to the presence of progressively enlarging vulvar nodules. Consequently, the diagnostic investigation involves histopathological examination and confirmation through immunohistochemistry. Objective: To present a comprehensive understanding of this rarely studied pathology. The primary objective is to provide valuable insights that could aid in the future development of universally applicable treatment guidelines. Case Presentation: A 57-year-old female, with no prior comorbidities, menopause at 36, who presented with a left vulvar nodule accompanied by intense pain and swelling, later diagnosed with small cell neuroendocrine carcinoma in the vulva. Conclusion: This case report highlights the importance of enhancing our knowledge regarding small cell neuroendocrine carcinoma in the vulva, given its scarcity in medical literature. The information presented here underscores the need for standardized diagnostic and treatment approaches, paving the way for future consensus on managing this uncommon but challenging neoplasm.展开更多
This study examines the depth of information regarding Female Genital Mutilation (FGM)/Female Cutting (FC) present in US medical textbooks. According to Klein et al. (2018) [1], despite substantial attention regarding...This study examines the depth of information regarding Female Genital Mutilation (FGM)/Female Cutting (FC) present in US medical textbooks. According to Klein et al. (2018) [1], despite substantial attention regarding the effects of FGM, this practice is still ongoing all over the world. Healthcare providers are very important actors who need to understand FGM in order to provide care to girls and women subjected to it, but the small amount of existing work in this area shows a low level of knowledge and training about FGM/FC among U.S. physicians. The Center for Disease Control and Prevention (CDC) first published the estimated number of girls at risk of FGM/FC in the U.S. to be about 168,000 in 1997;that number had increased to 513,000 girls in the US by 2012 (according to Goldberg et al.) In this study, a small sample of medical textbooks were analyzed for the degree to which the textbooks include information regarding FGM/FC. The results of this study show that US medical textbooks do not include information regarding FGM/FC, suggesting that most medical providers don’t have knowledge and training about FGM/FC. The inadequate information on FGM/FC in medical textbooks reflects a culturally biased lack of recognition of the number of girls and women affected in the US. This maintains an ongoing pattern of silence that reinforces gender inequality. Considering the inadequate information covered in US medical textbooks on FGM/FC, and the concordant lack of provider training to provide advice and care to affected girls and women, incorrect and missed diagnoses may lead to harm to victims of FGM/FC. Providers would be better equipped to care for women and girls if their medical training included information regarding FGM/FC.展开更多
From the perspective view of Chinese medicine,the Gan(Liver)meridian of Foot-Jueyin starts from the great toe,running upward along the medial side of the thigh to the perineal area,where it curves around the external ...From the perspective view of Chinese medicine,the Gan(Liver)meridian of Foot-Jueyin starts from the great toe,running upward along the medial side of the thigh to the perineal area,where it curves around the external genitalia and goes up to the lower abdomen.In clinical practice,acupoints in the feet of the Gan meridian of Foot-Jueyin are used to treat the genitourinary and external genitalia diseases.Studies have shown that reproductive system diseases have specific pathological reactions in the places(radial side of tibia and foot)where Gan meridian of Foot-Jueyin passes by.Why does this happen?In this article,we begin by briefly reviewing the evidences linking foot and genitalia.We then explore the potential mechanism of the relationship between genitals and the Gan meridian of Foot-Jueyin.The brain cerebral cortex is characterized by cortical interactions.Numerous studies show that different cerebral cortex function areas(especially the adjacent areas)are overlapping and interact with each other.Finally,we presume that there is a specific connection between the feet and the genitals.Physiologically in the cortical homunculus,the genital area lies adjacent or overlapped to the foot areas,the two areas may interact with each other.The functional reorganization between different areas of the cerebral cortex under pathological conditions may be the underlying mechanism of the relationship between the feet and the genitals.展开更多
To study the epidemio-clinical aspects, and the therapeutic attitudes of genital prolapse (GP) in the gynecology department of Hôpital du Mali (HDM). This is a descriptive retro-prospective study over five (...To study the epidemio-clinical aspects, and the therapeutic attitudes of genital prolapse (GP) in the gynecology department of Hôpital du Mali (HDM). This is a descriptive retro-prospective study over five (5) years from January 2015 to December 2019, conducted in the gynecology department of HDM. We had collected 100 cases of GP out of 989 surgeries, with a frequency of 9.89%. The age group of 60 years and over accounted for 33% of our patients, with a mean age of 50 years. Multiparous were the most affected (89%). The notion of obstructed labor was observed in 52% of patients. The most found reason for consultation was the feeling of lump in a vagina, with 65%. Grade III according to BADEN-WALKER classification system (BWCS) concerned 72% of our patients. Triple perineal surgery and hysterectomy involved 56% of our patients. Spinal anesthesia was performed in 96% of cases. Per and postoperative complications were dominated by urinary retention in 4% and by infection of the surgical site in 2%. The average hospital stay was 3.2 days. We recorded 88% of satisfied patients after the intervention. No deaths were recorded during the study. The management of genital prolapse remains essentially surgical;it requires a semiological analysis and a mastery of the surgical technique.展开更多
