The Clinical Study Of Testicular Microlithiasis

Objective and BackgroundTesticular microlithiasis is a clinical symptom complex with calcification in testicle, it is a seldom seen disease. Priebe reported this disease first in 1970, while Doherty described the sonogram of testicular microlithiasis first in 1987. Large scale investigation showed that the morbidity of testicular microlithiasis is 0.6%～9%. Now, few report about the preservation and treatment of testicular microlithiasis was published, but scholars has pay close attention to the etiopathogenisis,pathogenesy,epidemiology,ultrasonic appearance of testicular microlithiasis, especially the relationship between testicular microlithiasis and male sterility.We investigated phys exam,color Doppler ultrasonography,semen analysis,the levels of tumor index. And did tumor nyxis, then observed biopsy specimen under electron microscope and light microscope in order to approach the pathogenesy of testicular microlithiasis and the relationship between testicular microlithiasis and testiculoma,male sterility.Materials and methods:Choose 15 testicular microlithiasis patients in First Affiliated Hospital, Medical School of ZheJiang University and our hospital from january 2008 to january 2010.We investigated phys exam,color Doppler ultrasonography,the levels of tumor index. And nine of them were given semen analysis, five of them were given tumor nyxis, then we observed biopsy specimen under electron microscope and light microscope. One of the patient was complicating testiculoma,we treated him with operation.Results:The left testis of testiculoma patient was 1.8cm* 1.2cm and soft, while the another one was 2.5cm* 1.5cm and hard, we can touch trabs shape tumor at rightepididymis, boundary clrealy. The last 14 patients were normal about phys exam. Color Doppler ultrasonography showed that rarefaction or close-set punctiform dense echo in parenchyma of testis, diameter was 1 mm, no sound shadow after punctiform dense echo, someone with comet tail sign. Several decakis punctiformdense echo in one sectiones and interdependent each other. Left atrophia testiculiand testicular microlithiasis,low echo area on the both sides about testiculoma patient. The levels of tumor index were all normal. Semen analysis showed that normal with 3 patients,ambly-spermatozoa and oligospermatism with 6 patients. The density of spermatozoa was 54.65±13.16x 106/ml; the azoospermia was 34.22±12.06%; the motility rate of 43.54±21.85%. we can found testicular microlithiasis at different level and different stage as wsell as pathological change under electron microscope and light microscope. Four patients of testicle pain were all improved after anti-inflammatory and odynolysis, but recurrentattacks easily. One testiculoma patient, we treated him with both testicles radical excision. The athological section after operation that small amounts tumour cells alignment with trabs shape,and infiltrative growth.Conclusions:It is important to examine the scrotum of the patient with high frequency color ultrasound system to diagnose the testicular microlithiasis. TM can decrease the quality of ejaculum and lead to aphoria. TM was associated with a substantially elevated risk of a concurrent diagnosis of testiculoma. It is necessary to follow up the patients with testicular microlithiasis strictly. If hypoechoic mass is found, testicular exploration is necessary.