A rare case of tuberculosis in a 50-year-old man presented as a scrotal mass from about 2 years ago, which was associated with renal involvement and one side hydronephrosis. The patient did not recover with usual treatments, and epididimectomy and biopsy and excision of the right epididymis performed and a sample was sent to examine by pathology. Nectrotizing granulomatous inflammation was reported that improved by prescribing anti-tuberculosis drugs completely. In the scrotal masses and epididimiorchitis, the scrotal tuberculosis should be considered as a differential diagnosis by urologist and radiologist colleagues. Because the disease is completely treated by anti-TB drug therapy, it will reduce the delay in diagnosis and unnecessary orchidectomy.

Snakebite is considered a major health threat in Iran, mostly caused by pit vipers(Crotalidae species). A bite by a viper snake causes the release of plasma and blood tothe tissue around the bite inflammation and tissue damage. The occurrence ofEPIDIDYMITIS in the absence of a bite in the scrotal area is an unusual phenomenon. Inthis case report study, we reported EPIDIDYMITIS in a 16-year-old patient who wasbitten by a viper on the right leg. This patient initially experienced local bleeding,reversible coagulopathy (thrombocytopenia and increased prothrombin time andinternational normalized ratio), leukocytosis, and neutrophilia. Due to the occurrenceof a new organic complication, re-administration of five vials of snake antidotepolyvalent serum along with corticosteroid, pain reliever, and antihistamine alleviatedEPIDIDYMITIS and the patient was discharged consequently with full recovery. In thisarticle, the details of the relevant diagnostic and treatment for this young person areprovided.

Background: Ultrasound is the primary modality for the evaluation of patients with acute scrotum. Accurate exclusion of testicular torsion is prevented from unnecessary surgical exploration. Objectives: We assessed scrotal changes in pediatric testicular torsion in comparison epidydimits, with purpose to determine more specific points for differentiation testicular torsion from EPIDIDYMITIS. Methods: During 2011-2017 a descriptive case control study was performed in Dr. Sheikh and Akbar Children hospital, Mashhad medical university of science. The 41 pediatric patients with acute scrotum (21 cases with testicular torsion and 20 cases with EPIDIDYMITIS) were examined. Eventually, the sonographic findings were analyzed to compare the results. Results: Testicular and epididymal enlargement, hydrocele, the hyperemia of surrounding tissues and the scrotal skin thickening are observed in both EPIDIDYMITIS and torsion without any significant difference (P 0. 05). Some other findings where observed in both groups with a significant difference (P 0. 05) such as changes in echogenicity of testis and epididymis, abnormal testicular axis and spermatic cord changes are observed in both EPIDIDYMITIS and torsion; but they had low sensitivity. The most specific signs of testicular torsion were testicular parenchymal heterogenicity (94%), testicularflowpattern (94%), increased echogenicity of epididymis (73%), heterogenicity of epididymis (84%), abnormal epididymis location (100%), mass-like configuration of epididymis (100%) and epididymis flow pattern (100%). The most epididymal findings are more specific and sensitive than testicular findings. Conclusions: Avascularity, heterogenicity, displacement and mass-like configuration of epididymis are reliable sonographic findings for differentiation testicular torsion from EPIDIDYMITIS. They have high diagnostic value with sensitivity of 75%-100% and specificity of 84-100%. So, making proper use of them can minimize diagnostic pitfalls.

Tuberculosis (TB) global prevalence remains almost unchanged over the past few decades. Though genitourinary tract tuberculosis is common, it is rarely associated with scrotal fistula. We present a rare case of advanced tuberculous epididymo-orchitis (TBEO) which culminated in removing the testis. Before final diagnosis is made, it was unresponsive to empirical therapy of bacterial epididymo-orchitis. The approaches to this case were clinical, radiological and histopatologic. For treatment and follow up see the case report.

