Tuberculose testicular: Caso clínico Testicular tuberculosis: Case report

A tuberculose testicular é uma entidade clínica rara que ocorre em aproximadamente 3% dos doente com tuberculose genital. Clinicamente, a tuberculose do testículo não pode ser distinguida de lesões como o tumor testicular ou enfarte, podendo em alguns casos mimetizar uma torção testicular. Os homens com idades compreendidas entre os 20 e os 50 anos são os mais frequentemente afectados e queixam-se habitualmente de dor ou aumento de tamanho do testículo. A ecografia e actualmente a melhor técnica para a visualização e a orientação diagnostica de lesões testiculares. Os autores apresentam o caso de um homem de 58 anos, seguido em consulta de Pneumologia por tuberculose pulmonar, que inicia quadro de dor e aumento testicular direito ao 2.o mês de tratamento antibacilar e cuja avaliação inicial, secundada por ecografia, foi sugestiva de lesão neoplásica. O diagnóstico final revelou tratar-se de uma tuberculose testicular.Testicular tuberculosis is rare, occurring in approximately 3% of patients with genital tuberculosis. It is often clinically indistinguishable from lesions such as testicular tumour and infarction and may even mimic testicular torsion. Men aged 20-50 years old are most commonly affected and often present with painful or painless enlargement of the scrotum. Ultrasound (US) is currently the best technique for imaging the scrotum and its contents and for diagnosing testicular lesions. We present the case of a 58 year-old male, followed in pneumology for pulmonary tuberculosis, who complained of pain and right scrotum enlargement in the second month of anti-tuberculosis chemotherapy. First assessment, seconded by US, suggested a neoplasic lesion, and the final diagnosis revealed testicular tuberculosis

Tuberculose testicular: Caso clínico

Resumo: A tuberculose testicular é uma entidade clínica rara que ocorre em aproximadamente 3% dos doente com tuberculose genital. Clinicamente, a tuberculose do testículo não pode ser distinguida de lesões como o tumor testicular ou enfarte, podendo em alguns casos mimetizar uma torção testicular. Os homens com idades compreendidas entre os 20 e os 50 anos são os mais frequentemente afectados e queixam-se habitualmente de dor ou aumento de tamanho do testículo. A ecografia é actualmente a melhor técnica para a visualização e a orientação diagnóstica de lesões testiculares. Os autores apresentam o caso de um homem de 58 anos, seguido em consulta de Pneumologia por tuberculose pulmonar, que inicia quadro de dor e aumento testicular direito ao 2.° mês de tratamento antibacilar e cuja avaliação inicial, secundada por ecografia, foi sugestiva de lesão neoplásica. O diagnóstico final revelou tratar-se de uma tuberculose testicular. Abstract: Testicular tuberculosis is rare, occurring in approximately 3% of patients with genital tuberculosis. It is often clinically indistinguishable from lesions such as testicular tumour and infarction and may even mimic testicular torsion. Men aged 20-50 years old are most commonly affected and often present with painful or painless enlargement of the scrotum. Ultrasound (US) is currently the best technique for imaging the scrotum and its contents and for diagnosing testicular lesions.We present the case of a 58 year-old male, followed in pneumology for pulmonary tuberculosis, who complained of pain and right scrotum enlargement in the second month of anti-tuberculosis chemotherapy. First assessment, seconded by US, suggested a neoplasic lesion, and the final diagnosis revealed testicular tuberculosis. Palavras-chave: Tuberculose, testículo, Key-words: Tuberculosis, testicul

Microsurgical vasovasostomy: our experience

To describe the initial experience of CHVNG/E in microsurgical vasovasostomy. The two‐layer technique was applied under microscope magnification in every patient by the same surgeon. 8 bilateral vasovasostomies were performed for vasectomy reversal between 2008 and 2014 at our unit. All the patients were available for follow‐up, with a mean follow‐up time of 6 months. Mean patient age was 38.8 ± 8.7 years and the interval between vasectomy and recanalization of 6 ± 1.5 years. Overall spermatozoid patency rate was 100%, with mobile spermatozoa in the ejaculate of all patients (median 12 x 106 /mL, interquartile interval [7 x 106 /mL‐21 x 106 /mL]). Four of the 8 patients fathered after the procedure. Our results were comparable to the ones described in the literature, confirming the performance of a good surgical technique. Microsurgical vasovasostomy constitutes a very safe method of vasectomy reversal, enabling couples to obtain pregnancies without additional medical treatment. To our knowledge, this is the first group of patients treated by this method in Portugal

