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A 59-year-old man presented with a painless testicular mass and underwent a radical orchiectomy. The resected specimen showed a 5-cm-sized, white-yellow and homogenous solid mass in the testicular parenchyma. Histologically, the central part of the tumor exhibited typical features of seminoma. The peripheral part of the tumor exhibited diffuse infiltration of small, monotonous lymphoid cells involving the tunica albuginea. The monotonous lymphoid cells were immunoreactive for CD20, CD79a, CD5, and CD23, and negative for CD3, CD10, and cyclin D1. Kappa light chain restriction was detected on flow cytometry using the resected specimen. Considering the circulating lymphoid cell count of >5.0×103/µL, we diagnosed the peripheral component of the tumor as an infiltration of chronic lymphocytic leukemia. This extremely rare combination of seminoma and lymphoid neoplasm should be considered in the differential diagnosis of classic seminoma with extensive lymphoid reaction in tumors arising in elderly patients.

The silver pomfret (Pampus argenteus) is a widely distributed and economically important marine fish in the Indo-Pacific. In this study, we acquired the second generation of wild P. argenteus by artificial breeding and further studied the testicular development and ultrastructure of spermatogenesis. The results of gonadosomatic index (GSI) showed the spawning period of this marine fish was from April to June. Besides, through morphological analysis, we found that P. argenteus had an anastomosing tubular testis surrounded by a layer of tunica albuginea, in which spermatogenesis occurred in cysts where the synchronous germ cells were completely surrounded by the cytoplasmic projection of Sertoli cells. Meanwhile, based on submicroscopic characteristics, the germ cells are classified into nine different types. During the ontogenesis of testis, both the early stage of spermatogenesis and sperm were observed in P. argenteus. At sperm maturation stage, different types of spermatozoa and activation of sperms occurred non-synchronously in the tubules. Cytoplasmic bridges also were observed among synchronous germ cells within the cysts, suggesting an interrelated and differentiated relationship among these germ cells.

Histomorphological changes in testicular parameters and seminiferous epithelium of different age groups male donkeys; pre-pubertal-pubertal and post-pubertal periods were observed. The present study was performed on Testes of 14 donkeys obtained from local markets from Menoufia governorate. Animals divided into four age groups (pre-pubertal-pubertal - post-pubertal and senile after the collection, gross anatomical features of the testes were examined and recorded. The present anatomical result showed that the testis of the donkey was not completely descended into the scrotum around birth. The mean weight, length and width of both left and right testicles in groups differed significantly (p≤0.05) from each other. The both testicles were appeared not symmetrical, the left testes were larger than right one. All morphmetrical parameters were significantly increased when age advanced. The beginning of seminiferous epithelial cycle at 1.5 years old. Marked morphmetrical changes in donkey testes occurred from period of puberty until middle of sexual maturity at 6- 7-year-old after that a serious of regressive changes occurred. A marked increase in the weight and diameter of the testes was recorded at 2-6-year-old; The parenchyma of testis was dark reddish in color; it was covered by a thick tunica albuginea consisting of outer and inner fibrous layers in addition to middle vascular one. The diameter of the seminiferous tubules was greatly increased than those recorded at the early stage of the postnatal development. The present histological results emphasized an irregular arrangement of the testicular lobules of the donkey during various stages of the postnatal life. Such arrangement does not allow some lobules to have direct contact with the mediastinum testis. Numerous seminiferous tubules with different shapes and size were highly active.

Blast testicular injury from gunshot may result in severe testicular damage and rupture, which is seen very rarely in the pediatric population. The management of these wounds is difficult and most of them result in orchiectomy. A patient with bilateral severe testicular rupture and large tunica albuginea defects due to gunshot that was repaired with tunica vaginalis flaps was presented in this study. A 16-year-old boy was administered with both ruptured testes that are located out of the scrotum. He was a sheep-man in the field and fired to kill the fox but shot himself. The first examination revealed both tunica albuginea defects and unviable tissues but normal blood supply in testes. He was taken to the operating theatre and the exploration revealed a bullet hole in the cranial portion of the scrotum on the left side of the penis. Tunica albuginea defects were severe and primer closure could not be achieved; however, defects were minimized with a few primer sutures on the tunica albuginea edges. Not to sacrifice the viable testicular tissue for closing the tunica albuginea, tunica vaginalis flaps were prepared and sutured to the remaining edges with absorbable sutures. At his fourth-month follow-up, Doppler ultrasound revealed normal blood supply of both testes. Severe testicular rupture with tunica albuginea defect sometimes could not be closed primarily without excision of viable testicular tissue. In these cases, the vascularized tunica vaginalis flaps provide an alternative method of closure for bilateral testicular injury in pediatric patients.

Background Collagenase Clostridium histolyticum (CCH), also know as Xiaflex, with penile modeling is considered to be the gold standard non-surgical option for management of Peyronie’s disease and is known to be safe and efficacious. Corporal rupture is a rare but known adverse event of CCH treatment, however there are limited studies describing corporal herniation without rupture. Here we present a patient who experienced a rare complication following CCH injections for Peyronie’s disease: lateral herniation of the tunica albuginea in the setting of a dorsal penile plaque. Case presentation A 58-year-old male presented to our clinic seeking treatment for Peyronie’s disease. On exam, he was found to have a palpable dorsal plaque and > 30 degrees leftward curvature of the penis. He was deemed an appropriate candidate for and patient decided to proceed with CCH and modeling. He received 2 cycles of CCH injections (4 total CCH injections) with in-office and at-home penile modeling, per manufacturer’s protocol. Two weeks following in-office modeling during his second CCH cycle, the patient reported a painless, soft swelling involving the left side of his penile shaft only occurring with erection. Exam and history were suggestive of lateral herniation rather than corporal rupture. CCH was discontinued. Patient declined further evaluation with penile ultrasound. Conclusions This is the first case report detailing lateral herniation with CCH injections. Symptoms and exam that should raise suspicion of corporal herniation are a soft, painless mass with erection.

Background: Peyronie’s disease (PD) is a progressive disorder of the connective tissue of the tunica albuginea of the penis that produces an abnormal curvature, painful erections and different degrees of erectile dysfunction (ED). The aim of this study is to evaluate our initial experience in the surgical treatment of PD using an autologous graft of testicular vaginal tunica. Materials and methods: A retrospective study of 23 patients was carried out between 2015 and 2019. The successful surgical stretching rate was defined as a functional 20 degrees of curvature or less. Postoperative sexual function and complications rate were evaluated as secondary objectives. We used the abbreviated IIEF-5 questionnaire and evaluated the sexual function before and after the surgical procedure. Wilcoxon signed-rank test for paired samples (U test) was used, considering a value of pResults: Only one patient presented a recurrence of the penile curvature, resulting in a 95.6% success rate of functional stretching. We observed a 1.6 and 0.9 difference between pre- and postoperative total score and satisfaction ( p = 0.002 and p = 0.003 respectively) Conclusion: In this series, the use of testicular vaginal tunic was found to be safe and effective with a significant change in the quality of sexual life, especially reflected in the overall satisfaction after the procedure and a low rate of complications. Level of evidence: Not applicable for this multicentre audit.