Introduction: Female Genital Bilharzia (FGB) is a pathology secondary to infection by Schistosoma haematobium. It is one of the neglected tropical diseases, capable of causing infertility, difficulties in childbirth a...Introduction: Female Genital Bilharzia (FGB) is a pathology secondary to infection by Schistosoma haematobium. It is one of the neglected tropical diseases, capable of causing infertility, difficulties in childbirth and even cervical cancer. It represents a real public health problem. We therefore conducted a study in the maternity ward of the Saint-Louis regional hospital, with the overall aim of determining the prevalence of FBG in patients undergoing colposcopy. The specific objectives were to define the patient profile, and to compare colposcopic images with the World Health Organization (WHO) atlas. Methodology: We conducted a descriptive, analytical cross-sectional study of all colposcopic images taken at the maternity ward of the Saint-Louis regional hospital from August 1, 2018, to September 30, 2020, i.e. 25 months. The images were compared with the BGF images described in the WHO atlas. Results: We collected 178 colposcopy images. FBG images numbered 50, or 28%. The mean age of the patients was 44.5 years ±11.4 at the extremes of 18 and 78 years. Mean gestational age was 4.69 ± 2.72. Among patients with a bilharzian lesion on the cervix, visual acid inspection (VIA) was negative in 60% of cases (p = 0.007, Odd Ratio = 3.6 (1.49 - 9.07)). Conclusion: the results of our study show that FBG is a reality in our daily practice. It occurs in adult, multigestating, non-occupational women whose examination reveals a negative visual inspection with acetic acid (VIA). Healthcare providers therefore need to be trained in the recognition of lesions associated with genital bilharziasis, and public awareness needs to be raised.展开更多
Background: Female Genital Mutilation is still practiced in Ebonyi State in Southeast Nigeria, despite the complications that follows it and government legislation against the practice. Aim: To determine the impact of...Background: Female Genital Mutilation is still practiced in Ebonyi State in Southeast Nigeria, despite the complications that follows it and government legislation against the practice. Aim: To determine the impact of Culture, Beliefs, attitude and Peer Group Influence on the persistence Female Genital Mutilation practice in the State especially in the rural areas. Materials and Methods: Qualitative study that used Focused Group Discussion and In-depth interviews for data collection. Those willing and given consent were recruited into the group discussion according to age, marital status, educational level and their location in the state. In-depth interviews were used with the Stake Holders, Opinion Leaders, Traditional Rulers and the Clergy. Result: A total of 454 participants were recruited from the 13 local government areas of Ebonyi State but only 420 (92.5%) participated. The age ranges of participants were 25 to 35 years for single males and females while the married participants male and female were aged 35 to 70 years. One hundred single females (23.8%) and 94 single males (21.4%) participated while 97 (23.1%) married women and 95 (22.6%) married men participated. Out of the 26 health workers recruited only 22 (5.2%) participated. Four traditional rulers, 4 women leaders, 4 youth leaders and 2 clergy 12 (2.9%) in number had in-depth interviews. All the participants had knowledge of FGM and its practice. Rural health workers are getting more involved. ‘Female Genital Crushing’ is replacing actual cutting. The participants all agreed there is no benefit and the practice should stop. Conclusion: Female Genital Mutilation is secretly practiced and is getting replaced by “Female Genital Crushing” perpetrated by rural health workers as well as mothers, fathers, traditional birth attendants and the peer group playing a major role with low knowledge of the Law against Female genital mutilation.展开更多
Background: Cystocele is an anatomical form of pelvic organ prolapse. It involves herniation of the bladder through the anterior wall of the vagina. Objectives: To report the anatomical and functional results of vagin...Background: Cystocele is an anatomical form of pelvic organ prolapse. It involves herniation of the bladder through the anterior wall of the vagina. Objectives: To report the anatomical and functional results of vaginal cure of cystocele in five cases. Patients and methods: A cross-sectional descriptive study of five patients presenting with a cystocele between January 2021 and December 2022 at the Urology Department of the Bouaké University Hospital (Côte d’Ivoire). All patients underwent vaginal cure of cystocele. The results of the operation were assessed on the basis of judgment criteria. The parameters studied were: age, marital status, profession, history, reason for consultation and outcome of the operation. Results: During the study period, five patients underwent vaginal cystocele surgery. The mean age was 46.6 years with extremes of 32 and 63 years. Three patients were married. All patients had a history of obstructed labour due to fetal macrosomia. 4 patients had grade II cystocele and one patient had grade III cystocele. All patients underwent anterior colpo-perineorrhaphy. The average operating time was 56 minutes (45 - 65 minutes). There was no morbidity. The average hospital stay was 3.6 days. The average duration of the urinary catheter was 2.2 days. At three months post-op, 4 patients had a good anatomical and functional result with a very good degree of satisfaction, compared with one patient who was moderately satisfied and had an average anatomical and functional result. At six months, all five patients had a good anatomical and functional result with a very good degree of satisfaction. Conclusion: Cure of cystoceles by the vaginal route is a technique that offers several advantages, especially the significant reduction in patient morbidity. Its anatomical and functional results demonstrate its reliability.展开更多
Magnetic resonance (MR) imaging of the scrotum represents an important supplemental diagnostic tool in the evaluation of scrotal diseases. Diffusion-weighted (DW) MR imaging is a developing technique, proved to im...Magnetic resonance (MR) imaging of the scrotum represents an important supplemental diagnostic tool in the evaluation of scrotal diseases. Diffusion-weighted (DW) MR imaging is a developing technique, proved to improve tissue characterization. We evaluated the feasibility and diagnostic performance of DW MR imaging in the detection and characterization of scrotal lesions. We retrospectively evaluated 31 scrotal lesions (23 intratesticular and 8 extratesticular) in 26 men. All MR examinations were performed on a 1.5-T unit, using a pelvic-phased array coil. DW sequences were obtained using a single shot, multislice spin echo planar diffusion pulse sequence and a b factor of 0 and 900 s mm-2. The DW MR characteristics and the apparent diffusion coefficient (ADC) values of normal scrotal contents and scrotal diseases were evaluated. Comparison between the ADC values of normal scrotum, benign lesions and scrotal malignancies was performed. The accuracy of conventional sequences, DW images alone and DW imaging combined with conventional images in differentiating benign from malignant scmtal lesions was calculated. The ADC values of testicular malignancies were different from those of normal testis and benign intratesticular lesions, and the ADC values of benign extratesticular lesions from those of normal epididymis (P〈0.05). The overall accuracy of conventional imaging, DW imaging alone and DW MR combined with conventional sequences in the characterization of intratesticular lesions was 91%, 87% and 100%, respectively. Our findings suggest that DW MR imaging and ADC values may provide valuable information in the diagnosis and characterization of scrotal diseases.展开更多
