Gangrene of the External Genitalia at Chu-Abeche

Introduction: Gangrene of the external genitalia organs (EGO) is a medico-surgical emergency that is still very common in Third World countries. The main etiologies are urogenital, dermocutaneous and proctological. Mortality remains very high despite therapeutic advances. Our aim was to report on the epidemiological, diagnostic and therapeutic aspects of gangrene of the external genitalia, and to identify prognostic factors. Patients and Method: This was a 5-year retrospective descriptive study, from February 2016 to February 2021, of cases of gangrene of the external genitalia admitted to and treated in the Urology Department of Abeche University Hospital. Results: We collected 49 cases of gangrene of the external genitalia. The mean age of patients was 42 ± 16.81, with extremes of 20 and 81 years. The age group most concerned was between 20 and 29. The most frequent reasons for consultation were suppuration of the external genitalia and scrotal swelling. The average consultation time was 19.05 ± 16.02 days. The most common comorbidity was diabetes (35.9%). The most frequent pathological antecedents were urinary tract infections and endourethral maneuvers, reported in 40.5% and 38.7% respectively. Urogenital aetiology was predominant in 54.7%, and idiopathic in 35.9%. Lesions involved the scrotum in 60.6%, the scrotum and penis in 16.5%, and the penis alone in 5.7% of cases. Lesions extended to the perineum in 13.6% of cases, and to the abdomen in 3.6%. Vascular filling via the central venous line was performed in 58.6% of cases, and via the peripheral venous line in 41.4%. 3rd-generation cephalosporins and associated imidazoles were the most commonly used antibiotics. Necrosectomy was performed in 37 patients (73.4%), debridement combined with bypass cystostomy in 26.6% of cases. Colostomy was performed in 4% of cases. 90.8% of patients were cured and 9.2% died. The average hospital stay was 30 ± 75 days. Conclusion: The gangrene of the external genitalia is a medical and surgical emergency which has become rare in Europe, but which is still very common in the context of our practice in Chad. The severity of the disease is linked to delayed consultation and co-morbidity factors. Mortality remains very high despite therapeutic advances.

Damage to the External Genitalia by Traction Following Assault and Battery at the C.H.U Gabriel Touré: About a Case

Trauma to the external genitalia by tearing is rare. We report the case of a 30-year-old patient, admitted to the emergency room for trauma of the external genitalia by traction following a blow and intentional injury. The authors highlight the lesions that can occur during this type of trauma and insist on the systematic search for urethral and cavernous lesions. Conclusion: Trauma to the external genitalia by intentional assault and battery is rare in our context. They occur most often in a young person and are frequently associated with damage to the corpora cavernosa and urethra.

Differential diagnosis of ambiguous genitalia in Chinese patients

Objective: To study the etiology and differential diagnos is of ambiguous genitalia.Methods: One hundred and five cases of ambiguous genitalia with disorders of sexual differentiation were analyzed based on clinical characterist ics and basic research. Results: Ambiguous genitalia are closely related to the functio n of androgen. It could be classified into 3 groups: androgen excess, androgen d eficiency and failure of gonadal differentiation. Differential diagnosis depends on clinical manifestations, chromosome examination, serum hormone determination s, final gonadal pathology, receptor study etc.Conclusion: Ambiguous genitalia are related to abnormal androgen ic effect and early correct etiological diagnosis is the key to its management.

Recent Injuries of External Genitalia: Clinical Aspects and Management

Aim: Report the epidemiological, clinicopathological characteristics and ensuring management of recent traumas of the external genitalia in Urology. Methods: This was a descriptive retrospective study of 47 cases of patients suffering from recent traumas of the external genitalia over a period of 5 years. The variables studied were sociodemographic, clinical, paraclinical, therapeutic and evolutionary. Results: A total of 47 patients, including 46 men, were managed. The mean age was 26.8 years, ranging from 6 to 56 years. The circumstances of occurrence were: the missteps of coitus (n = 16), traffic accidents (n = 9) and criminal injuries (n = 8). The fracture of the penis (n = 16) was the most common lesion followed by the scrotal wound (n = 11). The management was medical and surgical and varied by the type of lesion. The outcome was favorable in 91.5% of cases. Conclusion: The incidence of traumas of the external genitalia was 9.4 in urology department in N'Djamena. Penis fracture was the frequent lesion. The management is multidisciplinary, medical and surgical.