Peyronie’s disease affects penile mechanics, but published research lacks biomechanical characterization of affected tunica albuginea. This work aims to establish mechanical testing methodology and characterize pathological tissue mechanics of Peyronie’s disease. Tunica albuginea was obtained from patients (n = 5) undergoing reconstructive surgery for Peyronie’s disease, sectioned into test specimens (n = 12), stored frozen at −20 °C, and imaged with micro-computed tomography (µCT). A tensile testing protocol was developed based on similar soft tissues. Correlation of mechanical summary variables (force, displacement, stiffness, work, Young’s modulus, ultimate tensile stress, strain at ultimate tensile stress, and toughness) and µCT features were assessed with linear regression. Specimens empirically grouped into hard or soft stress–strain behavior were compared using a Student’s t-test. Surface strain and failure patterns were described qualitatively. Specimens displayed high inter- and intra-subject variability. Mineralization volume was not correlated with mechanical parameters. Empirically hard tissue had higher ultimate tensile stress. Failure mechanisms and strain patterns differed between mineralized and non-mineralized specimens. Size, shape, and quantity of mineralization may be more important in determining Peyronie’s disease plaque behavior than presence of mineralization alone, and single summary variables like modulus may not fully describe mechanical behavior.

Antecedentes: El trauma testicular y escrotal ocurre principalmente en jóvenes entre 15 y 40 años. El 50% de las heridas testiculares por arma de fuego terminan en orquiectomía. La presentación clínica es con dolor, edema, equimosis y hematoma; laceración de piel o exposición de tejido. El diagnóstico es clínico. La evidencia o sospecha de una ruptura testicular es una urgencia y requiere exploración quirúrgica inmediata. El manejo quirúrgico recomendado es con cierre primario de la túnica albugínea cuando es posible y orquiectomía cuando no es posible. Caso clínico: Presentamos el caso de un masculino de 20 años con trauma testicular por arma de fuego; condicionándole trauma izquierdo grado V y derecho grado IV. Se realizó orquiectomía simple izquierda y orquiectomía parcial derecha con reconstrucción testicular por medio de injerto de túnica albugínea contralateral. El paciente cursó con una evolución satisfactoria; al estudio ultrasonográfico Doppler de control se observó vascularidad conservada y hormonalmente niveles de testosterona en aumento. Discusión: La meta en el tratamiento del trauma testicular es preservar el tejido viable y reparar el testículo. El cierre primario está descrito ante una laceración de la túnica albugínea con bordes fácilmente identificables, lo cual no fue posible en este caso. Dentro de las reparaciones descritas existen injertos de túnica vaginalis, mallas de material reabsorbible y biológicas con resultados no concluyentes. El uso de túnica albugínea como reparación y protección del testículo contralateral, permitió una reconstrucción óptima; evitando el aumento de presión que se produce al usar la túnica ipsilateral y permitiendo la preservación del parénquima y fisiología testicular.

Introduction Testicular injury with a tunica albuginea tear is typically reconstructed by primary closure. We herein describe the successful use of a tunica vaginalis flap for reconstruction of a ruptured testis for which primary closure was not possible. Case presentation A 21-year-old man visited our hospital with scrotal swelling after a baseball struck his left testis. Magnetic resonance imaging and ultrasonography indicated a left tunica albuginea tear, and emergency surgery was performed. Primary closure of the tunica albuginea was impossible since a tight closure could cause secondary damage. A vascular pedicle flap was prepared by shaping the tunica vaginalis to replace the tunica albuginea. He was discharged 2 days postoperatively. Ultrasonography showed normal size and blood flow in the ruptured testis at the 2-week and 3-month follow-up. Conclusion A testicular vaginalis flap should be considered when primary closure is difficult in cases of testicular rupture with tunica albuginea damage.

Penile fracture is a rare urological emergency requiring prompt diagnosis and management. The role of high-resolution ultrasonography is established in detecting a tear, in the tunica albuginea. The late complications of penile fracture are distressing and may manifest as asymmetrical and insufficient penile tumescence, penile ischemia, and sometimes urethral stenosis. The current case series demonstrates the combined role of post-papaverine penile Doppler duplex ultrasonography and sonourethrography techniques in assessing the late presenting cases of penile fractures. The combination of these two techniques was found to be a useful comprehensive imaging tool. This combination can be employed in clinical practice to define the extent of trauma and penile insufficiency, in an efficient manner.

Purpose Erectile dysfunction (ED) is one of the increasing diseases with aging society. The basis of ED derived from local penile abnormality is poorly understood because of the complex three‐dimensional (3D) distribution of sinusoids in corpus cavernosum (CC). Understanding the 3D histological structure of penis is thus necessary. Analyses on the status of regulatory signals for such abnormality are also performed. Methods To analyze the 3D structure of sinusoid, 3D reconstruction from serial sections of murine CC were performed. Histological analyses between young (2 months old) and aged (14 months old) CC were performed. As for chondrogenic signaling status of aged CC, SOX9 and RBPJK staining was examined. Results Sinusoids prominently developed in the outer regions of CC adjacent to tunica albuginea. Aged CC samples contained ectopic chondrocytes in such regions. Associating with the appearance of chondrocytes, the expression of SOX9, chondrogenic regulator, was upregulated. The expression of RBPJK, one of the Notch signal regulators, was downregulated in the aged CC. Conclusions Prominent sinusoids distribute in the outer region of CC which may possess important roles for erection. A possibility of ectopic chondrogenesis induced by alteration of SOX9/Notch signaling with aging is indicated.