Aim: To investigate age-related inflammatory events in the male genital tract. Methods: In a total of 4 265 randomly collected patients attending the andrological outpatient clinic of the Center for Dermatology and ...Aim: To investigate age-related inflammatory events in the male genital tract. Methods: In a total of 4 265 randomly collected patients attending the andrological outpatient clinic of the Center for Dermatology and Andrology, University of Giessen, Germany, ejaculate volume, pH-value, sperm concentration, total and progressive sperm motility, concentration of polymorphonuclear (PMN) elastase, number of peroxidase-positive cells and fructose were measured and correlated with patient's age. Results: While ejaculate volume, motility and fructose all correlated negatively with age, sperm concentration, PMN elastase and the pH-value showed a positive correlation. The prevalence of male genital tract inflammation (as defined by PMN elastase 〉 250 ng/mL) and its severity increased significantly. PMN elastase did not correlate with sperm motility. Fructose as a marker of seminal vesicle function showed a significant negative relationship with the PMN elastase levels, the number of peroxidase-positive cells and sperm motility. Conclusion: The significant increases of PMN elastase levels as marker of male genital tract inflammation in older men appear to be indicative of age-related changes in local immunoregulatory mechanisms. Because there is no association of PMN elastase with sperm motility, a direct inhibitory effect of this enzyme can be excluded.展开更多
To evaluate the anesthetic effect of ultrasound-guided(USG)ilioinguinal/iliohypogastric nerve(Ⅱ/IHN)block combined with genital branch of genitofemoral nerve(GFN)block in the elderly undergoing inguinal hernia repair...To evaluate the anesthetic effect of ultrasound-guided(USG)ilioinguinal/iliohypogastric nerve(Ⅱ/IHN)block combined with genital branch of genitofemoral nerve(GFN)block in the elderly undergoing inguinal hernia repair,54 old patients(aged 60-96years,ASAⅠ-Ⅲ)with indirect hernia were enrolled and scheduled for unilateral tensiofree herniorrhaphy.Patients were grouped randomly to receive either USGⅡ/IHN plus GFN block(Group G)or USGⅡ/IHN block alone(GroupⅠ).The intraoperative visual analogue scale(VAS)scores were recorded at skin incision,at spermatic cord/round ligament traction and at sac ligation.The resting and dynamic VAS scores were recorded postoperatively.The requirements of extra sedatives and analgesics for intra-and postoperative analgesia were assessed.Occurrence of complications of the block,postoperative nausea and vomiting and femoral nerve palsy was also reported.Both groups showed similar sensory block.When stretching spermatic cord/round ligament,the patients in group G had significantly lower VAS scores than in group.And group G used much fewer adjuvant sedatives and analgesics to achieve adequate anaesthesia.In addition,group G was presented with better intraoperative anaesthesia and lower postoperative dynamic VAS scores at all time points tested.No significant difference was found in the postoperative requirement of rescue medication.Both groups showed no complications related to the block and group G reported no femoral nerve palsy.The addition of GFN block toⅡ/IHN block improves the quality of perioperative anesthesia and analgesia in the elderly and reduces the consumption of extra sedatives and analgesics during the surgery.展开更多
The aims of this study were (a) to determine the prevalence of subjects with semen hyperviscosity (SHV) in a large population of male partners of subfertile couples; (b) to identify any correlation between SHV a...The aims of this study were (a) to determine the prevalence of subjects with semen hyperviscosity (SHV) in a large population of male partners of subfertile couples; (b) to identify any correlation between SHV and infections or inflammation of the genital tract; (c) to assess the effects of therapeutic approaches for treating SHV; and (d) to assess sperm kinetic parameters after successful treatment of SHV. A retrospective study of 1 833 male partners of subfertile couples was conducted. Next, clinical, seminal, bacteriological and ultrasound studies involving 52 subjects suffering from SHV were performed, and the SHV was classified as being mild (length of thread 〉 2 cm and ≤4 cm), moderate (〉 4 cm and ≤ 6 cm) or severe (〉 6 cm). The prevalence of SHV was observed in 26.2% (480) of the subjects, with 13.2% suffering from mild, 6.6% from moderate and 6.4% from severe SHV. Treatment was completely successful in only 27 subjects (52.0%), primarily in those who had mild basal SHV with a positive semen culture. In these subjects, progressive motility percentage, straight line velocity and linearity were significantly higher than pre-treatment levels. SHV is often found in subjects with subfertility. Pathogenesis was strictly related to infective/inflammatory factors in only 48.0% of cases; therefore, it is possible that biochemical, enzymatic or genetic factors have a role in this condition.展开更多
For assisted reproduction technologies (ART), numerous techniques were developed to isolate spermatozoa capable of fertilizing oocytes. While early methodologies only focused on isolating viable, motile spermatozoa,...For assisted reproduction technologies (ART), numerous techniques were developed to isolate spermatozoa capable of fertilizing oocytes. While early methodologies only focused on isolating viable, motile spermatozoa, with progress of ART, particularly intracytoplasmic sperm injection (ICSI), it became clear that these parameters are insufficient for the identification of the most suitable spermatozoon for fertilization. Conventional sperm preparation techniques, namely, swim-up, density gradient centrifugation and glass wool filtration, are not efficient enough to produce sperm populations free of DNA damage, because these techniques are not physiological and not modeled on the stringent sperm selection processes taking place in the female genital tract. These processes only allow one male germ cell out of tens of millions to fuse with the oocyte. Sites of sperm selection in the female genital tract are the cervix, uterus, uterotubal junction, oviduct, cumulus oophorus and the zona pellucida. Newer strategies of sperm preparation are founded oni (i) morphological assessment by means of'motile sperm organelle morphological examination (MSOM E)'; (ii) electrical charge; and (ili) molecular binding characteristics of the sperm cell. Whereas separation methods based on electrical charge take advantage of the sperm's adherence to a test tube surface or separate in an electrophoresis, molecular binding techniques use Annexin V or hyaluronic acid (HA) as substrates. Techniques in this category are magnet-activated cell sorting, Annexin V-activated glass wool filtration, flow cytometry and picked spermatozoa for ICSI (PICSI) from HA-coated dishes and HA-containing media. Future developments may include Raman microspectrometry, confocal light absorption and scattering spectroscopic microscopy and polarization microscopy.展开更多
