The Canadian journal of urology · 2022
Testicular schistosomiasis: a systematic review of the literature.
Систематический обзорСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Nazemi Azadeh, Persily Jesse, Wysock James S
Аннотация
INTRODUCTION: To consolidate reported information on presentation, diagnosis, and treatment modalities in testicular schistosomiasis (TS) to provide a reference tool for this rare disease.
MATERIALS AND METHODS: A comprehensive PubMed search was performed using PRISMA guidelines, which yielded 21 articles detailing 22 cases of TS.
RESULTS: Testicular schistosomiasis remains a rare disease, presenting at a variety of ages (median age 27). All reports of this condition are associated with exposure to an endemic area. The most common presenting symptoms include nonspecific testicular swelling (54.5%) followed by a testicular mass/nodule (18.4%). Diagnosis relies upon clinical suspicion due to low specificity on laboratory and imaging evaluation, with only 18% of urine evaluations positive for parasitic infection. Final diagnosis was made on biopsy (38.1%), radical orchiectomy (47.6%) or frozen section during partial orchiectomy (14.3%). Treatment included anthelmintic mediation (37%), radical/partial orchiectomy (31%), or some combination of the above.
CONCLUSIONS: This systematic review of individual patient data reveals that while urine tests and imaging may aid in diagnosis, all patients require definitive histologic diagnosis. It is important to obtain a thorough history to elucidate exposure to endemic areas and inform whether biopsy, and subsequent testicular preservation, may be appropriate.
MATERIALS AND METHODS: A comprehensive PubMed search was performed using PRISMA guidelines, which yielded 21 articles detailing 22 cases of TS.
RESULTS: Testicular schistosomiasis remains a rare disease, presenting at a variety of ages (median age 27). All reports of this condition are associated with exposure to an endemic area. The most common presenting symptoms include nonspecific testicular swelling (54.5%) followed by a testicular mass/nodule (18.4%). Diagnosis relies upon clinical suspicion due to low specificity on laboratory and imaging evaluation, with only 18% of urine evaluations positive for parasitic infection. Final diagnosis was made on biopsy (38.1%), radical orchiectomy (47.6%) or frozen section during partial orchiectomy (14.3%). Treatment included anthelmintic mediation (37%), radical/partial orchiectomy (31%), or some combination of the above.
CONCLUSIONS: This systematic review of individual patient data reveals that while urine tests and imaging may aid in diagnosis, all patients require definitive histologic diagnosis. It is important to obtain a thorough history to elucidate exposure to endemic areas and inform whether biopsy, and subsequent testicular preservation, may be appropriate.