Open Access

ARTICLE

Testicular schistosomiasis: a systematic review of the literature

Azadeh Nazemi, Jesse Persily, James S. Wysock

Department of Urology, New York University Grossman School of Medicine, New York, New York, USA
Address correspondence to Dr. James S. Wysock, 222 East 41^st St, 12^th Floor, New York, NY 10017 USA

Canadian Journal of Urology 2022, 29(6), 11366-11370.

Abstract

Introduction: To consolidate reported information on presentation, diagnosis, and treatment modalities in testicular schistosomiasis (TS) to provide a reference tool for this rare disease.
Materials and methods: A comprehensive PubMed search was performed using PRISMA guidelines, which yielded 21 articles detailing 22 cases of TS.
Results: Testicular schistosomiasis remains a rare disease, presenting at a variety of ages (median age 27). All reports of this condition are associated with exposure to an endemic area. The most common presenting symptoms include nonspecific testicular swelling (54.5%) followed by a testicular mass/nodule (18.4%). Diagnosis relies upon clinical suspicion due to low specificity on laboratory and imaging evaluation, with only 18% of urine evaluations positive for parasitic infection. Final diagnosis was made on biopsy (38.1%), radical orchiectomy (47.6%) or frozen section during partial orchiectomy (14.3%). Treatment included anthelmintic mediation (37%), radical/partial orchiectomy (31%), or some combination of the above.
Conclusions: This systematic review of individual patient data reveals that while urine tests and imaging may aid in diagnosis, all patients require definitive histologic diagnosis. It is important to obtain a thorough history to elucidate exposure to endemic areas and inform whether biopsy, and subsequent testicular preservation, may be appropriate.

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