Impact on sexual function of surgical treatment in rectal cancer

ABSTRACT Introduction The development of new surgical techniques and medical devices, like therapeutical multimodal approaches has allowed for better outcomes on patients with rectal cancer (RCa). Owing to that, an increased awareness and investment towards better outcomes regarding patients’ sexual and urinary function has been recently observed. Aim Evaluate and characterize the sexual dysfunction of patients submitted to surgical treatment for RCa. Materials and Methods An observational retrospective study including all male patients who underwent a surgical treatment for RCa between January 2011 December 2014 (n=43) was performed, complemented with an inquiry questionnaire to every patient about its sexual habits and level of function before and after surgery. Discussion All patients were male, with an average of 64yo. (range 42-83yo.). The surgical procedure was a rectum anterior resection (RAR) in 22 patients (56%) and an abdominoperineal resection (APR) in 19(44%). Sixty three percent described their sexual life as important/very important. Sexual function worsening was observed in 76% (65% with complains on erectile function, and 27% on ejaculation). Fourteen patients (38%) didn't resume sexual activity after surgery. Increased age (p=0.007), surgery performed (APR) (p=0.03) and the presence of a stoma (p=0.03) were predictors of ED after surgery. A secondary analysis found that the type of surgery (APR) (p=0.04), lower third tumor's location (p=0.03) and presence of comorbidities (p=0.013) (namely, smokers and diabetic patients) were predictors of de novo ED after surgery. Conclusions This study demonstrated the clear negative impact in sexual function of patients submitted to a surgical treatment for RCa. Since it is a valued feature for patients, it becomes essential to correctly evaluate/identify these cases in order to offer an adequate therapeutical option

Repercussões do processo de ensinar-aprender em serviços de saúde na qualidade de vida dos usuários Repercussions of the teaching-learning process in health services in the quality of life of users

Estudo de abordagem qualitativa cujo objetivo foi o de conhecer percepções de usuários de serviços de saúde atendidos por docentes e alunos de cursos de graduação em saúde de uma universidade de Santa Catarina, Brasil, sobre a repercussão dessa participação na sua qualidade de vida e saúde. Os dados foram coletados pela técnica da entrevista em profundidade com vinte indivíduos que buscaram atendimento nos locais onde eram realizados os processos de ensino-aprendizagem. O processo de análise-reflexão-síntese dos dados, com base no referencial teórico adotado, evidenciou repercussões positivas na qualidade de vida e saúde dos usuários, particularmente em razão dos atributos identificados nas interações que mediaram o atendimento às necessidades específicas apresentadas por eles. O conjunto de categorias identificado nas interações professor-aluno-usuário pode ser caracterizado como um construto de atenção humanizada em processos de ensino-aprendizagem, o qual por si só, pelos seus atributos de cuidado, representa um espaço terapêutico e de realização para todos os participantes. Processos dessa natureza podem contribuir para a concretização das diretrizes curriculares, integradas às políticas públicas em saúde, as quais orientam para a assistência integral e humanizada, tendo em vista a atenção à saúde para promoção da qualidade de vida da população em diferentes contextos.<br>This study had a qualitative approach, with the purpose of understanding users' perceptions of health services provided by professors and students of undergraduate courses in health at a university in the state of Santa Catarina, Brazil, and on the repercussions of this participation on their own health and quality of life. The data was collected by the indepth interview technique from twenty individuals who sought treatment in locations where teaching-learning processes were carried out. The data analysis-reflection-synthesis process, based on the theoretical reference adopted, indicated positive repercussions on users' quality of life and health, particularly with regards to the attributes identified in interactions that permeated the treatment of the specific necessities presented by them. The set of categories identified in the professor-student-user interactions may be characterized as a construct of humanized attention in teaching-learning processes, which in and of themselves, represent a space for treatment and its execution for all the participants, because of their care-related attributes. Processes of this nature may contribute to the establishment of curricular directives, integrated with public health policies, which could be directed at full and humanized health care, considering the promotion of the quality of life of the population in different contexts