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Introduction: The differentiation of unilateral versus bilateral varicoceles and testicular volume measurements are important in determining the need for adolescent varicocele surgery and also in following patients after varicocelectomy. The aim of this study was to prospectively compare the findings of physical examination and color Doppler ultrasonography in the diagnosis of pediatric varicoceles and to compare the findings using the Prader orchidometer and scrotal ultrasonography in the measurement of testicular volumes. Patients and Methods: This study included 68 boys with varicoceles, ranging in age from 8 to 19 years. Varicoceles were diagnosed using both physical examination and scrotal color Doppler ultrasonography. The testicular volumes of 136 testicles were measured using the Prader orchidometer and scrotal ultrasonography. A difference of more than 10% or 2 ml in each testicular volume was considered significant. Results: The mean age of the boys was 13.5 ± 2.3 years. On physical examination, a left unilateral varicocele was diagnosed in 46 boys (67.6%). The other 22 boys (32.4%) had bilateral varicoceles. Color Doppler ultrasonography detected bilateral varicoceles in 4 of the 46 boys (8.7%) who were diagnosed by physical examination as having only left unilateral varicoceles (grade 3 in 3 patients and grade 2 in 1 patient). A different of more than 10% or 2 ml in testicular volume using the Prader orchidometer versus scrotal ultrasonography was detected in 3 out of 136 testicles (2.2%). The correlation between ultrasonography and Prader orchidometer results in the measurement of testicular volumes was statistically highly significantly consistent using the intraclass correlation test (r = 0.997 and p < 0.001 for the left testis; r = 0.998 and p < 0.001 for the right testis). Conclusions: Although the management of subclinical varicoceles remains controversial, these data show that color Doppler ultrasonography may be necessary in the diagnosis of bilateral varicoceles, especially in boys with high-grade left varicoceles. In contrast, scrotal ultrasonography, if considered the gold standard, did not show superiority over the Prader orchidometer in measuring testicular volumes.

Purpose: Totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) are laparoscopic techniques frequently used in inguinal hernia surgeries. There are very few studies directly comparing the outcomes of TEP and TAPP. The present study compared both techniques' technical aspects, intraoperative and postoperative early complications.Methods: In this study, 108 patients diagnosed with inguinal hernia underwent laparoscopic surgery between May 2016 and December 2020. Seventy six of these patients (70.4%) underwent TEP, and 32 (29.6%) underwent TAPP. This study was retrospective. However, the data were registered prospectively (including video recordings).Results: No significant difference was found between the groups regarding age, sex, body mass index, American Society of Anesthesiologist physical status classification, and duration of hospitalization. Although the TEP group had a higher overall complication rate than TAPP, the difference between the two groups was not significant (TEP, 9.2% vs. TAPP, 3.1%, p = 0.979). Two conversions and two recurrences (2.6% each) were observed in TEP. The hematoma was seen in one case in both techniques (3.1% vs. 1.3%, p = 0.665), respectively. A patient in the TEP group developed a pseudoaneurysm and was treated with endovascular embolization. Conclusion:In our study, conversion and intraoperative early postoperative complications were more prevalent in TEP than TAPP. On the other hand, no significant difference was determined between the results of the two techniques. It has been found that TAPP is as safe as TEP in inguinal hernia surgery; however, the superiority of one method over the other was not observed in this study.

In this report, we present a 13-year-old male patient with multiple pyogenic granulomas (PG) on the face after landmine injury. To the best of our knowledge, PG after landmine injury has not been reported previously. The case has been reported in view of its rarity and its etiology.