ABSTRACT
Objective:To study the clinical manifestations, diagnostic methods and therapeutic outcomes of transverse testicular ectopia (TTE).Methods:Clinical data of 8 cases of TTE treated in the Department of the First Urologic Surgery, Xinxiang Central Hospital and Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from May 2004 to November 2018 were retrospectively analyzed.Clinical manifestations, diagnostic methods, surgical treatment and follow-up results of TTE were summarized.Results:The age of 8 cases of TTE was 1 year 5 months to 5 years.Among the 8 cases of TTE, 6 cases were involved with the left side and 2 cases with the right side.All patients were admitted due to scrotal emptiness.Three cases were combined with persistent Müllerian duct syndrome (PMDS) and 1 case combined with hypospadias.Preoperative diagnosis of TTE was definitely made in 5 cases, involving 4 cases diagnosed by ultrasound and 1 case diagnosed by magnetic resonance imaging.Laparoscopy was performed in 2 cases, including 1 case treated with laparoscopic scrotopexy, and the other one transferred to an open surgery of trans-septal orchiopexy due to poor development of the spermatic cord.Open surgery was performed in 6 cases, including 1 case with bilateral testicular fixation in the ipsilateral scrotum due to adhesion of spermatic cord closely, and 5 cases with trans-septal orchiopexy.Müllerian ducts residues were excised during surgery in 3 cases combined with PMDS.Postoperative wound infection or hematoma was not reported in all cases.Orchiepididymitis and the involvement of contralateral testes occurred in 1 case treated with trans-septal orchiopexy at 11 months postoperatively, which were relieved after anti-inflammatory treatment.All cases were postoperatively followed up for 3-48 months, and the development and blood supply of bilateral testes were detected normal by ultrasonography.Postoperative testicular atrophy was not reported.Conclusions:The possibility of TTE should be considered in patients with unilateral cryptorchidism combined with contralateral inguinal mass.Ultrasonography is preferred to the diagnosis of TTE.Laparoscopic surgery plays an important role in the diagnosis and treatment of TTE, which is helpful to identify abnormalities in the Müllerian duct structure.
ABSTRACT
An ectopic testis is any testis that presents outside the line of its normal descent after exiting the external inguinal ring. Sites for ectopic testes include the superficial inguinal pouch of Denis Browne, femoral, suprapubic, contralateral hemiscrotum, perineum and pubopenile region. This case describes yet another rare site of ectopic testis in an 11 year boy. The diagnosis was essentially clinical complimented by ultrasonography. Scrotal repositioning was successfully achieved.
ABSTRACT
During the routine dissection of abdomen, two adult male cadavers, aged 55 & 67years, presented with unilateral and the bilateral undescended testes respectively. One of them presented with unilateral and the other with bilateral undescended testes. In both cases the testes were found at the superficial inguinal ring. The histological examinations indicated normal testicular tissue. Undescended testis is the inability of the testis to reach the scrotum. In living, it has to be differentiated from testicular agenesis, ectopic testis and retractile testis. The genetic sex of the male is determined at the time of fertilization but the phenotypical sex starts as early as 4th month of intrauterine life and completed along with the descent just before birth. The embryological basis and clinical significance has been explained.
ABSTRACT
Perineal ectopic testis (PET) is a rarity in pediatric surgical practice seen in less than 10% cases of maldescended testis. An eighteen months old boy presented with empty right scrotum and a palpable soft mass in the perineum which on preoperative ultrasonography was consistent with testicular morphology. Orchidopexy was performed by standard operative technique and testis was placed in Dartos Pouch. The case is reported to highlight the importance of examination of ectopic sites in a cryptorchid child and the need for long term follow-up of patient.
ABSTRACT
Há consenso de opinião entre os cirurgiões pediátricos no sentido de que, no ser humano, a migração do testículo é um evento complexo e mediado por dois fatores, hormonal e mecânico; e também, que a cirurgia precoce (antes de dois anos de idade), em oposição à operação mais tardia, é benéfica para manter a fertilidade. Todavia, o hormônio gonadotrófico coriônico (HGC) induz ao aumento da gônada e do escroto, alongamento e espessamento das estruturas do cordão espermático e a migração parcial do testículo; tudo isto pode fazer com que a cirurgia se torne simplificada. Destarte, aqueles pacientes com testículo alto poderão apresentar melhor resultado ao tratamento cirúrgico, se o HGC for administrado no peri ou pré-operatório, ou quando o resultado cirúrgico não for satisfatório, poderá ser melhor valendo-se da aplicação de HGC no pós-operatório. Desde que a hormonioterapia com HGC tem provado ser eficiente, de alguma forma facilitando a subsequente cirurgia, entendo que seja o tratamento coadjuvante de escolha para pacientes com distopia do testículo. Em decorrência desta discussão apresentei as finalidades da cirurgia e meu modo de tratar o problema clinicamente. Por outro lado, sempre existiu a necessidade de uma classificação, a qual é sugerida aqui, a fim de assegurar que todos tenham as mesmas definições. Minha expectativa é que não levemos mais outras décadas em debates, para conseguir respostas mais bem fundamentadas para este tipo de questão...
Subject(s)
Humans , Male , Testicular NeoplasmsABSTRACT
Objetivo: Presentar esta anomalía de migración testicular ectópica en tres niños de diferentes edades y revisar la literatura. Pacientes y Métodos. Presentamos el caso de tres niños de diferentes edades (2 años 1 m, 5 años, 1 años 7 m) portadores de testículos ectópicos, diagnosticados y operados por el autor. Resultados. El motivo de consulta en los tres casos fue de una masa en el área de los genitales externos. El examen físico permitió comprobar que la masa era el testículo ectópico ubicados en el área perineal y en el pene, en los 2 niños que presentaron el testículo perineal tenían cada uno de ellos criptorquidia contra lateral. En ninguno de los tres pacientes hubo dificultad para realizar la orquidopexia.
Objective: Presenting this anomaly of ectopic testicular migration in three children of different ages and review literature. Patients and methods. We present the case of three children of different ages (2 years 1 m, 5 years, 1 years 7 m) carriers of ectopic testicles, diagnosed and operated by the author. Results. The reason for consultation in all three cases was of a mass in the area of the external genitalia. Examination allowed checking that the mass was ectopic testicle located in the perineal area and in the penis; the 2 children who presented the perineal testicle had each cryptochidismagainst side. In none of the three patients there difficulty to perform the orchidopexy.
Subject(s)
Humans , Male , Child, Preschool , Orchiopexy , Testis/abnormalities , Testis/surgery , CryptorchidismABSTRACT
Incidence of testicular tumor is 1-2% in all male tumor. Various series report that 3.6-11.6% of testicular tumor arise in patient with cryptorchidism or a history of cryptorchidism. But testicular tumors developed in suprapubic ectopic testis were reported rarely. Seminoma is one of the most radiosensitive tumor. However, the survival of patients with advanced tumor is poor. Therefore adjuvant systemic chemotherapy is essential for proper treatment of these patients. Recently we experienced a case of advanced seminoma resulted from suprapubic ectopic testis and treated by orchiectomy, systemic chemotherapy and radiation with good result.