Contribution of the Medical Imaging in Care of Ambiguous Genitalia

We report a case of ambiguous genitalia in a 15-year-old patient to demonstrate input of medical imaging in the diagnosis and care of this rare congenital deformation. Disorders of sexual differentiation (DSD) have been defined as congenital conditions in which development of chromosome, gonad, or anatomic sex is atypical and that raise an issue in the sex assignment. In lower socioeconomic countries where antenatal diagnosis is almost non-existent, due to lack of technical facilities, their medical and surgical management is hard. The case which we report was investigated by ultrasonography and genitography, which remains primary indications in our context.

External Genitalia Gangrene: Clinical, Therapeutic Aspects and Prognosis at University Hospital Souro Sanou of Bobo Dioulasso (Burkina Faso)

Objective: To describe the clinical aspects and the management of external genitalia gangrene in the Urology department of the Bobo Dioulasso CHUSS. Patients and methods: This was a retrospective and descriptive study over a period of 6 years from January 2011 to December 2016, which covered 54 patients hospitalized in the urology department of the University Hospital Souro Sanou for external genitalia gangrene. Results: The mean age of our patients was 53.8 years. The large ulcero-necrosis of scrotum was the main reason for reference. Our patients consulted on average 8.23 days after the onset of symptomatology. A risk factor was found in 44.2% of cases and a cause was identified in 65.3% of patients. A urogenital cause was present in 32.7%. Probabilistic antibiotic therapy and medical reanimation were systematic at admission. Debridement was performed on average 18 hours after admission and 10 patients had more than one debridement. We noted a mortality rate of 5.5%. Conclusion: Fournier’s gangrene is a serious infectious disease whose diagnosis is often delayed in our context. Early surgical debridement remains the essential therapeutic gesture to reduce mortality.

Severe External Genitalia Lesion by Firearm: A Case Report

Gunshot wounds to external genitalia are rare either in war field and civilian setting accounting for 2% - 4% of all injuries with often a lesion to the urinary tract. We report a case of external genital injury in a 27 years old man, accidentally injured by his own arm when he pressed the trigger of his gun placed in his pants. He had no past medical or surgical history, he presented to the emergency room (ER) with hemorrhagic scrotal and penile injuries with adjacent urethral tissue damage. He underwent a scrotal flap urethroplasty, and realignment of the corpus cavernosa and the tunica albugina. The patient lost his Foley catheter at post-operative day 3 and subsequently developed a urethral stenosis. Gunshot wounds to external genitalia are rare. A good reconstruction is necessary to avoid an impact on sexual and voiding function.

Management of Trauma to the External Genitalia at the Nianankoro-Fomba Hospital in Segou Mali

Trauma to the male genitalia is not very common and mainly affects a young population. There is probably a particular instinct in men to defend their external genitalia;indeed, in the flaccid state, the penis is little exposed, and fairly well protected and its mobility allows it to move with the impact of trauma and thus reduce the vulnating force. Open trauma is rare, as is testicular dislocation, the most common being closed trauma. Testicular trauma is an uncommon accident that affects young people. Trauma is most often caused by road and traffic accidents. Animal bites are rare, as is genital self-mutilation related to a psychiatric disorder. Surgical exploration is the rule except in cases of moderate testicular trauma. Our objective was to report our experience in an emergency context where treatment is poorly codified and to review the literature. We recorded four patients with external genitalia trauma managed in the urology department from April 2013 to March 2022. Our patients were children with open genitalia trauma following a traffic accident, scrotal injuries were encountered in three patients, and additional penile injuries in one patient. All patients were treated surgically. The follow-up was straightforward.

Trauma of External Genitalia by Firearm: Therapeutic Strategy and Result, about a Case at CHU-YO, Ouagadougou, Burkina Faso

Introduction: Ballistic traumas of the external genitalia are rare especially in civil practice. Emergency surgical exploration is the rule. Case Report: Mr. F.Y., 29 years old, a security agent, admitted to the Urological Emergency Unit of Yalgado Ouédraogo University Hospital of Ouagadougou for trauma of the penile and left purse by firearm. The clinical examination revealed a good hemodynamic status, bladder distension. A suprapubic catheterization was performed. We noted a transfixing and bleeding wound on the penile, and on the left purse which was edematous. The patient was admitted to the operation room 07 hours after trauma. Exploration found a total destruction of the left testicle classified grade 5 of the classification of the American Association of the Surgery of Trauma (AAST). We performed a left orchiectomy. There was a partial rupture of the ventral face of the penile urethra. We performed an end-to-end anastomosis on a Foley catheter CH 18. The Foley catheter was removed after two weeks. Urination was spontaneous without dysuria. Erections were painless and without kinking of penile. Conclusion: Open traumas of the external genitalia are rare and their treatment is an extreme surgical emergency.

