不确定的丸病变的诊断和管理
Stefanie M Croghan1,2, Jamil W Malak3,4, Pat Rohan5
1Department of Surgery, Royal College of Surgeons, Dublin, Ireland. stefaniecroghan@rcsi.ie.
Nature reviews. Urology
|July 6, 2023
概括
现代成像技术经常检测到小丸病变. 许多是良性的,促使人们考虑器官保存策略,以避免过度治疗.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 诊断成像 诊断成像 诊断成像
- 在瘤学瘤学.
背景情况:
- 现代成像技术经常识别小或不确定的丸病变.
- 传统的治疗包括对任何疑似恶性瘤进行激进的枝切除术,风险是对良性疾病进行过度治疗.
- 激进切除术可以显著影响生育能力,内分泌功能和心理健康,特别是在特定的患者群体中.
研究的目的:
- 评估对模两可的丸病变的器官保护策略.
- 评估积极监测和组织学采样对不确定的丸发现的有效性.
- 为了最大限度地减少与良性丸病变的激进花切除术相关的过度治疗.
主要方法:
- 基于图像的积极监测对不确定性病变的审查≤15毫米.
- 对组织学采样结果的分析,包括对25毫米以下的病变的冷截面分析.
- 考虑在活检期间进行局部化手术前标记或手术内超声波.
主要成果:
- 积极监测显示,在选定的队列中,接受手术治疗的转化率较低.
- 组织学分析表明,大约三分之二的标记阴性,不确定的单独丸病变 (≤25毫米) 是良性的.
- 冷部位分析表明丸病变的诊断准确度很高.
结论:
- 通过现代成像检测到的大量小的,不确定的丸病变是良性的.
- 节省器官的诊断和治疗策略,包括积极监测和有针对性的活检,越来越可行.
- 这些方法旨在减少过度治疗,保持丸功能和患者的福祉.
相关概念视频
Disorders of the Male Reproductive System
474
Men's health issues are increasingly recognized as significant, with several conditions posing common threats. Among these, testicular cancer is especially prevalent in younger men, particularly those aged 20 to 35 years. The disease often manifests as a painless mass in the testicles, sometimes accompanied by a sensation of heaviness or a dull ache.
Prostate disorders are another major concern. These conditions can impair urinary flow due to the prostate's location around the urethra....
Prostate disorders are another major concern. These conditions can impair urinary flow due to the prostate's location around the urethra....
474
Urinary Tract Calculi III: Medical Management
9
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
9
Testes: Histology
1.1K
A tough, fibrous membrane, the tunica albuginea, covers the testes, extending inward to form fibrous partitions or septa, dividing them into internal compartments called lobules. Each lobule has 1 to 3 tightly coiled seminiferous tubules where sperm production occurs. These tubules merge into a tubular network at the back of the testis, known as the rete testis. It connects to 15 to 20 efferent ductules, leading to the epididymis.
The spermatogenic cells, responsible for producing sperm, are...
The spermatogenic cells, responsible for producing sperm, are...
1.1K
Appendicitis-II: Diagnostic Studies and Management
100
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
100
Aneurysm III: Interprofessional Care
10
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
10
Pulmonary Tuberculosis IV
172
Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
172


