Are we doing right suggesting a non-operative management for suspected appendicitis in children?

The Authors analyze the pros and cons of the antibiotic therapy without surgery to treat children and adolescents affected by acute appendiciti

Testicular torsion: preliminary results of in vitro cell stimulation using chorionic gonadotropin

Testicular torsion is a pathology that occurs in young males generally before the age of 25. Despite surgery representing the only effective approach, there is still a need to identify a marker that can predict whether a preserved testicle will be functional. In addition, no therapeutic approach is currently considered in the post-operative phase. Through an approach based on the in vitro culture of a tissue strictly linked to the testicle, the gubernaculum, we defined the healthy state of the organ and the possible responsiveness to a therapy used in the andrology field, chorionic gonadotropin (hCG). Firstly, we optimized a protocol to obtain viable cells starting from a small piece of gubernacular tissue harvested during surgery with the aim to amplify cells in vitro. Intriguingly, only for a patient whose testicle had been removed during surgery due to an excessive necrotic area, gubernacular cells were not able to grow in culture. These data support the possibility of exploiting the gubernaculum to evaluate the healthy state of the testicle. Then, as we demonstrate that gubernacular cells express a luteinizing hormone receptor, to which hCG is specific, we analyzed the cellular response to hCG treatment on in vitro cultured cells derived from patients affected by testicular torsion. Our study opens the way for the possibility of evaluating testicle wellbeing after derotation through in vitro culture of a small piece of gubernaculum together with predicting the response to the treatment with hCG, which can have a positive effect on cell proliferation and vascularization

painful varicocele in pediatric age: is there a correlation between pain, testicular damage and hormonal values to justify surgery?

The Authors describe symtoms in patients affected by varicocel

Infertility Worldwide: The Lack of Global Pediatric Andrologists and Prevention

Andrology is the medical specialty dealing with men’s health and reproductive system, including the genital, hormonal, reproductive, sexual, as well as psychological aspects, from birth to adulthood. Regular andrological checkups are essential both to reveal possible problems and to receive thorough advice and information so as to ensure that sexual and reproductive functions are well preserved. Estimates report that about one in three males suffers from andrological diseases, their rates varying according to the age: 27–30% of pediatric male subjects have reproductive and/or sexual conditions. In adulthood, 40% of men are affected by andrological diseases, in particular infertility and sexual problems. We studied medical literature about infertility, its prevention, and its treatment; our outcomes were to evaluate the role of research to prevent infertility especially in pediatric and adolescent age. The analysis of the data shows that in absolute numbers, the conditions directly associated with infertility are less studied than the treatment with medically assisted procreation. This research is intended as a warning to the countries worldwide: all those involved in the pediatric treatment area should be stimulated to act toward this goal, and each country should bear the responsibility of promoting and financing andrological screening campaigns

The laparoscopic Vecchietti technique for vaginal agenesis

The Authors describe the Vecchietti tecnique for the treatment of the agenesis of the vagin

Hypospadias anatomy: Elastosonographic evaluation of the normal and hypospadic penis

Background Hypospadias is one of the most common congenital anomalies in childhood. The aim of this study is to apply elastosonography on normal and hypospadic penis to verify the structural differences in tissues composition and stiffness. Materials and methods We analyzed medical chart of patients treated at our Institution for hypospadias during the period December 2005 and December 2014 (group 1). Other two groups were enrolled for this study: group 2- patients with hypospadias waiting for surgery and group 3-patients without hypospadias. Inclusion and exclusion criteria were created; all patients underwent penile ultrasound and elastosonography. Elastographic index of elasticity was defined as soft, medium-hard or hard. We assigned the value 1 to soft tissue, 2 and 3 to medium-hard and hard respectively. Results During the study period 294 patients were treated for hypospadias. After reviewing medical chart 115 patients were considered for analysis (group 1). 22 patients were enrolled in group 2 and 38 patients were enrolled in group 3. Group 1: 7 proximal hypospadias, 29 penile hypospadias, 79 distal hypospadias. Patients with hypospadias had malformation also at corpus spongiosum and cavernosum respect to controls. Elastography showed a corpus spongiosum stiffness defined as medium-hard or hard in all cases of the pathologic group and soft in all the subjects of the control group (p < 0.05). Conclusions Elastosonography showed how the hypospadia anatomy is deeply altered, even in an anatomical area far from meatal abnormality: corpus spongiosum in hypospadic penis seems to be globally stiffer and less elastic and cavernous corpora are less developed.[Figure presented

relationship between varicocele grade, vein reflux and testicular growth arrest

The Authors describe their experience about adolescent patients affected by varicocele and the correlation between spermatic vein reflux, varicocele grade and testicular trophis

Phimosis and topical steroids: new clinical findings

The Authors analyze their results in children affected by phimosis treted with topical steroid for a mont

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

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