1.Management of the impalpable testis in children.
Yi YANG ; Ying HOU ; Chang-lin WANG
National Journal of Andrology 2006;12(12):1105-1107
OBJECTIVETo explore the management of the impalpable testis in children.
METHODSFrom April 2003 to August 2005, 36 children aged 20 months to 8 years with impalpable testes underwent inguinal and laparoscopy explorations. The clinical data were reviewed, including the indications of laparoscopy and inguinal explorations and the correspondence between the ultrasonic and surgical
RESULTSOf the 36 cases (36 / 361 ) of impalpable testis (41 testes), laparoscopy and inguinal explorations revealed 18 results. testes to be vanishing ones, 21 located intra-abdominally and 2 scrotal nubbins. Manifestations were divided into 4 types according to the laparoscopic findings, and 9 testes fell into Type I, 9 Type II, 13 Type III and 10 Type IV. Orchidopexies were performed by traditional and laparoscopic techniques. The positive diagnoses by ultrasound accounted for 75% (27/36). The volumes of the contralateral testes of the cryptorchid children were larger than those with intra-abdominal testes and testicular nubbins. One case of testicular atrophy was detected by ultrasound in the follow-up period.
CONCLUSIONLaparoscopy should be performed as a routine in children with impalpable testes. Children with Type II testes need not undergo inguinal exploration. Inguinal and scrotal explorations are necessary for children with Type I testes. Preoperative ultrasonic examination of the contralateral testis helps to evaluate vanishing testes or testicular nubbins.
Child ; Cryptorchidism ; diagnosis ; pathology ; surgery ; Follow-Up Studies ; Groin ; pathology ; Humans ; Male ; Testis ; pathology
2.Discussion of new classification of epididymal malformation in cryptorchidism of children.
Dian-Liang ZHANG ; Zhen LI ; Jia-Lun XIE
National Journal of Andrology 2002;8(6):419-421
OBJECTIVESTo discuss the new classification of epididymal malformation in cryptorchidism.
METHODSOne hundred and fifty-three boys who were two to four year old underwent orchidopexy for cryptorchidism and 144 hydroceles who were two to eight year old were enrolled into control. Based on the observation of the status between testis and epididymia, the length of epididymis and the configuration of epididymis as well as spermaduct, we divided epididymal malformations in cryptorchidism into three types. Type I: obstruction of sperm transport, including I A, I B and I C; Type II: possible obstruction of sperm transport, defined by II A and II B; Type III: no obstruction of sperm transport, classified into III A and III B.
RESULTSThere were 47 (23.4%) out of 201 undescended testes with malformation of epididymides and 16 (10.3%) out of 155 testes in the control(P < 0.05). 11 of 48 cases of bilateral cryptorchidism had the same malformations, with 2 cases of type IB, 2 of IC, 1 of II A, 4 of III A and 2 of IV B underwent orchidopexy or orchiectomy.
CONCLUSIONSThese data showed that the incidence of epididymal abnormalities in cryptorchidism was higher than that in the hydroceles and it's not essential to have orchiectomy unlimitedly to serious epididymal abnormalities.
Child ; Child, Preschool ; Cryptorchidism ; classification ; pathology ; surgery ; Epididymis ; abnormalities ; Humans ; Male ; Testicular Hydrocele ; pathology
3.Androgen Insensitivity Syndrome with Bilateral Cryptorchidism and Seminoma in Tibet:Report of One Case.
Qian WEI ; Zhen DA ; Qu-Zhen CIREN ; Zhen HUO ; Peng ZUO
Acta Academiae Medicinae Sinicae 2022;44(1):173-176
Androgen insensitivity syndrome(AIS)with bilateral testicular malignant transformation is very rare,and its diagnosis should be based on clinical manifestations,physical examination,serological findings,karyotype analysis,and pathological findings.This study reported a case of complete androgen insensitivity syndrome among Tibetan in Tibet.It took 17 years from the discovery of congenital absence of uterus to bilateral pelvic mass resection.Pathological examination confirmed that bilateral pelvic space occupying lesions were dysplastic testicular tissue with seminoma and sertoli cell adenoma-like nodules.This study summarized the clinicopathological features to deepen the understanding of the disease.
Androgen-Insensitivity Syndrome/surgery*
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Cryptorchidism
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Female
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Humans
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Male
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Seminoma/pathology*
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Testicular Neoplasms/pathology*
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Tibet
4.Sertoli cell tumors associated with feminizing syndrome and spermatic cord torsion in two cryptorchid dogs.