Introduction. Available insufficient and contradictory data on the presence, structure and possible role of the valves of the penile veins determined the aim of the study.The study objective is the examination of the valve apparatus of the deep dorsal (DDV) and superficial dorsal veins (SDV) of the human penis.Materials and methods. The material was veins obtained at the autopsy by microdissection from the coronal sulcus to the base of the penis – 51 cases – and cross sections of cavernous bodies distal to the suspensory ligament – 103 cases – a total of 154 observations. Standard histological techniques were used. Staining with hematoxilin and eosin, fuchsin and picrofuchsin, Mallory staining were used.Results. Two branches of the DDV were identified in 7.8 % of observations, usually as a division of the main trunk. DDV valves were found in 92.2 % of the observations, with the frequency of occurrence immediately distal to the suspensory ligament being about 38 %. Perhaps the valves of this localization play the role of an osteal valve. Valves were detected in 75 % of the cases in the studied area of SDV. A total of 190 valve images were obtained and analyzed. The valves have a well developed roller, collagen and smooth muscle fibers of which are woven into the middle shell of the vein wall. The base of the valve roller has fibers located in intersecting planes, which strengthens it. The flaps of the valve are thin and consist mainly of collagen fibers. Valves of DDV and SDV have a similar structure. Valves are regularly found in the envelope veins, the perforant veins of the tunica albuginea, the veins of the subshell venous plexus, the paraurethral veins. All valves have a clear orientation, aimed at unilateral outflow of blood from the penis.Conclusion. The results of the study indicate the presence of a formed valvular apparatus in the veins of the human penis, which provides unidirectional venous outflow from the cavernous bodies, preventing retrograde blood flow. The findings add to existing knowledge about the structure of the valvular apparatus of the penile veins and its potential role in erectile function and dysfunction.

Up to 20–30% of patients with Peyronie’s disease (PD) suffer from some degree of erectile dysfunction (ED). When medical management fails, the surgical approach towards those with PD and ED relies on the penile prosthesis. Graft material has advanced in recent years, and hemostatic patch material has emerged as a promising, easy to use, and cost-effective approach. Intracorporal techniques that obviate the need for neurovascular bundle mobilization have recently been described, and can be considered a frontier for further investigation. A thorough literature review was performed using the PubMed online database with query: “Penile Prosthesis” and “Peyronie’s disease” with “Plaque excision,” “Plaque incision,” “Tunica albuginea plication,” “Modeling,” and “Excision and grafting.” While the three-piece inflatable penile prosthesis (IPP) is commonly used, malleable implants may also achieve success where three-pieces are unavailable or not appropriate for use. When implant alone does not correct the deformity, manual modeling is a mainstay in treating residual curvature. Tunica plication, incision, and excision/graft techniques are required in patients with more severe/complicated plaques.

It is known that the extracellular matrix structure and composition changes with aging in many organs. Despite this, knowledge on how does the extracellular part of the ovary change with increasing age in women and how those changes might be related to women’s loss of fertility is still lacking. For this, we propose that recurrent injury and repair events on the outermost layers of the ovary due to ovulation are partly responsible for those changes women experience with aging. The histological analysis of the ovaries from 18 female-to-male transgender patients revealed that the ovarian tunica albuginea (TA) increases its thickness and density correlatively with increasing age of the patient (r = 0.52 and r = 0.55, P

Following civil unrest during 2020, physicians began to notice a variety of injuries resulting from crowd control weapons. While prior research emphasized ocular trauma, genitourinary complications of injuries have yet to be investigated. A previously healthy 27-year-old male presented to the emergency department due to sudden onset of severe left testicular pain following rubber bullet trauma. Physical exam showed extreme tenderness, abrasion, contusion, and edema of the left testicle with normal right testicle. Doppler ultrasound showed minimal blood flow to the superior pole with irregularity of the tunica albuginea. Surgery confirmed testicular rupture with a large tunical violation and extruded spermatic tubules. The testicle was thoroughly irrigated, non-viable tubules were debrided, and intraoperative ultrasound confirmed restoration of blood flow. Patient was discharged and instructed to follow-up should he face any fertility concerns in the future. Current crowd control guidelines state projectiles should be aimed at the lower abdomen or extremities; however, projectiles can cause testicular trauma which may lead to hypogonadism, infection, and psychological impact. Until there are changes to methods of crowd control, attendees should consider the use of athletic cups.

Resume Introduction Les complications concernant les cylindres proximaux des prothèses péniennes peuvent être traitées par un abord crural sans avoir recours à l’incision péno-scrotale classique. Dans cet article, on décrit une nouvelle voie d’abord crurale directe pour la prise en charge des complications prothétiques proximale. Matériels and Méthodes Il s’agit d’une étude rétrospective, entre 2014 et 2019, sur 13 patients ayant eu une correction chirurgicale par voie d’abord crurale, suite à des complications prothétiques cylindriques proximales. La zone affectée est. identifiée avant le début de l’opération. En position de lithotomie, une incision longitudinale de 2 cm est. réalisée directement au niveau de la zone atteinte. La dissection se fait à travers le fascia de Colles, suivie d’une incision longitudinale de la tunique albuginée à la partie proximale du cylindre atteint. A travers cette incision, le cylindre peut être retiré et la gestion de son problème sera aisée. Résultats Le temps opératoire moyen était de 40 min. Aucune complication durant ou après l’opération n’a été rapportée. Tous les patients (âge moyen = 57 ans) sont sortis de l’hôpital le même jour. Le suivi postopératoire a révélé une correction de toutes les déformations existantes après 1, 3 et 6 mois. Tous les patients étaient satisfaits et ont rapporté moins de douleur et une durée de convalescence plus courte qu’après la première procédure. Conclusion Notre technique chirurgicale, applicable pour tout type de prothèses péniennes, est. à la fois faisable et sans risque majeur. Elle simplifie la reprise chirurgicale des complications de prothèses péniennes proximales sans avoir recours à l’incision initiale, ce qui évite les adhérences et de mettre en danger le matériel implanté et l’urètre. Elle peut également améliorer la sécurité et la satisfaction des patients en réduisant les blessures iatrogènes et le temps de récupération postopératoire.

Background Penile curvature in men with Peyronie’s disease (PD)—caused by tunica anchoring plaques with loss of focal fiber elasticity—theoretically increases the risk of penile fracture during sexual activity. Penile fracture is the result of tearing of the tunica albuginea of one or both corpora cavernosa, usually during sexual intercourse, and is among the most serious urological emergencies. Generally, a patient presented to a surgical emergency within 48 h of injury can be handled successfully with minimum complications. Immediate surgical treatment is the current standard of care and has a relatively low risk of late complications. Case presentation We present a case of penile fracture in a male with a history of PD referred to the emergency department with severe pain. Clinical history assessment and physical examination revealed a penile fracture with underlying PD. He underwent emergency surgical exploration via subcoronal incision. Penile plication was not necessary for our case because the angulation of the penis was less than 15° after examination of artificial erection. Conclusion Penile fracture in a patient with underlying PD is a rare urological emergency that should be treated surgically with fracture repair as early as possible. Penile plication might be necessary in severe cases (angulation > 60°).