Objective: Acute scrotal conditions are a common clinical setting that present with pain and swelling of the hemiscrotum. The aim of our study has been to evaluate the findings in boys operated on acute scrotum.Methods: A descriptive study was conducted on 100 patients with acute scrotum admitted to Mofid Children's Hospital from March 1993 to March 2007. Data included history, age, primary symptoms, definite diagnosis, side involvement, paraclinical tests, imaging modalities, medical or surgical management and type of the surgery.Findings: Diagnosis was made mainly by clinical signs and symptoms and surgical exploration. Torsion of testis (n=31) was the most common cause of acute scrotum followed by incarcerated inguinal hernia (n=30), torsion of testicular appendage (n=27), epididymo-orchitis (n=7), idiopathic scrotal edema (n=4) and hematocele (n=1). Most (34%) of the patients were in the first year of life and the mean age was 5.4 years. The commonest signs were pain and swelling (62%) followed by pain, swelling and redness (21%) and pain alone (16%). 83 patients consisting of 31 with torsion of testis, 14 with torsion of testicular appendage, 30 with incarcerated hernia and 7 with epididymo–orchitis underwent surgical exploration after careful physical examination. 10 of 31 patients with torsion of testis had orchiectomy and orchiopexy of contra–lateral testis and the rest had detorsion and bilateral orchiopexy. 80% of patients were referred to the hospital after 12 hours of clinical onset of symptoms.Conclusion: Early exploration of scrotum based on careful physical examination excludes the risk of misdiagnosis by diagnostic procedures and unnecessary delay by diagnostic techniques. Exploration of scrotum is a relatively safe and simple procedure with good cosmetic results; it also allows an accurate diagnosis to be made.

INTRODUCTION Behç et's disease (BD) is a systemic vasculitis characterized by the involvement of joints, gastrointestinal system, central nervous system, as well as recurrent genital and oral ulcerations, and ocular involvement. BD also may affect any sizes of arteries and veins. Central nervous system and major vessel involvement account for most of the deaths from this disease. (1) EPIDIDYMITIS, occasionally recurrent, occur in 4% to 11% of patients. We report two BD patients presenting with attacks of recurrent epididymo-orchitis...

Background: Despite extensive research on the diseases of the reproductive system (testis and epididymis) in dogs, the extent of reproductive complications is unknown.Objectives: The purpose of the present study was to evaluate the clinical, macroscopic, and histopathological findings of testicular and epididymal tissues in dogs of Ahvaz County, Khuzestan Province, Iran. Methods: In the present study, 77 castrated testes were evaluated in different animal ages (from 7 months until 12 years). After macroscopic evaluation, the testicle and epididymis tissues were placed in 10% buffered formalin and processed.Results: Sixty-eight cases of dogs had testicles with normal appearance. Four cases of dogs had cryptorchidism, which was determined during clinical examination. In five cases, the epididymis was swollen with dilated spaces. The microscopic study of the samples showed the presence of various lesions in 45 cases (58.44%). Four (8.89%) of 45 samples with lesions had unilateral cryptorchidism. Testicular degeneration was among the most important cases observed in 14(31.11%). Twenty-two (48.89%) out of 45 samples with lesions had EPIDIDYMITIS. Severe hyperplasia of the mucous membrane covering the epididymis was observed in these samples. EPIDIDYMITIS and degeneration were observed in 12 cases simultaneously. Two cases of chronic EPIDIDYMITIS were associated with bleeding. Another finding was the observation of intranuclear and intracytoplasmic inclusions (in 29 cases). In 21 cases, EPIDIDYMITIS was also visible simultaneously, determined by the presence of fibrosis around the ducts and mucous hyperplasia. Bleeding was seen in 5 cases (11.11%).Conclusion: Considering the relatively high prevalence of testicular degeneration, EPIDIDYMITIS, and the presence of inclusions in the studied dogs, castration in males and histopathological evaluations are very important for a definitive diagnosis of complications because they can lead to infertility, especially in purebred dogs that are kept in shelters (because of the chronic course of some infectious diseases).

Background: Testis torsion is an emergency medical situation, requiring decisive action for diagnosis and treatment. 40% cases of scrotal pain are due to this problem. The most important differential diagnosis includes testis appendix torsion, idiopathic scrotal swelling, epididymoorchitis, and epididymal torsion. Materials and methods: This retrospective-descriptive study has performed on 63 children referring to Mofid hospital during 1994-1999. Epidemiological characteristics, clinical manifestations and the age of the candidates were all collected. Results: Diagnosis was made mainly by clinical manifestations. Testis torsion (33.3%) and its appendix torsion (27%) were the most common forms. Meanwhile, most of the candidates had less than one year old (22.2%). The most common presenting sign was pain and swelling (27%), whereas pain itself and swelling itself were reported in 23.8% and 25.4% of the cases, respectively. Among those who undertook operation (73%), 11.1 % had orchidectomy and 20.6% had appendectomy. All of these patients presented with pain, swelling, and redness whereas 80% came over 12 hours post the occurrence of the presenting signs. Conclusion: The study revealed that prompt diagnosis and treatment of the patients with scrotal pain or swelling could prevent from orchidectomy or appendectomy.