The oriental armyworm,Mythimna separata(Lepidoptera:Noctuidae)is a harmful pest which causes heavy loss in agricultural crops.Sex identification of M.separata is very important for understanding the biology and manage...The oriental armyworm,Mythimna separata(Lepidoptera:Noctuidae)is a harmful pest which causes heavy loss in agricultural crops.Sex identification of M.separata is very important for understanding the biology and management of this pest.Development of fast and convenient methods to identify M.separata female and male is the necessary prerequisite for con ducting gender-related studies.In this study,new methods to differentiate sex of M.separata at pupal and adult stages were investigated.Our results showed that posterior abdominal segments containing genital organs which are morphological traits to differentiate female and male.Genital openings are important characters for the female and male pupae differentiation.For female pupa,it locates on the ventral side of eighth and ninth abdominal segments and appears as a visible longitudinal suture;for male pupa,it locates on the ventral side of the ninth abdominal segment and appears as a short slit surrounded by a pair of visible semicircular lumps.Bristle numbers are another indicator for sex differentiation of adults.Each female has three-bristled frenulum and each male has one bristled-frenulum near the base of hind wing of each side of moth body.We confirmed the two sex differentiation methods manually by dissecting genitalia of adults and found their genger was as same as what we examined the sex of pupae and adults using the morphological methods.展开更多
Determination of markers of sperm function, accessory sex gland secretion and silent male genital tractinflammation is of considerable diagnostic value in the evaluation of male infertility. The introduction of bioche...Determination of markers of sperm function, accessory sex gland secretion and silent male genital tractinflammation is of considerable diagnostic value in the evaluation of male infertility. The introduction of biochemicaltests into the analysis of male factor has the advantage that standardized assays with a coefficient of variationcharacteristic of clinical chemistry are performed, in contrast to biological test systems with a large variability.Biochemical parameters may be used in clinical practice to evaluate the sperm fertilizing capacity (acrosin, aniline blue,ROS), to characterize male accessory sex gland secretions (fructose, α-glucosidase, PSA), and to identify men withsilent genital tract inflammation (elastase, C'3 complement component, coeruloplasmin, IgA, IgG, ROS).展开更多
Objective:To assess the prevalence of bacterial strains and fungal strains infecting the vaginal tract and test their sensitivity to antibiotics in women attending Saint Camille Medical Centre in Ouagadougou.Methods:F...Objective:To assess the prevalence of bacterial strains and fungal strains infecting the vaginal tract and test their sensitivity to antibiotics in women attending Saint Camille Medical Centre in Ouagadougou.Methods:From January 2008 to December 2009,a total of 2000 vaginal swabs were cultivated for bacterial and fungal identification and isolation.Furthermore,bacterial strains were tested for their susceptibility to several antibiotics used in routine in the centre. Results:The results revealed that microbial isolation and identification was attempted for 1536/2000 sample,a positivity rate of 76.80%.Candida albicans(48.76%),followed by Escherichia coli(16.67%),Streptococcus agalactiae(8-14%) and Staphylococcus aureus(7.55%) were the major agents of genital tract infections in patients.Mycoplasma hominis and Ureaplasma urealyticum combined accounted for less than 7%.Trichomonas vaginalis was identified in 1.04%coses.The antimicrobial tests revealed that the microorganisms developed resistance to several antibiotics including beta lactams.However,antibiotics such as cefamenzol,ciprofloxacin and norfloxacin were still active on these bacteria.Conclusions:The results reveal that many sexually active women are infected by one or more microbial pathogens,probably because of the lock of hygiene or the adoption of some risky behaviors,such as not using condoms or having multiple sexual partners.Efforts should be made to address these points in the country.展开更多
Aim: To present a simple technique during penile prosthesis implantation that promotes the perception of increased phallic length. Methods: The penoscrotal web is defined. A "check mark" incision is made with exci...Aim: To present a simple technique during penile prosthesis implantation that promotes the perception of increased phallic length. Methods: The penoscrotal web is defined. A "check mark" incision is made with excision of scrotal tissue. Excellent exposure is provided for implantation of the cylinders, pump and reservoir. Wound closure is performed longitudinally. Results: This technique is a modified extension of surgeries described in the pediatric literature for webbed penis. Loss of penile length following penile implantation surgery is worrisome for patients suffering from erectile dysfunction (ED). This technique helps with patient satisfaction, cosmetic results, and improves perception of penile length. Conclusion: Ventral phalloplasty is a safe, technically simple procedure that may be performed in concert with penile prosthesis implantation or as a stand alone procedure under'certain circumstances.展开更多
Penile reconstruction still represents a formidable challenge for the urologist. In this review, the most recent advances in penile reconstruction after trauma, excision of benign and malignant disease and in patients...Penile reconstruction still represents a formidable challenge for the urologist. In this review, the most recent advances in penile reconstruction after trauma, excision of benign and malignant disease and in patients with micropenis, aphallia or female to male gender dysphoria are reported.展开更多
In order to investigate the IFN-γ and IL-4 expression of CD8^+T lymphoeytes in the peripheral blood from patients with recurrent genital herpes (RGH) at different clinical periods and their relationship with the p...In order to investigate the IFN-γ and IL-4 expression of CD8^+T lymphoeytes in the peripheral blood from patients with recurrent genital herpes (RGH) at different clinical periods and their relationship with the pathogenesis of RGH, flow cytometry was used to detect the intracellular cytokines (IFN-γ and IL-4) of CD8^+ T lymphocytes in the peripheral blood of 30 patients with RGH at acute period, 20 patients with RGH at recovery period and 15 healthy volunteers. The results showed that RGH patients at acute period had a lower percentage of Tcl subsets in peripheral blood than that of healthy controls (P〈0. 001), especially a remarkable decreased percentage of Tc1 subsets (P〈0. 001) among those RGH patients with recurrent number more than 3 in the recent half a year. Tc1/Tc2 ratio in the RGH patients at acute period was significantly decreased as conapared with normal control group (P〈0.05). The recurrent number of acute patients in the recent half a year was significantly correlated with the percentage of Tc1 subsets and the ratio of Tc1/Tc2 (P〈 0.05). A decreased percentage of Tc1 subsets was found among the RGH patients with recurrent number more than 3 in the recent half a year at recovery period in comparison with healthy volunteers (P〈0.05), and it was significantly correlated with the recurrent number in the recent half a year (P〈0.05). It is concluded that there are Tc1/Tc2 imbalance and a low level of Tc1 subsets in RGH patients who are relapsing repeatedly in the near period. The low level of Tc1 subsets may be an important factor for the recurrence of RGH and the reactivation of latent herpesvirus infection.展开更多