SummaryAvian testes have been used in the study of germ cell transfer, importantly for understanding the preservation and control of birds. For this purpose, we use light microscopy, electron microscopy and immunohistochemistry to understand the reproductive efficiency of dove testes. The tunica albuginea was thin and septula testes were not observed. The testicular parenchyma was formed mainly of closely packed convoluted seminiferous tubules with little interstitial area. Three types of spermatogonia were distinguished. The primary spermatocyte appeared as the largest spermatogenic cell and was identified at different stages of meiosis. Different morphological stages of the spermatid were categorized. Various cellular associations were described within the seminiferous epithelium. The cytoplasm of Sertoli cells was pale and ill defined due to its close relationship to the germinal epithelium. The spermatid attached to the luminal border of Sertoli cells and germ cells were closely associated. A single layer of myoid cells surrounded the seminiferous tubule. Testicular telocytes of doves were located in the peritubular region and near the blood vessels. Telopods appeared as long cytoplasmic processes arising from the cell body. Leydig cells were distributed singly or in small groups and cords. The intensity of androgen receptor (AR) immunostaining in the testes of the dove was established for the first time and is described in this paper.

Background Microdissection testicular sperm extraction (microTESE) is considered the gold standard method of sperm retrieval from patients with non-obstructive azoospermia (NOA). For careful and thorough examination of seminiferous tubules during microTESE, maximizing surface area of the testicles which we are able to search is essential. Objectives To develop a systematic procedure for microTESE to maximize surface area and to achieve high sperm retrieval rate (SRR) in microTESE. Materials and methods We simulated microTESE using three-dimensional (3D) simulation model and analyzed mathematically the sum of the surface area in various methods. The best method obtained from this simulation model was applied to 102 patients with NOA from 2014 to 2018. These new clinical results were compared with those of 56 patients who underwent a previous method of microTESE from 2011 to 2014. Results The mathematical 3D simulation model of microTESE indicated that a longitudinal incision on the tunica albuginea and following transverse slicing incisions of testicular parenchyma maximized the surface area coverage. Forty-six (45%) out of 102 patients who underwent microTESE with the new method had successful retrieval of testicular spermatozoa compared with 16 (29%) of 56 patients with the previous method of microTESE (P = .04). Discussion Transverse resections of parenchyma in our method run parallel to the courses of intratesticular arteries and do not interfere with the blood supply. The small amount of extracted seminiferous tubules was equivalent to that of the previous method, and no patients exhibited post-operative symptoms of androgen deficiency in our study. As for post-operative pain, our new method was comparable with the previous method. Although our study needs a longer follow-up, there will be limited effects on testicular functions. Conclusion Longitudinal incision on the tunica albuginea and following transverse slicing incisions in the testicular parenchyma maximized the surface area and improved the SRR of microTESE.

Peyronie's disease (PD) is a connective tissue disorder of the penis characterized by fibrosis and plaque formation within the tunica albuginea. PD is characterized by painful penile curvature that impairs sexual intercourse. Stem cell therapy is one of the recent non-invasive treatment options for patients with PD and it has promising results. Stem cells are undifferentiated cells that are capable of self-renewal and differentiation, promoting the repair of tissues via their immunomodulatory and anti-inflammatory action. Adipose-derived stem cells (ADSC) are used most widely due to their abundant tissue source and ease of isolation. Multiple studies have indicated the efficacy of stem cell therapy as a potential treatment for fibrotic diseases. Clearly, ADSCs may represent a way to treat and prevent PD in both rat and human models. Further clinical studies are needed to confirm the efficacy of stem cell therapy for PD in humans.

Purpose: Obliterative urethral stenosis is a type of urethral lesion that compromises the whole corpus spongiosum's circumference. We present our experience in resolving complex long segment urethral obliteration in a single procedure using a combination of dorsal onlay oral mucosa graft (OMG) and ventral fasciocutaneous penile skin flap. Materials and methods: A prospectively maintained database was reviewed, which included data of men presenting long, obliterative strictures. Patients were excluded if they were lost to follow-up before one year. Failure was defined as need for further urethral instrumentation. The surgical technique used consisted on the fixation of OMG to the tunica albuginea of the corpus cavernosum, thus creating a new urethral plate. Penile or foreskin flaps were employed to complete the ventral aspect. Postoperative follow-up was done with a voiding cystourethrography at week 3. Results: A total of 21 patients were included with a median age of 49 years. Mean follow-up was 25 months. Failure was found for 3 patients (2 of them needing dilations and only one required a new urethral reconstruction). Conclusion: Single stage combination of dorsal OMG with ventral fasciocutaneous penile flap showed good results for selected patients affected with obliterative urethral stenosis.

Complex abdominal wall defects might be challenging for human and veterinary surgeons worldwide. Defects from trauma or congenital causes may lead to hernias development. The introduction of meshes to reinforce hernia repairs has improved surgical outcomes and several synthetic and biologic materials have been used. In this context, biomaterial prosthesis seems to be a satisfactory solution when managing great abdominal wall defects. The aim of the current study is to evaluate the bovine tunica albuginea (BTA) preserved in honey as graft material for rats’ abdominal wall reinforcement in incisional herniorrhaphy surgery as well as its viability, cicatrization and integration into the host tissue. Wistar rats were assigned to two main groups: 1) animals (n = 20) underwent median longitudinal laparotomy followed by laparorraphy with suture of the bovine tunica albuginea (BTA) graft as abdominal wall reinforcement; and 2) animals (n = 20) underwent only laparotomy and subsequent laparorrhaphy. Rats were clinically evaluated until euthanasia at post-surgical day 7, 14, 21 and 28. Necropsy and histopathological analysis of abdominal wall fragments were performed to compare groups and subgroups findings. BTA promoted abundant fibrosis, providing resistance and low postoperative complication rates. Besides, animals did not show rejection signs to the implant. In conclusion, BTA preserved in honey is an affordable, easy collection and handling biomaterial for graft, demanding simple surgical implantation technique for abdominal wall repair in rats.

Objectives To evaluate the magnetic resonance imaging (MRI) findings of traumatic bulbar stricture and to evaluate their ability to estimate repair complexity. Methods Eighty-nine men with traumatic bulbar stricture who underwent urethrography and MRI at least 3 months post-injury and subsequent excision and primary anastomosis were retrospectively analyzed. The associations of MRI findings, including continuity of the tunica albuginea of the corpus spongiosum, periurethral fistula, spongiofibrosis length (SFL), and distal and proximal bulbar urethral length (PBL) from the stricture, with urethrography and operative parameters were evaluated. Results Mean SFL was significantly longer than mean stricture length on urethrography (14.9 vs. 7.9 mm, p Conclusions In contrast to urethrography findings, MRI findings help predict traumatic bulbar stricture repair complexity.