为害小麦新害虫——显脉污灯蛾Spilarctia bisecta Leech (Lepidoptera: Arctiidae)

小麦是我国三大粮食作物之一,其在生产过程中受到多种害虫为害;在调查重庆市潼南区小麦病虫害过程中新发现一种鳞翅目害虫为害小麦,对其进行形态学及细胞色素氧化酶Ⅰ亚基(cytochrome oxidaseⅠ,COⅠ)基因序列鉴定,确定其为显脉污灯蛾Spilarctia bisecta Leech。污灯蛾属中有多种为害农作物的害虫,但显脉污灯蛾在中国还未有为害小麦的确切报道,这一发现提醒我们应当注意小麦和其他禾本科作物上的潜在害虫。

下尿路和外生殖器战创伤及其诊疗研究进展

近年来,随着现代战争模式、武器及防护装备的不断革新,战创伤的发生机制、模式发生了很大变化。防弹衣及简易爆炸装置的广泛使用使泌尿生殖系统战创伤发生率逐渐升高,且泌尿生殖系统战创伤的模式也发生了改变,即从内部结构(肾脏、输尿管、膀胱)转移到外部结构(阴囊、睾丸、阴茎、尿道),提示应将泌尿生殖系统战创伤的研究重点逐渐转移到下尿路及外生殖器创伤。本文就数次现代战争中泌尿生殖系统战创伤的发生率、治疗以及预后进行综述,主要阐述下尿路及外生殖器战创伤相关情况及其诊疗的相关进展。

人工牛黄甲硝唑胶囊致男性患者外生殖器多形红斑型药疹的诊疗分析

目的:分析1例人工牛黄甲硝唑胶囊致男性患者外生殖器多形红斑型药疹的诊疗过程,为临床该药的用药安全提供参考。方法与结果:该患者因牙痛而自行购买人工牛黄甲硝唑胶囊服用,但第2天患者发现外生殖器不行米粒至豆粒大小的红斑,呈密集对称分布,伴轻微瘙痒,遂自行停药;但停药多日后仍未见好转,皮损还逐渐增大,且表面出现糜烂、渗出,遂入院治疗;入院后,对患者予以了抗炎、抗感染治疗,2周后患者红斑基本消失,1个月后患者皮损也基本痊愈;其间,医生采用诺氏评估量表考察多形红斑型药疹与人工牛黄甲硝唑胶囊的关联性,结果评分为6分,即关联性为“很可能”。结论:人工牛黄甲硝唑胶囊所致药疹仅出现在外生殖器部位而未涉及身体其他部位的情况较为罕见,临床在宣教时应做好用药交代,以便于患者早分辨、早治疗。

中药熏蒸联合氦氖激光用于外阴白色病变的临床效果研究

目的:分析中药熏蒸联合氦氖激光在外阴白色病变患者中的效果。方法:选取2021年7月—2023年7月信丰县妇幼保健院收治的68例外阴白色病变患者,按随机数字表法分为两组,各34例。对照组行氦氖激光治疗,观察组加以中药熏蒸治疗,1个月为1个疗程,持续治疗3个疗程。对比两组临床疗效、症状改善情况、生活质量、复发率。结果:观察组治疗总有效率高于对照组,外阴痒、阴痛、皮肤弹性、色素脱失改善时间短于对照组,有统计学差异(P<0.05);治疗前,两组生活质量综合评定问卷(GQOLI-74)内各维度评分相比,无统计学差异(P>0.05);治疗后,观察组GQOLI-74内各维度评分高于对照组,有统计学差异(P<0.05)。随访3个月,观察组复发率低于对照组,有统计学差异(P<0.05)。结论:中药熏蒸联合氦氖激光能够减轻外阴白色病变患者症状,提高生活质量,减少复发。

Comparative morphology study of the male genitalia in the tribe Astathini from China(Coleoptera:Cerambycidae)

The male genitalia of 13 species from four genera of Astathini were described and analyzed. The result showed that five genital characters, such as shape of the apex of 8th abdominal tergaum and sternum, ratio of the length of lateral lobes to tegmen, can be used to identify genera of Astathini; six characters, such as ratio of the length of lateral lobes to tegmen, ratio of the length of roof to lateral lobes, shape of the apex of ventral plate of median lobe, can be used to identify species in Bacchisa.