文摘<strong>Introduction:</strong> Trauma of the external male genital organs (TEMGO) is multifaceted and rare. The objective of this work was to provide an overview of these lesions by describing the epidemiology, the diagnostic approach, their therapeutic and prognostic aspects. <strong>Materials and Methods:</strong> It was a retrospective study carried out over a ten-year period, from January 1, 2009 to December 31, 2018. It included male patients, admitted and treated in surgical emergencies and in the urology department of the Sylvanus Olympio Teaching Hospital in Lomé for trauma of male external genital organs. <strong>Results:</strong> Thirty-five cases had been collected. They had represented 1.5% of urological emergencies. The subjects were young with a mean age of 29.6 ± 3.1 years, with extremes of 18 and 60 years. Trauma to the penis was more frequent and found in 60% of cases, with the mechanism of coitus misstep in 54.3%, leading to a fracture of the penis. Testicular contusions were found in 22.9% of the cases. The ultrasound was performed in 6 patients. Four orchidectomies were performed for an unsustainable testicle found at scrototomy. The postoperative had been simple in all cases. Fifteen patients (42.8%) had been regularly followed on 18 months. Residual testicular pain and mode-rate erectile dysfunction was noted respectively in 3 and 2 patients. <strong>Conclusion:</strong> TEMGO, although rare, require perfect knowledge for adequate therapeutic decisions, as they can compromise the functional prognosis of concerned organs.
文摘Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. When present, these neoplasms often manifest with nonspecific signs and symptoms such as pain, itching, swelling, single-focus lesions, bleeding, and enlargement of inguinal lymph nodes, in addition to the presence of progressively enlarging vulvar nodules. Consequently, the diagnostic investigation involves histopathological examination and confirmation through immunohistochemistry. Objective: To present a comprehensive understanding of this rarely studied pathology. The primary objective is to provide valuable insights that could aid in the future development of universally applicable treatment guidelines. Case Presentation: A 57-year-old female, with no prior comorbidities, menopause at 36, who presented with a left vulvar nodule accompanied by intense pain and swelling, later diagnosed with small cell neuroendocrine carcinoma in the vulva. Conclusion: This case report highlights the importance of enhancing our knowledge regarding small cell neuroendocrine carcinoma in the vulva, given its scarcity in medical literature. The information presented here underscores the need for standardized diagnostic and treatment approaches, paving the way for future consensus on managing this uncommon but challenging neoplasm.
文摘This study examines the depth of information regarding Female Genital Mutilation (FGM)/Female Cutting (FC) present in US medical textbooks. According to Klein et al. (2018) [1], despite substantial attention regarding the effects of FGM, this practice is still ongoing all over the world. Healthcare providers are very important actors who need to understand FGM in order to provide care to girls and women subjected to it, but the small amount of existing work in this area shows a low level of knowledge and training about FGM/FC among U.S. physicians. The Center for Disease Control and Prevention (CDC) first published the estimated number of girls at risk of FGM/FC in the U.S. to be about 168,000 in 1997;that number had increased to 513,000 girls in the US by 2012 (according to Goldberg et al.) In this study, a small sample of medical textbooks were analyzed for the degree to which the textbooks include information regarding FGM/FC. The results of this study show that US medical textbooks do not include information regarding FGM/FC, suggesting that most medical providers don’t have knowledge and training about FGM/FC. The inadequate information on FGM/FC in medical textbooks reflects a culturally biased lack of recognition of the number of girls and women affected in the US. This maintains an ongoing pattern of silence that reinforces gender inequality. Considering the inadequate information covered in US medical textbooks on FGM/FC, and the concordant lack of provider training to provide advice and care to affected girls and women, incorrect and missed diagnoses may lead to harm to victims of FGM/FC. Providers would be better equipped to care for women and girls if their medical training included information regarding FGM/FC.
基金Supported by the National Key Research and Development Program of China(No.2019YFC1709100No.2019YFC1709102)National Natural Science Foundation of China(No.81673888)。
文摘From the perspective view of Chinese medicine,the Gan(Liver)meridian of Foot-Jueyin starts from the great toe,running upward along the medial side of the thigh to the perineal area,where it curves around the external genitalia and goes up to the lower abdomen.In clinical practice,acupoints in the feet of the Gan meridian of Foot-Jueyin are used to treat the genitourinary and external genitalia diseases.Studies have shown that reproductive system diseases have specific pathological reactions in the places(radial side of tibia and foot)where Gan meridian of Foot-Jueyin passes by.Why does this happen?In this article,we begin by briefly reviewing the evidences linking foot and genitalia.We then explore the potential mechanism of the relationship between genitals and the Gan meridian of Foot-Jueyin.The brain cerebral cortex is characterized by cortical interactions.Numerous studies show that different cerebral cortex function areas(especially the adjacent areas)are overlapping and interact with each other.Finally,we presume that there is a specific connection between the feet and the genitals.Physiologically in the cortical homunculus,the genital area lies adjacent or overlapped to the foot areas,the two areas may interact with each other.The functional reorganization between different areas of the cerebral cortex under pathological conditions may be the underlying mechanism of the relationship between the feet and the genitals.