Urethral injuries are infrequent, and management is challenging. We present a case of urethral transection associated with a penile fracture following gunshot injury. During the initial exploration complete urethral transection revealed with a bleeding penile fracture. With the use of an antegrade guidewire and a catheter, urethral ends aligned, and penile fracture repaired with suturing the tunica albuginea. Post-surgery urethrogram revealed stricture formation at bulbar urethra and detail of a gunshot injury was disclosed. Delayed stricture excision and end-to-end anastomosis was achieved, resulting in satisfactory urethral and penile functions., Highlights • Traumatic complete urethral transections with penile fracture in children are extremely rare and management is challenging. • Application of a suprapubic catheter without disturbing the urethral injury is recommended for urethral transection, but no recommendation if it is a complete transection and associates with bleeding penile fracture. • Post-surgical urethrogram is important to identify stricture formation.

Introduction Several conditions can cause penile length and girth loss. Surgical techniques have been used to restore these penile alterations in patients with severe erectile dysfunction during penile prosthesis implantation. One technique uses multiple small incisions in a mesh pattern (similar to a skin mesh) with satisfactory curvature correction without using a graft, however, this technique does not allow simultaneous increase in penile length and girth. Aim To identify a new surgical technique that increases both the length and girth at the same place on the corpora cavernosa (CC), allowing a simultaneously longitudinal and transverse increase of the tunica albuginea. Methods A sheet with a star-shaped perforation was created using a mathematical model to allow a longitudinal and transversal increase in the material. Two previously published penile model simulators, with and without deformity, were used to test the mechanical modification of this incision pattern in the CC. Main Outcome Measure The effect of the incisions pattern on the geometry of the CC simulator. Results The star-shaped incision (auxetic) simultaneously increased the length, girth, and volume of the CC simulator. This auxetic technique could correct any penile deformity, re-establishing the original penile anatomy. The new auxetic incision is only a conceptual and experimental technique awaiting clinical evidence. Conclusion The data presented here show that the auxetic technique successfully increases both the length and girth at the same place on the CC simulators, opening a new potential solution to correct challenging cases of complex penile deformities and to restore volume loss.

A 25-year-old patient was referred to the fertility clinic in our hospital, complaining of primary infertility for 3 years. The patient reported having irregular menses, and physical examination showed clinical hirsutism, while transvaginal ultrasound revealed polycystic ovarian morphology. Hormonal workup showed elevated Anti-Müllerian Hormone (7 ng/ml), and normal levels of prolactin and thyroid stimulating hormone. Hysterosalpingogram revealed bilateral obstruction of fallopian tubes. Semen analysis of the husband was within normal limits.

INTRODUCTION AND OBJECTIVE:Peyronie’s Disease (PD) refers to curvature of the erect penis caused by fibrosis of the tunica albuginea of the corpora cavernosa. In 2013, collagenase clostridium histo...

INTRODUCTION AND OBJECTIVE:The penis is fundamentally a biomechanical implement. Penile load-bearing is assumed by the tunica albuginea, a sheet of collagenous tissue enveloping the corpora caverno...

Background: Peyronie’s disease (PD) is characterized by the formation of fibrous plaque in tunica albuginea, causing several problems in patients. The etiology of this disease is not fully understood, and there are few effective treatments. To better understand the molecular pathways of PD, we studied miR-29b, a microRNA that could be involved with this illness. MicroRNAs are endogenous molecules that act by inhibiting messenger RNA. MiR-29b regulates 11 of 20 collagen genes and the TGF-β1 gene, which are related to PD progression. Methods: We compared miR-29b expression in 11 patients with PD and 14 patients without PD (control group). For the patients with PD, we utilized samples from the fibrous plaque ( n = 9), from the tunica albuginea ( n = 11), and from the corpus cavernosum ( n = 8). For the control group, we utilized samples from the tunica albuginea ( n = 14) and from the corpus cavernosum ( n = 10). MiR-29b expression was determined by q-PCR. Results: We found a downregulation of miR-29b in the fibrous plaque, tunica albuginea and corpus cavernosum of patients with PD in comparison with the control group ( p = 0.0484, p = 0.0025, and p = 0.0016, respectively). Conclusion: Although our study has a small sample, we showed for the first time an evidence that the downregulation of miR-29b is associated with PD.

A penile fracture is defined as a tear of the tunica albuginea, surrounding the corpus cavernosa. It occurs when the erect penis is subjected to an abnormal ‘bending’ force, inducing an acute increase in intracavernosal pressures, exceeding the tensile strength of the tunica albuginea, which is

Background Testis cord elongation and coiling, which occur in the final stage of testis formation, have been attributed to Sertoli cell proliferation; however, the underlying mechanisms remain unclear. Objective The aim of the present study was to clarify the precise three-dimensional (3D) structure of testis cords in the final stage of testis formation in mice and rats. Materials and methods We reconstructed whole testis cords in the final stage of testis formation in mice (on embryonic day (E) 15.5 and E18.5) and rats (on E16.5 and E19.5) using serial paraffin sections and high-performance 3D reconstruction software. Results Detailed morphometric parameters were calculated for 3D-reconstructed testis cords in 6 mouse and rat testes each. The mean numbers of testis cords in mice and rats were 12.7 and 27.8, respectively. The mean number of branching points per testis cord was 1.52 in mice, whereas it was only 0.30 in rats. In contrast, the mean ratio of the inner cords, i.e., cords not in contact with the tunica albuginea, was 23.0% in rats, whereas it was only 6.5% in mice. In both species, the cords on the cranial side coiled more strongly than those on the caudal side, consistent with the greater expansion of the testis volume on the caudal side. All cords formed right-handed helices from the rete testis side. Discussion and conclusions The present results suggest that testis cords undergo anastomosis at a higher frequency in mice than in rats and that the coiling of testis cords proceeds from the cranial to caudal side of the testis in both species. This article is protected by copyright. All rights reserved.

Testicular rupture after blunt scrotal trauma is characterized by rupture of the tunica albuginea and extrusion of seminiferous tubules. This is a serious injury and appropriate evaluation and management are necessary both for symptom control, but also for preservation of the testicle. Clinical examination of the scrotum following trauma is difficult and may result in incorrect triage of patients for surgical exploration. This case study describes the assessment and management of blunt testicular trauma in an adolescent lacrosse player.