Comparative morphology study of the male genitalia of the genus Aegosoma from China(Coleoptera:Cerambycidae),with a new record species

A new record species of genus Aegosoma Serville, 1832 is reported from China. The male genitalia of seven species from the genus Aegosoma are described and compared. The result shows that 16 genital characters, such as narrow position of the apex of parameres, ratio of length and width of parameres, curvature of tegmen, ratio of spiculum gastrale and spiculum relictum, ratio of penis and tegmen, ratio of median structs and median lobe, curvature of penis, ratio of tegmen and parameres etc., can be used to identify species of Aegosoma. A key to Chinese species of Aegosoma is presented.

CO_(2)点阵激光技术治疗外阴硬化性苔藓的临床研究

目的探究CO_(2)点阵激光技术在外阴硬化性苔藓治疗中的临床效果。方法选择本院60例外阴硬化性苔藓病变患者为研究对象,采用随机数字表法分为试验组和对照组,每组30例。对照组采用糖皮质激素+中成药泡洗,试验组采用CO_(2)点阵激光治疗。比较两组治疗前后外阴瘙痒、皮肤颜色、裂口、性交疼痛变化评分,评估临床疗效及复发时间。结果治疗后,两组外阴瘙痒、皮肤颜色和性交疼痛评分均低于治疗前,且试验组低于对照组(P<0.05)。试验组治疗总有效率高于对照组(P<0.05)。结论CO_(2)点阵激光治疗外阴硬化性苔藓患者临床疗效较好,能显著改善患者的外阴瘙痒、皮肤颜色和性交疼痛等症状,可视为外阴硬化性苔藓的一种有效治疗手段,值得在临床进一步推广与应用。

影响女性身心健康的新病症:持续性生殖器官兴奋紊乱/生殖器官-骨盆感觉障碍综合征的研究现状及专家共识解读

持续性生殖器官兴奋紊乱(PGAD)和生殖器官-骨盆感觉障碍(GPD)二者合称为持续性生殖器官兴奋紊乱/生殖器官-骨盆感觉障碍综合征(PGAD/GPD),是近年新发现的一种以自发或继发出现持续性性兴奋状态和/或生殖器官及骨盆其他区域感觉异常为特征的特殊病症。此病主要累及女性,因其症状特殊性,常对患者的身心健康造成严重影响,大多数患者处于焦虑、抑郁状态,甚至有自杀倾向。PGAD/GPD已引起国外医疗界的重视,并将其纳入国际疾病分类-11(ICD-11)。目前国内对这一新发现病症普遍认识不足。本文总结了PGAD/GPD的国外研究现状并结合国际妇女性健康研究学会(ISSWSH)最新专家共识对PGAD/GPD的流行病学特点、病理生理机制、诊断和治疗方案进行了介绍,初步探讨了PGAD/GPD的未来研究方向及国内医学界应采取的应对思路,以期引起国内广大医学工作者对此病的关注。

Extramammary Paget’s Disease Manifested by Intraepithelial Adenocarcinoma of the Vulva and Anus Combined with Invasive Adenocarcinoma of the Ampullary Part of the Rectum