文摘To study the epidemio-clinical aspects, and the therapeutic attitudes of genital prolapse (GP) in the gynecology department of Hôpital du Mali (HDM). This is a descriptive retro-prospective study over five (5) years from January 2015 to December 2019, conducted in the gynecology department of HDM. We had collected 100 cases of GP out of 989 surgeries, with a frequency of 9.89%. The age group of 60 years and over accounted for 33% of our patients, with a mean age of 50 years. Multiparous were the most affected (89%). The notion of obstructed labor was observed in 52% of patients. The most found reason for consultation was the feeling of lump in a vagina, with 65%. Grade III according to BADEN-WALKER classification system (BWCS) concerned 72% of our patients. Triple perineal surgery and hysterectomy involved 56% of our patients. Spinal anesthesia was performed in 96% of cases. Per and postoperative complications were dominated by urinary retention in 4% and by infection of the surgical site in 2%. The average hospital stay was 3.2 days. We recorded 88% of satisfied patients after the intervention. No deaths were recorded during the study. The management of genital prolapse remains essentially surgical;it requires a semiological analysis and a mastery of the surgical technique.
文摘Introduction: Female Genital Bilharzia (FGB) is a pathology secondary to infection by Schistosoma haematobium. It is one of the neglected tropical diseases, capable of causing infertility, difficulties in childbirth and even cervical cancer. It represents a real public health problem. We therefore conducted a study in the maternity ward of the Saint-Louis regional hospital, with the overall aim of determining the prevalence of FBG in patients undergoing colposcopy. The specific objectives were to define the patient profile, and to compare colposcopic images with the World Health Organization (WHO) atlas. Methodology: We conducted a descriptive, analytical cross-sectional study of all colposcopic images taken at the maternity ward of the Saint-Louis regional hospital from August 1, 2018, to September 30, 2020, i.e. 25 months. The images were compared with the BGF images described in the WHO atlas. Results: We collected 178 colposcopy images. FBG images numbered 50, or 28%. The mean age of the patients was 44.5 years ±11.4 at the extremes of 18 and 78 years. Mean gestational age was 4.69 ± 2.72. Among patients with a bilharzian lesion on the cervix, visual acid inspection (VIA) was negative in 60% of cases (p = 0.007, Odd Ratio = 3.6 (1.49 - 9.07)). Conclusion: the results of our study show that FBG is a reality in our daily practice. It occurs in adult, multigestating, non-occupational women whose examination reveals a negative visual inspection with acetic acid (VIA). Healthcare providers therefore need to be trained in the recognition of lesions associated with genital bilharziasis, and public awareness needs to be raised.
文摘Background: Female Genital Mutilation is still practiced in Ebonyi State in Southeast Nigeria, despite the complications that follows it and government legislation against the practice. Aim: To determine the impact of Culture, Beliefs, attitude and Peer Group Influence on the persistence Female Genital Mutilation practice in the State especially in the rural areas. Materials and Methods: Qualitative study that used Focused Group Discussion and In-depth interviews for data collection. Those willing and given consent were recruited into the group discussion according to age, marital status, educational level and their location in the state. In-depth interviews were used with the Stake Holders, Opinion Leaders, Traditional Rulers and the Clergy. Result: A total of 454 participants were recruited from the 13 local government areas of Ebonyi State but only 420 (92.5%) participated. The age ranges of participants were 25 to 35 years for single males and females while the married participants male and female were aged 35 to 70 years. One hundred single females (23.8%) and 94 single males (21.4%) participated while 97 (23.1%) married women and 95 (22.6%) married men participated. Out of the 26 health workers recruited only 22 (5.2%) participated. Four traditional rulers, 4 women leaders, 4 youth leaders and 2 clergy 12 (2.9%) in number had in-depth interviews. All the participants had knowledge of FGM and its practice. Rural health workers are getting more involved. ‘Female Genital Crushing’ is replacing actual cutting. The participants all agreed there is no benefit and the practice should stop. Conclusion: Female Genital Mutilation is secretly practiced and is getting replaced by “Female Genital Crushing” perpetrated by rural health workers as well as mothers, fathers, traditional birth attendants and the peer group playing a major role with low knowledge of the Law against Female genital mutilation.
文摘Background: Cystocele is an anatomical form of pelvic organ prolapse. It involves herniation of the bladder through the anterior wall of the vagina. Objectives: To report the anatomical and functional results of vaginal cure of cystocele in five cases. Patients and methods: A cross-sectional descriptive study of five patients presenting with a cystocele between January 2021 and December 2022 at the Urology Department of the Bouaké University Hospital (Côte d’Ivoire). All patients underwent vaginal cure of cystocele. The results of the operation were assessed on the basis of judgment criteria. The parameters studied were: age, marital status, profession, history, reason for consultation and outcome of the operation. Results: During the study period, five patients underwent vaginal cystocele surgery. The mean age was 46.6 years with extremes of 32 and 63 years. Three patients were married. All patients had a history of obstructed labour due to fetal macrosomia. 4 patients had grade II cystocele and one patient had grade III cystocele. All patients underwent anterior colpo-perineorrhaphy. The average operating time was 56 minutes (45 - 65 minutes). There was no morbidity. The average hospital stay was 3.6 days. The average duration of the urinary catheter was 2.2 days. At three months post-op, 4 patients had a good anatomical and functional result with a very good degree of satisfaction, compared with one patient who was moderately satisfied and had an average anatomical and functional result. At six months, all five patients had a good anatomical and functional result with a very good degree of satisfaction. Conclusion: Cure of cystoceles by the vaginal route is a technique that offers several advantages, especially the significant reduction in patient morbidity. Its anatomical and functional results demonstrate its reliability.