Background The clitoris is the primary somatosensory organ of female sexual response. Knowledge of its neural anatomy and related landmarks is essential for safe genital surgery. Objectives The aim of this study was to describe the distal course of the dorsal nerves of the clitoris and associated structures. Methods Clitorises of 10 fresh cadavers were dissected. Measurements of the dorsal nerves, suspensory ligament, clitoral body, clitoral hood, and clitoral glans were obtained. The course of the dorsal nerves was examined. Results The dorsal nerves of the clitoris were larger than expected, ranging from 2.0 to 3.2 mm in diameter, on average, along their course in the clitoral body. In 9 of 10 specimens, the dorsal nerves could be traced to within 6 mm of the glans. They traveled deep to a superficial clitoral fascia but superficial to the tunica albuginea, were variably located between 10 and 2 o’clock, and were separated by the deep suspensory ligament (DSL) of the clitoris. The mean length of the descending clitoral body, from the angle to the base of the glans, was 37.0 mm. The mean distance from the pubic rim to the DSL was 37.7 mm. Conclusions The clitoral body is substantial in length, mostly lying superficially under the clitoral hood and mons pubis. The dorsal nerves of the clitoris are large and superficial, terminating at or near the base of the clitoral glans. Knowledge of this anatomy is critical prior to performing surgery near the clitoris.

Penile prosthesis implantation is a treatment choice in patients with erectile dysfunction (ED) and concomitant penile curvature due to Peyronie disease. Methods for correction of penile deformity during prosthesis implantation are still under discussion, considering variable efficiency and higher risk of complications. Our aim was to describe clinical case which represent our first experience of performing multiple corporal incisions through innovative subcoronoral approach without subsequent substitution of tunica albuginea. As a result of graft-free technique an effective penile straightening was achieved after three-piece prosthesis implantation with good long-term functional and cosmetic results. The first experience of graft-free technique of corporotomy during penile prosthesis implantation through subcoronal approach suggests its potential efficacy and safety in patients with a combination of ED and Peyronie disease.

Paratesticular leiomyoma is a rare benign neoplasm that may arise from smooth muscle cells contained in either the epididymis, the spermatic cord, or the tunica albuginea. Usually patients present a palpable, asymptomatic mass, with a higher prevalence among the fourth and fifth decade of life. In this case report we describe a 57-year-old man with bilateral scrotal palpable masses evaluated with ultrasound and magnetic resonance imaging that were suggestive for leiomyoma. The lesions were surgically removed and pathology revealed no signs of malignancy confirming the diagnostic hypothesis of leiomyoma. Ultrasound is considered the imaging modality of choice for the initial evaluation of testicular masses since it allows an accurate localization (ie testicular vs paratesticular) and can identify signs of malignancy. Magnetic resonance imaging is less frequently performed but can considerably improve lesion characterization. Keywords: Paratesticular, Leiomyoma, US, MRI, Diagnostics

The abdominal type of cryptorchism was modeled on random-bred albino rats by replacing both testes from the scrotum into the abdominal cavity for 3 weeks; thereupon they were manipulated into the scrotum. In control rats, no additional surgery was performed. In experimental rats, the testicular tissue obtained from 1-2-day rat pups was transplanted under testicular tunica albuginea. Prior to orchiopexy, the weight of testes decreased by 62.5-64.1%. In 6 month after the surgery, it increased by 36.1% in the control group, whereas in experimental rats the weight of testes elevated by 123.2% and approximated the normal value. Histologically, the control group demonstrated persistent disturbance in spermatogenesis with emptiness of numerous seminiferous tubules where only Sertoli cells could be revealed and with pronounced dystrophic alterations in the spermatogenous epithelium of the partially preserved tubules where spermatogenesis was blocked at the spermatogonial level. In contrast, the transplantation region of the experimental testes exhibited formation of novel mature testicular tissue enclosed by a connective tissue capsule incorporating the seminiferous tubules with differentiated epithelium and with the clusters of Leydig cells in the stroma. In 6 month, spermatogenesis was observed in most seminiferous tubules of the host testicular tissue, which had spermatozoa in the lumens. To the moment of orchiopexy, the blood testosterone decreased by about 2.5-fold. In control group it remained diminished during entire observation period (up to 6 month), while in the experiment group its level normalized completely as early as in 2 month and remained even elevated to the end of observation period.

MR imaging has been increasingly used as a problem-solving adjunct after an initial ultrasound examination for a variety of penile disorders, and is the best cross-sectional imaging modality for the assessment of urethra and periurethral disease. Critical advantages of MR imaging for penile and urethra imaging include high soft tissue contrast resolution providing detailed anatomic evaluation, which is important for the demonstration and assessment of critical structures such as tunica albuginea or walls of the urethra, larger field of view for better evaluation of extent of disease, and demonstration of proteinaceous material and varying ages of the blood products.

Background Penis transplantation represents an exciting new avenue for restoration of male urogenitalia. However, little is known about the specific immunological features of penile transplants, limiting their application in complex urogenital reconstruction. To properly study this emerging form of transplantation, adequate preclinical models are a necessity. The purpose of this study is to establish a clinical and histological rejection classification of urogenital tissue transplants using a new rat heterotopic penile transplant model that includes preputial skin. Methods Syngeneic and allogeneic heterotopic penile transplantations were performed on Lewis and Brown Norway rats using a new model designed by our group. Grafts were clinically and histologically monitored at postoperative days (POD) 3-30. Results Six syngeneic and 25 allogeneic transplants were performed. All syngeneic and tacrolimus-treated grafts survived until endpoint. Allogeneic graft rejection is shown to follow a 4-stage clinical progression with all untreated allografts developing epidermal sloughing at POD7 and full rejecting between POD14 and POD16. Histological samples were used to develop a specific 4-grade rejection classification analogous to the 2007 Banff Criteria for skin-containing allografts. Conclusions Graft skin and urethral lining tissue are first rejection targets followed by tunica albuginea and corpora cavernosa in a distal to proximal pattern. We established a robust and reproducible murine model to study the immunobiology of male genital tissue in the context of transplantation and developed a novel 4-grade clinical and histological rejection scale based on graft skin and urethral lining as the main targets of rejection.

