Marta Peretti

The Role of Sonoelastography in the Evaluation of Testes With Varicocele

OBJECTIVE To evaluate the role of elastosonography in the evaluation of testicular elasticity as a predictive sign of testicular damage in patients with varicocele. MATERIALS AND METHODS Between December 2010 and December 2014, we evaluated patients with varicocele by sonoelastography (SE) of the testes. We created 3 groups: group A included patients with untreated varicocele; group B, patients treated with the same technique; and group C, healthy age-matched patients without varicocele. All patients underwent SE for the evaluation of testicular stiffness and results were graded from 1 to 3 following the color scale grading. RESULTS During the study period, 36 boys (9-16 years old) with untreated varicocele, 47 treated patients, and 24 age-matched healthy subjects underwent control visit for varicocele and SE. All right testes of all groups were scored as 1, whereas testes with varicocele were stiffer than normal; all hypotrophies were scored as 3, whereas not all testes that were scored 3 were associated with testicular hypotrophy. There was a significant and statistical recovery rate of the testicular volume and the sonoelastographic score after surgery. CONCLUSION Testes with varicocele are significantly stiffer than normal ones. All testes with testicular hypotrophy had grade 3 sonoelastographic scores, but not all patients with a grade 3 score have testicular hypotrophy or continuous spermatic vein reflux. Our results show that sonoelasography can play a significant role in the evaluation of testicular elasticity as a predictive sign of testicular damage.

Wandering spleen with a ten-time twisted vascular pedicle

Torsion of a wandering spleen is a rare cause of acute abdomen in children, usually diagnosed with color-Doppler ultrasonography and enhanced computed tomography. We report a pediatric case of torsion of wandering spleen.

Trichobezoars in children: therapeutic complications

Trichobezoars are concretions formed by the accumulation of hair or fibers in the gastrointestinal tract, usually associated with underlying psychiatric disorders in females between 13 and 20 years old. Endoscopy, the gold standard for diagnosis, brings some additional advantages: sample taking, size reducing and, rarely, mass removal. This study shows that endoscopy can cause severe complications resulting in a surgical emergency.

PS-068 Varicocele And Adolescent: The Role Of Elastosonography In The Evaluation Of Testes

Background Varicocele is the first cause of male sub-fertility and it is well know its correlation with testicular growth arrest. In paediatric age testicular hypotrophy is the main indication for surgical treatment. The aim of this study is to evaluate the role of elastosonography in the evaluation of testicular elasticity as predictive sign of testicular damage. Materials and methods 13 boys (9–13 years old) with untreated varicocele (bilateral in 3 boys and left unilateral in 10) and 12 age-matched healthy subjects underwent elastosonography. Varicocele was classified following the Dubin and Amelar classification and spermatic vein reflux was classified following a modified Hirsch classification (as short, medium and continuous spermatic vein reflux). The testicular elasticity was expressed as a three-point scale (1: normal; 2: slightly to moderately stiffer than normal; 3: severely stiffer than normal). None had testicular hypotrophy. Statistical analysis was performed by means of the Student’s t-test. Results 2 patients had grade I varicocele, II in 9 patients had grade II varicocele and 5 patients had grade III varicocele; 3 cases had “short£ spermatic vein reflux, 6 patients had “medium” spermatic vein reflux and 7 patients had continuous spermatic vein reflux. The elasticity was 1 in all 34 normal testes; in the testes with varicocele it was graded 2 in 9 cases and 3 in 7 cases. The differences in the degree of elasticity between normal testes and testes with varicocele and between continuous and medium/short spermatic vein reflux were highly significant (p < 0.001 in both cases); the difference between stage III and stages I/II varicocele was just below significance (p = 0.053). Conclusion Testes with varicocele are significantly stiffer than normal ones, with a positive correlation to the clinical grade and significantly to the duration of spermatic vein reflux.