文摘Magnetic resonance (MR) imaging of the scrotum represents an important supplemental diagnostic tool in the evaluation of scrotal diseases. Diffusion-weighted (DW) MR imaging is a developing technique, proved to improve tissue characterization. We evaluated the feasibility and diagnostic performance of DW MR imaging in the detection and characterization of scrotal lesions. We retrospectively evaluated 31 scrotal lesions (23 intratesticular and 8 extratesticular) in 26 men. All MR examinations were performed on a 1.5-T unit, using a pelvic-phased array coil. DW sequences were obtained using a single shot, multislice spin echo planar diffusion pulse sequence and a b factor of 0 and 900 s mm-2. The DW MR characteristics and the apparent diffusion coefficient (ADC) values of normal scrotal contents and scrotal diseases were evaluated. Comparison between the ADC values of normal scrotum, benign lesions and scrotal malignancies was performed. The accuracy of conventional sequences, DW images alone and DW imaging combined with conventional images in differentiating benign from malignant scmtal lesions was calculated. The ADC values of testicular malignancies were different from those of normal testis and benign intratesticular lesions, and the ADC values of benign extratesticular lesions from those of normal epididymis (P〈0.05). The overall accuracy of conventional imaging, DW imaging alone and DW MR combined with conventional sequences in the characterization of intratesticular lesions was 91%, 87% and 100%, respectively. Our findings suggest that DW MR imaging and ADC values may provide valuable information in the diagnosis and characterization of scrotal diseases.
文摘Aim: To investigate age-related inflammatory events in the male genital tract. Methods: In a total of 4 265 randomly collected patients attending the andrological outpatient clinic of the Center for Dermatology and Andrology, University of Giessen, Germany, ejaculate volume, pH-value, sperm concentration, total and progressive sperm motility, concentration of polymorphonuclear (PMN) elastase, number of peroxidase-positive cells and fructose were measured and correlated with patient's age. Results: While ejaculate volume, motility and fructose all correlated negatively with age, sperm concentration, PMN elastase and the pH-value showed a positive correlation. The prevalence of male genital tract inflammation (as defined by PMN elastase 〉 250 ng/mL) and its severity increased significantly. PMN elastase did not correlate with sperm motility. Fructose as a marker of seminal vesicle function showed a significant negative relationship with the PMN elastase levels, the number of peroxidase-positive cells and sperm motility. Conclusion: The significant increases of PMN elastase levels as marker of male genital tract inflammation in older men appear to be indicative of age-related changes in local immunoregulatory mechanisms. Because there is no association of PMN elastase with sperm motility, a direct inhibitory effect of this enzyme can be excluded.
文摘To evaluate the anesthetic effect of ultrasound-guided(USG)ilioinguinal/iliohypogastric nerve(Ⅱ/IHN)block combined with genital branch of genitofemoral nerve(GFN)block in the elderly undergoing inguinal hernia repair,54 old patients(aged 60-96years,ASAⅠ-Ⅲ)with indirect hernia were enrolled and scheduled for unilateral tensiofree herniorrhaphy.Patients were grouped randomly to receive either USGⅡ/IHN plus GFN block(Group G)or USGⅡ/IHN block alone(GroupⅠ).The intraoperative visual analogue scale(VAS)scores were recorded at skin incision,at spermatic cord/round ligament traction and at sac ligation.The resting and dynamic VAS scores were recorded postoperatively.The requirements of extra sedatives and analgesics for intra-and postoperative analgesia were assessed.Occurrence of complications of the block,postoperative nausea and vomiting and femoral nerve palsy was also reported.Both groups showed similar sensory block.When stretching spermatic cord/round ligament,the patients in group G had significantly lower VAS scores than in group.And group G used much fewer adjuvant sedatives and analgesics to achieve adequate anaesthesia.In addition,group G was presented with better intraoperative anaesthesia and lower postoperative dynamic VAS scores at all time points tested.No significant difference was found in the postoperative requirement of rescue medication.Both groups showed no complications related to the block and group G reported no femoral nerve palsy.The addition of GFN block toⅡ/IHN block improves the quality of perioperative anesthesia and analgesia in the elderly and reduces the consumption of extra sedatives and analgesics during the surgery.
文摘The aims of this study were (a) to determine the prevalence of subjects with semen hyperviscosity (SHV) in a large population of male partners of subfertile couples; (b) to identify any correlation between SHV and infections or inflammation of the genital tract; (c) to assess the effects of therapeutic approaches for treating SHV; and (d) to assess sperm kinetic parameters after successful treatment of SHV. A retrospective study of 1 833 male partners of subfertile couples was conducted. Next, clinical, seminal, bacteriological and ultrasound studies involving 52 subjects suffering from SHV were performed, and the SHV was classified as being mild (length of thread 〉 2 cm and ≤4 cm), moderate (〉 4 cm and ≤ 6 cm) or severe (〉 6 cm). The prevalence of SHV was observed in 26.2% (480) of the subjects, with 13.2% suffering from mild, 6.6% from moderate and 6.4% from severe SHV. Treatment was completely successful in only 27 subjects (52.0%), primarily in those who had mild basal SHV with a positive semen culture. In these subjects, progressive motility percentage, straight line velocity and linearity were significantly higher than pre-treatment levels. SHV is often found in subjects with subfertility. Pathogenesis was strictly related to infective/inflammatory factors in only 48.0% of cases; therefore, it is possible that biochemical, enzymatic or genetic factors have a role in this condition.
文摘For assisted reproduction technologies (ART), numerous techniques were developed to isolate spermatozoa capable of fertilizing oocytes. While early methodologies only focused on isolating viable, motile spermatozoa, with progress of ART, particularly intracytoplasmic sperm injection (ICSI), it became clear that these parameters are insufficient for the identification of the most suitable spermatozoon for fertilization. Conventional sperm preparation techniques, namely, swim-up, density gradient centrifugation and glass wool filtration, are not efficient enough to produce sperm populations free of DNA damage, because these techniques are not physiological and not modeled on the stringent sperm selection processes taking place in the female genital tract. These processes only allow one male germ cell out of tens of millions to fuse with the oocyte. Sites of sperm selection in the female genital tract are the cervix, uterus, uterotubal junction, oviduct, cumulus oophorus and the zona pellucida. Newer strategies of sperm preparation are founded oni (i) morphological assessment by means of'motile sperm organelle morphological examination (MSOM E)'; (ii) electrical charge; and (ili) molecular binding characteristics of the sperm cell. Whereas separation methods based on electrical charge take advantage of the sperm's adherence to a test tube surface or separate in an electrophoresis, molecular binding techniques use Annexin V or hyaluronic acid (HA) as substrates. Techniques in this category are magnet-activated cell sorting, Annexin V-activated glass wool filtration, flow cytometry and picked spermatozoa for ICSI (PICSI) from HA-coated dishes and HA-containing media. Future developments may include Raman microspectrometry, confocal light absorption and scattering spectroscopic microscopy and polarization microscopy.