Introduction Surgery remains the gold standard for treatment in stable patients with penile deformity associated to Peyronie’s disease (PD). Aim To evaluate the long-term results of plaque incision and buccal mucosa grafting (BMG), with or without additional tunica albuginea plication (TAP), in the correction of severe penile curvatures secondary to PD. Methods 72 patients with severe curvature caused by PD, normal erections, and stable disease entered this prospective study. Preoperatively, they underwent penile duplex ultrasounds with measurement of curvature and length of affected side. All procedures were carried out by 1 surgeon. Patients were seen at 1, 3, 6, and 12 months postoperatively, then yearly. Subjective outcome was assessed by the Sexual Encounter Profile (SEP) questionnaire, and objective outcome was assessed by an intracavernous injection (ICI) test performed within the first year for evaluating penile rigidity, straightness, and length. Main Outcome Measure Long-term outcomes include penile straightening, penile shortening, and sexual satisfaction. Results Mean curvature was 71.32 ± 17.6° (range 40–110); 33 (45.8%) patients had a 2-sided curvature with a mean second curvature of 33.79 ± 12.2° (range 10–60). Additional TAP was needed in 60% of patients for complete straightening or graft stretching. All patients resumed unassisted intercourse 1 month after surgery; 4 (5.5%) refused follow-up, claiming excessive penile shortening. In the remaining 68, the ICI test showed no recurvature, shortening, or de novo erectile dysfunction. At mean follow-up of 62.01 ± 34.3 months (range 12–135), all were able to obtain an erection (SEP-1), 97.1% to penetrate (SEP-2), and 89.7% to successfully complete intercourse (SEP-3); 80.9% of them were satisfied with erection hardness (SEP-4) and 86.8% were overall satisfied (SEP-5), with the main reason for dissatisfaction being expectation of better length and rigidity. Conclusion BMG, with or without TAP, provides excellent long-term results and is safe and reproducible, representing a valuable treatment option for PD, but great care should be taken in patient counseling to avoid unrealistic expectations.

Objectives To report our initial experience with the extra-tunical grafting (ETG) procedure. This procedure was recently introduced by UCSF investigators as a tunica-sparing technique for management of penile concavity deformities. Methods We retrospectively reviewed records of patients who underwent ETG at our tertiary-care referral center between 2017-2020. A collagen graft made from bovine pericardium (Lyoplant®) was placed overlying the defect without violating the tunica albuginea or mobilizing the neurovascular bundle. The stretched penile length (SPL) and circumference at the location of deformity were measured intra-operatively. Patient reported outcomes were evaluated by an anonymous ten-question online survey. Results Nineteen men underwent ETG with a median follow-up of 59 (IQR: 24 - 708) days. ETG was performed via either a window (15/19, 78%) or a de-gloving (4/19, 21%) incision with concomitant penile plication performed in 16/19 (84%) patients. Penile circumference increased by an average of 1.4 cm + 0.5 (p = 0.03) at the location of deformity, while pre- and post-operative SPL were similar (14.0 + 1.4 vs. 14.0 + 1.3 cm, p = 0.95). Overall patient satisfaction was reported by 13/15 (86%) patients. Twelve out of 15 (80%) patients reported concavity deformity to be “improved”, with 73% reporting “much better”. Among 8 patients with follow up greater than six months, graft palpability was reported in 4/8 (50%) patients but was not bothersome. Conclusions The ETG procedure appears to be safe and effective for the treatment of penile concavity deformities. Patient outcomes and satisfaction are favorable at intermediate follow up.

Urinary bladder damages leading to few viable bladder tissue available might demand a challenging reconstructive surgery. In this context, biomaterials are valid alternatives for bladder reconstruction. This study evaluated the bovine tunica albuginea fragment as graft material for cystoplasty in rats and honey-preserved implant viability.Thirty Wistar rats were assigned to two groups: (1) a test group (T) with a circular 1.0-cm-diameterbovine tunica albuginea graft application in the apex region by a continuous absorbable (Polyglactin 910 5-0) suture with stitching of all bladder layers and (2) a simulation group (S) in which animals underwent only partial cystectomy. In addition, each of these groups was further divided into three subgroups according to euthanasia period on post-surgery day 7, 15 and 30.Two animals had self-limiting hematuria at postsurgical period. At necropsy, frequent crystals and adhesion to the peritoneum were observed. At the histopathological evaluation, animals from the T group euthanized by 15th postoperative day had layers disorganization and initial muscle development, while T group rats euthanized by 30th postoperative day showed complete urothelization. Urothelization pattern was similar in both groups. Moreover, the muscular layer formation was present in both groups, but more evident in S group animals. Nevertheless, inflammatory infiltrate and neovascularization were remarkably more intense in T group rats.It might be concluded that bovine tunica albuginea graft was successful in repairing rats’ bladder, being a good biomaterial option in reconstructive urinary vesicle surgery. RESUMO: Lesões na vesícula urinária que culminem em pouco tecido vesical viável podem demandar cirurgias reconstrutivas desafiadoras. Neste contexto, biomateriais são alternativas válidas para a reconstrução da bexiga. O objetivo deste trabalho foi avaliar a túnica albugínea bovina como material para enxerto na cistoplastia em ratos, assim como a viabilidade deste implante preservado em mel. Trinta ratos Wistar foram divididos em dois grupos: (1) um grupo teste (T), no qual os animais foram submetidos a cistectomia parcial seguida de cistoplastia com aplicação do enxerto circular com 1,0cm de diâmetro de túnica albugínea bovina na região do ápice com sutura absorvível (Poliglactina 910 5-0) em padrão contínuo englobando todas as camadas da bexiga; e (2) um grupo simulação (S), cujos ratos realizaram apenas cistectomia parcial. Além disso, cada grupo foi posteriormente dividido em três subgrupos de acordo com a data de eutanásia no dia 7, 15 ou 30 de pós-operatório.Dois animais apresentaram hematúria autolimitante no período de observação pós-operatória. Na necrópsia, notaram-se cristais frequentes e aderências entre bexiga e peritônio. Na avaliação histopatológica, animais do grupo T eutanasiados com 15 dias de pós-operatório apresentavam camadas vesicais desorganizadas e formação de musculatura inicial na bexiga, enquanto aqueles eutanasiados com 30 dias de cirurgia mostraram urotelização completa. O padrão de urotelização foi semelhante nos dois grupos. Além disso, a formação da camada muscular esteve presente em ambos os grupos, porém mais evidente nos animais do grupo S. No entanto, o infiltrado inflamatório bem como a neovascularização foram notavelmente mais intensos nos ratos do grupo T.Pode-se concluir que o enxerto de túnica albugínea bovina foi bem sucedido no reparo da vesícula urinária de ratos, demonstrando ser uma boa opção de biomaterial para cirurgias reconstrutivas da vesícula urinária.

Peyronie’s disease (PD) is a disorder of the tunica albuginea from disordered and excessive deposition of collagen resulting in a palpable scar, pain, erect penile deformity and erectile dysfunctio...

