Scrotal trauma is one of the rare causes of genital trauma. Although it is not usually fatal, it generates multiple implications in the social and psychological components, impacting the male reproductive and endocrine functions. Blunt trauma is the most frequent scrotal trauma; however, a non-negligible portion is due to penetrating injuries. Its diagnosis has been clinical and its management has been relegated to exploratory surgical interventions, accompanied by a high testicular loss rate. According to this scenario, timely diagnosis and proper treatment become the management pillars of this entity. Although multiple tools have been described to characterize scrotal lesions objectively, testicular Doppler ultrasound can cost-effectively provide relevant information so as to avoid unnecessary surgical interventions.

IntroducciónLa hiperplasia prostática benigna (HPB), es la enfermedad urológica ligada a la edad más frecuente. Consiste en un incremento progresivo de la próstata por un proceso proliferativo no maligno del componente epitelial y estromal de la zona transicional y periuretral de la glándula prostática. 1-3 Palabras Clave► hiperplasia prostática benigna ► obstrucción del tracto de salida ► inflamación crónica ResumenLa obstrucción del tracto de salida ha sido asociada con la hiperplasia prostática benigna (HPB), dado el crecimiento progresivo del adenoma, lo cual lleva a un incremento en la resistencia al flujo urinario, junto con un efecto deletéreo en la función renal. Se han descrito múltiples teorías asociadas con el desarrollo de la hiperplasia. Entre las cuales se encuentran: La edad, el incremento en la actividad simpática, alteraciones hormonales, el síndrome metabólico y la inflamación crónica. En los últimos años, el rol de la inflamación prostática local en el entendimiento de la patogénesis y progresión de la HPB ha cobrado relevancia. Esa hipótesis plantea que infiltrados inflamatorios conllevan a una lesión tisular, generando así un proceso crónico de cicatrización que condiciona el incremento en el tamaño prostático. El presente artículo se enfoca en describir los mecanismos inflamatorios involucrados en la fisiopatología de la hiperplasia prostática benigna. Keywords► benign prostatic hyperplasia ► obstruction of the outflow tract ► chronic inflammation Abstract Urinary tract obstruction has been associated with benign prostatic hyperplasia (BPH), given the progressive adenoma growth. This process leads to an increase in urinary flow resistance, associated with a deleterious effect of renal function. Age, increased sympathetic activity, hormonal alterations, metabolic syndrome and chronic inflammation are among the multiple theories associated with the development of hyperplasia. In recent years, the role of local prostatic inflammation in understanding the pathogenesis and progression of BPH has become relevant. This hypothesis suggests that inflammatory infiltrates lead to a tissue injury, thus generating a chronic healing process that conditions the prostatic increase. The present article focuses on describing the inflammatory mechanisms involved on BPH pathophysiology.

Introduction: We aimed to identify the molecular diagnostic techniques available for urinary tract infection (UTI) diagnosis and their accuracy compared to traditional urinary culture. Methods: A systematic search was performed in MEDLINE (OVID), EMBASE, LILACS, and the Cochrane Central Register of Controlled Trials (CENTRAL). The populations were adult and pediatric patients with confirmed UTI by reference standard urine culture. The index test for the diagnosis of UTI was any molecular diagnostic technique. The primary outcome was the diagnosis of UTI with measures of sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively), positive likelihood ratio (LR+), negative likelihood ratio (LR–), diagnostic odds ratio (DOR), and area under the curve. The operative characteristics were determined, and a meta-analysis was performed. The evaluation of each included study was performed with the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Results: We identified 1230 studies with the search strategies. Ultimately, 13 studies met the inclusion criteria for qualitative analysis, and seven were included for the meta-analysis. Four molecular techniques were identified; however, it was only possible to synthesize the information from two of them. In multiplex polymerase chain reaction (PCR) meta-analysis, overall sensitivity was 0.80 (95% confidence interval [CI] 0.73–0.86) and specificity was 0.83 (95% CI 0.52–0.95). For the DOR, the overall result was 21 (95% CI 4.8–95). For reverse transcription (RT)-PCR, sensitivity was 0.94 (95% CI 0.73–0.99) and specificity was 0.59 (95% CI 0.063–0.96). For the DOR, the overall result was 23 (95% CI 1.1–467). Conclusions: Multiplex PCR and RT-PCR are molecular techniques that might be comparable to standard urine culture for UTI diagnosis. Refinement of these new diagnostic tools will avoid unnecessary antimicrobial therapy and the consequent development of drug-resistant resistant pathogens, as well as improve the ability to identify patients at risk and prevent or minimize sequelae derived from the infection.

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