基金This research was financially supported by the National Natural Science Foundation of China(31601691 and 31272089).The authors thank Dr.Xue Shuang(Anyang In stitute of Tech no logy,Henan Province,China)for technical assistanee in dissecting genitalia.
文摘The oriental armyworm,Mythimna separata(Lepidoptera:Noctuidae)is a harmful pest which causes heavy loss in agricultural crops.Sex identification of M.separata is very important for understanding the biology and management of this pest.Development of fast and convenient methods to identify M.separata female and male is the necessary prerequisite for con ducting gender-related studies.In this study,new methods to differentiate sex of M.separata at pupal and adult stages were investigated.Our results showed that posterior abdominal segments containing genital organs which are morphological traits to differentiate female and male.Genital openings are important characters for the female and male pupae differentiation.For female pupa,it locates on the ventral side of eighth and ninth abdominal segments and appears as a visible longitudinal suture;for male pupa,it locates on the ventral side of the ninth abdominal segment and appears as a short slit surrounded by a pair of visible semicircular lumps.Bristle numbers are another indicator for sex differentiation of adults.Each female has three-bristled frenulum and each male has one bristled-frenulum near the base of hind wing of each side of moth body.We confirmed the two sex differentiation methods manually by dissecting genitalia of adults and found their genger was as same as what we examined the sex of pupae and adults using the morphological methods.
文摘Determination of markers of sperm function, accessory sex gland secretion and silent male genital tractinflammation is of considerable diagnostic value in the evaluation of male infertility. The introduction of biochemicaltests into the analysis of male factor has the advantage that standardized assays with a coefficient of variationcharacteristic of clinical chemistry are performed, in contrast to biological test systems with a large variability.Biochemical parameters may be used in clinical practice to evaluate the sperm fertilizing capacity (acrosin, aniline blue,ROS), to characterize male accessory sex gland secretions (fructose, α-glucosidase, PSA), and to identify men withsilent genital tract inflammation (elastase, C'3 complement component, coeruloplasmin, IgA, IgG, ROS).
文摘Objective:To assess the prevalence of bacterial strains and fungal strains infecting the vaginal tract and test their sensitivity to antibiotics in women attending Saint Camille Medical Centre in Ouagadougou.Methods:From January 2008 to December 2009,a total of 2000 vaginal swabs were cultivated for bacterial and fungal identification and isolation.Furthermore,bacterial strains were tested for their susceptibility to several antibiotics used in routine in the centre. Results:The results revealed that microbial isolation and identification was attempted for 1536/2000 sample,a positivity rate of 76.80%.Candida albicans(48.76%),followed by Escherichia coli(16.67%),Streptococcus agalactiae(8-14%) and Staphylococcus aureus(7.55%) were the major agents of genital tract infections in patients.Mycoplasma hominis and Ureaplasma urealyticum combined accounted for less than 7%.Trichomonas vaginalis was identified in 1.04%coses.The antimicrobial tests revealed that the microorganisms developed resistance to several antibiotics including beta lactams.However,antibiotics such as cefamenzol,ciprofloxacin and norfloxacin were still active on these bacteria.Conclusions:The results reveal that many sexually active women are infected by one or more microbial pathogens,probably because of the lock of hygiene or the adoption of some risky behaviors,such as not using condoms or having multiple sexual partners.Efforts should be made to address these points in the country.
文摘Aim: To present a simple technique during penile prosthesis implantation that promotes the perception of increased phallic length. Methods: The penoscrotal web is defined. A "check mark" incision is made with excision of scrotal tissue. Excellent exposure is provided for implantation of the cylinders, pump and reservoir. Wound closure is performed longitudinally. Results: This technique is a modified extension of surgeries described in the pediatric literature for webbed penis. Loss of penile length following penile implantation surgery is worrisome for patients suffering from erectile dysfunction (ED). This technique helps with patient satisfaction, cosmetic results, and improves perception of penile length. Conclusion: Ventral phalloplasty is a safe, technically simple procedure that may be performed in concert with penile prosthesis implantation or as a stand alone procedure under'certain circumstances.
文摘Penile reconstruction still represents a formidable challenge for the urologist. In this review, the most recent advances in penile reconstruction after trauma, excision of benign and malignant disease and in patients with micropenis, aphallia or female to male gender dysphoria are reported.
文摘In order to investigate the IFN-γ and IL-4 expression of CD8^+T lymphoeytes in the peripheral blood from patients with recurrent genital herpes (RGH) at different clinical periods and their relationship with the pathogenesis of RGH, flow cytometry was used to detect the intracellular cytokines (IFN-γ and IL-4) of CD8^+ T lymphocytes in the peripheral blood of 30 patients with RGH at acute period, 20 patients with RGH at recovery period and 15 healthy volunteers. The results showed that RGH patients at acute period had a lower percentage of Tcl subsets in peripheral blood than that of healthy controls (P〈0. 001), especially a remarkable decreased percentage of Tc1 subsets (P〈0. 001) among those RGH patients with recurrent number more than 3 in the recent half a year. Tc1/Tc2 ratio in the RGH patients at acute period was significantly decreased as conapared with normal control group (P〈0.05). The recurrent number of acute patients in the recent half a year was significantly correlated with the percentage of Tc1 subsets and the ratio of Tc1/Tc2 (P〈 0.05). A decreased percentage of Tc1 subsets was found among the RGH patients with recurrent number more than 3 in the recent half a year at recovery period in comparison with healthy volunteers (P〈0.05), and it was significantly correlated with the recurrent number in the recent half a year (P〈0.05). It is concluded that there are Tc1/Tc2 imbalance and a low level of Tc1 subsets in RGH patients who are relapsing repeatedly in the near period. The low level of Tc1 subsets may be an important factor for the recurrence of RGH and the reactivation of latent herpesvirus infection.