The Object of the Study: The author of the given paper describes an unusual combination of two diseases: extramammary Paget’s disease manifested by intraepithelial adenocarcinoma of the vulva and anus combined with invasive adenocarcinoma of the ampullary part of the rectum and describes the atypical manifestations of these diseases. The Content: The content of this research paper includes a description of the patient, an analysis of the clinical picture, diagnostic methods and therapeutic interventions used, a report of the following disease, and the result of the presented case. The Result of the Research Work: The result of the research work is the analysis of a clinical case with two different tumors, where such a combination of tumors is rarely described in the literature. Moreover, no large specific sample with this combination of diseases is available. Patient Characteristics: The given case report describes a patient of the Palliative Care Unit of the Gerontology Clinic with a primary diagnosis of C20-rectal adenocarcinoma in the background of the anal canal, perineal skin Paget’s disease, stage IV. The presented complications of the patient’s primary diagnosis are multiple metastases in the liver;status post palliative chemotherapy;hepatomegaly;metastases to abdominal lymph nodes, inguinal lymph nodes;metastases at Th12, L4 level;pain syndrome. The presented above combination of diagnosed diseases is very rare. Applied Diagnostics: In October 2021, it was performed diagnostic manipulation: biopsy and the pathologist have provided a microscopic description. The first tissue fragment had a pronounced electrothermal lesion and the epithelial structures were not valuable. The second skin tissue fragment was covered with hyperplastic and acanthotic epithelium;its basal and middle layers contained multiple large cells proliferates extending into the medial epidermis, and the cytoplasm of these cells reacted positively with PAS (Periodic Acid Schiff reaction). It needs to be noted that the patient had previously had several years of biopsies from the perineal and anal epidermis, where Paget’s disease had also been diagnosed. The performed immunohistochemistry showed these cells to be CK20 positive, CK7 rare positive and p16 negative. The following pathohistological findings were made: morphological and immunohistochemical picture is consistent with Paget’s disease. According to the ICD-10, the patient was diagnosed with C51 malignant neoplasm of the female external genitalia. Using imaging diagnostics, it became clear that the patient’s rectal adenocarcinoma had progressed to metastatic stage with distant liver metastases in the background of anal canal, perineal skin Paget’s disease. Therapeutic Plan of the Patient: Based on the patient’s main diagnoses, the complications of the principal diagnosis, the patient’s overall severe condition, pain syndrome, age and comorbidities, palliative chemotherapy was approved as a therapeutic option in council of doctors. Monitoring and Outcome of the Patient: The patient’s general condition was becoming worse over time, and she was diagnosed with exitus latalis in December 2022. At that time, the patient was discharged from hospital and was on palliative care at home under the control of her family physician.

生殖道菌群在妊娠中的作用

生殖道菌群种类繁多,相互共生拮抗,在防御感染、促进妊娠、维持正常宫内环境等方面发挥重要作用。生殖道菌群与宿主相互作用产生的代谢产物不仅与菌群失调、宿主免疫有关,也与不良妊娠结局具有相关性。近年来,生殖道菌群在妊娠中作用的相关性研究逐渐受到学界的关注,故从阴道及宫颈菌群、宫腔菌群、输卵管及卵泡液菌群在正常妊娠中的作用,以及生殖道常见微生物与不良妊娠结局的相关性等方面试图阐述生殖道菌群与宿主之间复杂的相互作用,以期为研究不良妊娠结局发生的作用机制及治疗提供依据。

不同旱养方式对鹅睾丸及外生殖器组织形态学的影响

旨在探究不同旱养方式对公鹅生殖系统发育的影响。以同批孵化、健康的100只四川白鹅公鹅为试验对象,于120日龄时从中挑选60只体重相近的公鹅等分为2组(每组30只),分别进行笼养和网上地面混合平养,继续饲养至270日龄时屠宰并采集鹅睾丸及外生殖器进行组织形态学分析。形态学结果显示:笼养组鹅左侧、右侧和双侧睾丸重量及其器官指数极显著高于混合平养组(P<0.01),笼养组鹅右侧睾丸长径以及两侧睾丸短径显著高于混合平养组(P<0.05);笼养组鹅外生殖器的自然长度和基部直径显著高于混合平养组(P<0.05),拉直长度极显著高于混合平养组(P<0.01)。组织学结果显示:笼养组鹅睾丸中精原细胞数量显著高于混合平养组(P<0.05),睾丸实质间质比、生精上皮厚度、支持细胞数量和生殖细胞数量极显著高于混合平养组(P<0.01);笼养组鹅的外生殖器角化上皮厚度显著低于混合平养组(P<0.05)。相关性分析结果显示:鹅睾丸或外生殖器的形态学与组织学指标之间存在显著相关性(P<0.05),且两种饲养方式下鹅睾丸与外生殖器的组织形态学指标之间均存在显著相关性(P<0.05),但笼养组鹅睾丸与外生殖器组织形态学指标之间的相关性更强。综上,两种旱养方式下鹅睾丸与外生殖器的发育过程均密切相关;相较于混合平养,120日龄上笼且持续150 d的笼养方式显著促进了公鹅生殖系统发育及睾丸生精能力。