Penile fracture is described as a traumatic rupture of the tunica albuginea caused by blunt injury to the erect penis. It usually occurs as a single rupture of the tunica albuginea in one of two corpora cavernosa; a rupture with urethral injury is an extremely rare condition. Although its diagnosis is usually clinical, ultrasound plays an important role in confirming diagnosis and identifying the site of the injury. Here, we presented a case of penile fracture with complete urethral injury. A 43-year-old male was admitted to the hospital because of trauma to the genital and dysuria following sexual intercourse. After admission, the patient was diagnosed with double penile fracture and complete urethral injury after the physical and B-ultrasound examinations. Emergency surgery to remove the hematoma and repair the urethra was performed. The patient recovered smoothly and was discharged on the third day after operation. After two months' follow-up, the patient urinated smoothly and achieved an adequate erection without other complications. In this case, consistent with previous studies, emergency surgery for penile fracture is necessary and can preserve the urethral function and sexual function. In addition, there are two lesions in tunica albuginea in this case, so careful search for the penile shaft during the surgery is important to avoid the missed injuries. This report provides evidence of an uncommon and underreported clinical case.

Background Penile prostheses are the third option in the treatment of erectile dysfunction, however, despite their proven effectiveness, the occurrence of infections, advanced age of patients and comorbidities are the main limiting factors for this treatment modality. In the continuous search for biointegrated, clinically durable and minimally invasive treatment options, a possible model of penile prosthesis was sought through the use of intracavernous bacterial cellulose (BC) gel, in an experimental model of orchiectomized rabbits. Methods Thirty adult New Zealand rabbits were equally distributed into three groups: BC; vehicle and control. Each group was then subdivided according to the follow-up time of 3 and 6 months. Bilateral orchiectomy was performed 3 weeks before injection in the BC and vehicle groups. Pachymetry measurements of the penile axis, diameter and length were performed in situ. Histomorphometry analyzes of the corpora cavernosa (CC), thickness of the tunica albuginea, cell density, collagen and elastic fibers post-injection were also performed, in addition to immunohistochemistry for newly formed vessels. Results The implant of BC increased both the length and thickness of the penis three and six months after the last injection, with a consequent increase in the diameter of the CC. On the other hand, the filling effect was not observed in the control and vehicle groups, confirming the degradation of this tissue after orchiectomy and the effectiveness of BC as a filling agent. Histomorphometry analyzes corroborate the mass effect of BC integrated into the tissue, permeated by predominantly lymphomononuclear inflammatory infiltrate, multinucleated giant foreign body cells, fibroblasts, elastic fibers and newly formed vessels, without degradation or loss of volume, even after six months of implantation. Conclusions Biocompatibility and biointegration to the host tissue make BC a prosperous penile filling material, with local application and minimally invasive.

A pathological disorder of human penile function, known as Peyronie’s disease, is characterized by the formation of plaque particles within the tunica albuginea. The plagues in the shape of rigid plate form in the scars as a result of the imperfect healing process. Due to high stiffness, plagues are the source of pain and anomalous deformations during erectile penis function. The authors simulate the biomechanical behavior of the penile structure by a 3D finite element model. The numerical model is based on the real geometrical shape and the tissue structure with consideration of large nonlinear deformations. The penile erection is modeled by the initial strains imposed on the corpus cavernosa. The stress analysis is performed in a case study of various plague locations. The Peyronie’s syndrome manifested by the penis angular deviation simulated by the analysis is compared with the clinical data. The computational simulations provide a rational explanation for the clinical observations on patients. The objective is to apply the proposed modeling approach for the development and validation of treatment methods based on the application of shock waves.

During the first 5 years after penile prosthesis implantation, complications such as malfunction requiring revision or replacement occur in only 7% of cases. We present a case of a 62-year-old patient who had a Coloplast Titan® prosthesis implanted while also undergoing girth enhancement corporoplasty. Shortly after, the patient noticed an increasing bulge on the side of his penis, which prevented total deflation. An aneurysm of the right cylinder was identified during reoperation; cylinders were replaced and the redundant tunica albuginea and septal defect were corrected by plication from inside the corpora cavernosa.

Glutamine is often used to treat metabolic changes associated with anorexia-cachexia syndrome in patients with malignant neoplasms. Walker 256 tumor is an excellent model for studying these changes associated with cancer in different organs, including injuries in testicular functions. However, the effects of supplementing glutamine on testicular morphometry in this model have not yet been investigated. Thus, the objective of this study was to evaluate the effect of L-glutamine supplementation on testicular morphometry in rats transplanted with Walker 256 tumor cells. Forty puberty Wistar rats were divided into four groups: control without L-glutamine (C); control supplemented with L-glutamine (CG); inoculated with Walker 256 tumor cells (WT) and inoculated with Walker 256 tumor cells and supplemented with L-glutamine (WTG). The testicles were removed, weighed, fixed in Bouin, and included in paraffin for histomorphometric analysis. Walker 256 tumor caused quantitative changes in the tubular and intertubular compartments and tunica albuginea, with reductions in the percentages of lumen and tunica albuginea, number of Sertoli cells per gram of testis; number of Leydig cells; percentage of blood vessels and connective tissue in intertubule. However, glutamine supplementation prevented part of these changes caused by the tumor, presenting mainly a protective effect on the tunica albuginea and percentage of blood and lymph vessels in the intertubule. These results indicate the potential of L-glutamine was able to recover for testicular dysfunction associated with cancer.

Anuran amphibians show the largest diversity of amphibian reproductive modes,many of which imply egg deposition out of the water. This kind of egg depositionrequires specialisations to avoid egg desiccation. Physiological, anatomical and ethological traits integrate to define these modes. In particular, morphological featuresof the urogenital system correlate with these reproductive modes and the environmental conditions where egg-laying occurs. In this study, we describe the testicularhistology and spermatogenesis of the nest-building frog Leptodactylus latinasus, andwe compare it with other species that breed out of water. We found variations in testis size, the thickness of interstitial tissue, tunica albuginea, and peritubular tunics,flagellum length, and in the shape and size of the spermatozoal nucleus. Certainspecifics? characters differed at the species level, but not between families. Suchvariation could be an indicator of spermatozoal performance and environmentalconstraints under which fertilisation takes place. Fil: Pucci Alcaide, Ana. Instituto de Morfología Animalfundación Miguel Lillotucumán; Argentina Fil: Pucci Alcaide, Franco Jose. Instituto de Morfología Animalfundación Miguel Lillotucumán; Argentina Fil: Michel, Adriana Azucena. Instituto de Morfología Animalfundación Miguel Lillotucumán; Argentina Fil: Ponssa, María Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - Tucumán. Unidad Ejecutora Lillo; Argentina

We herein report a case of paratesticular cholesterol granuloma. A 5-year-old boy with a painless mass (10 mm in diameter) in the left scrotum. Although the mass shrank over the next eight months, it increased in size at six years of age. Surgical resection of the mass was performed. The mass originated from the tunica albuginea. The histological diagnosis was cholesterol granuloma. To our knowledge, this is the first case of cholesterol granuloma in the scrotum of a child.