Marco QUARTUCCIO ; Gabriele MARINO ; Giuseppe GARUFI ; Santo CRISTARELLA ; Antonina ZANGHI
Journal of Veterinary Science 2012;13(2):207-209
The association of cryptorchidism, functional Sertoli cell tumors, and spermatic cord torsion has been rarely reported in the literature. Two dogs were admitted for bilateral skin alopecia and weight loss. Both animals were cryptorchid and displayed a pendulous preputial sheath, prostate hypertrophy, and increased levels of circulating oestrogen. Transabdominal palpation and ultrasonography revealed the presence of neoplastic retained gonads. During surgery, spermatic cord torsion was also detected in the enlarged neoplastic testes of both dogs. Histologic examination confirmed the presence of Sertoli cell tumors that were primarily responsible for the feminizing syndrome. Complete remission of all symptoms occurred within 3 months after orchiectomy.
Animals
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Cryptorchidism/pathology/surgery/*veterinary
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Dog Diseases/*pathology/surgery
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Dogs
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Male
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Sertoli Cell Tumor/pathology/surgery/*veterinary
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Spermatic Cord Torsion/pathology/surgery/*veterinary
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Treatment Outcome
5.Ectopic mesonephric duct cyst with ectopic testicular malignancy: a case report and literature review.
Bin ZHANG ; Hong-Fei WU ; Deng-Yun DONG ; Hong-Xiang ZHENG ; Mei-Zhao LE
National Journal of Andrology 2013;19(11):1016-1019
OBJECTIVETo report a rare case of ectopic mesonephric duct cyst with ectopic testicular malignancy and improve the diagnosis and treatment of the disease.
METHODSWe retrospectively analyzed the clinical data of a case of ectopic mesonephric duct cyst with ectopic testicular malignancy, reviewed relevant literature at home and abroad, and investigated the pathogenesis, diagnosis and treatment of the disease.
RESULTSA large cyst and the right ectopic malignant testis were removed via abdominal incision, and the left undescended testis was lowered into the scrotum. Pathological examination confirmed the lesion to be right ectopic mesonephric duct cyst with right ectopic testicular seminoma. No metastasis was found during a year of follow-up.
CONCLUSIONEctopic mesonephric duct cyst with ectopic testicular malignancy was a rare disease. Imaging examination contributes to its diagnosis, but it has to be confirmed by pathology. Surgical removal should be performed as early as possible and follow-up treatment depends on the pathologic type and stage of ectopic testicular malignancy.
Cryptorchidism ; therapy ; Cysts ; pathology ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal ; surgery ; Seminoma ; surgery ; Testicular Neoplasms ; surgery ; Testis ; surgery ; Wolffian Ducts ; pathology
6.Epididymal Anomalies Associated with Patent Processus Vaginalis in Hydrocele and Cryptorchidism.
Journal of Korean Medical Science 2002;17(5):660-662
The epididymal anomalies and patent processus vaginalis are frequently seen in patients with cryptorchidism or hydrocele. We performed a prospective study on the relationship between the epididymal anomalies and the patency of the processus vaginalis in boys with hydrocele (190 cases) or cryptorchidism (89 cases) who were treated from August 1997 to February 2000 (mean age, 51 months; range, 12 to 152 months). The epididymal anomalies were observed with an overall frequency of 48%. Closed, partially closed, and open processus vaginalis were associated with an epididymal anomaly in 14, 38, and 65% of cases, respectively. The epididymal anomalies were more common in association with undescended (61%) than with descended (43%) testes without statistical significance (p=0.415). Incomplete attachment of the caput epididymis was the most common anomaly (35%), followed by detachment of caput and cauda epididymis (31%), cauda epididymis (24%), and long looping epididymis (10%). These data showed that the epididymal anomalies were strongly associated with the patency of the processus vaginalis irrespective of testicular descent (p<0.001), and they provide further evidence for the hypothesis that a common stimulus, possibly androgens, may be required for the epididymal development and obliteration of the processus vaginalis.
Adolescent
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Child
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Child, Preschool
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Cryptorchidism/embryology/*pathology/surgery
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Epididymis/*abnormalities/embryology
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Humans
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Infant
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Male
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Prospective Studies
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Testicular Hydrocele/embryology/*pathology/surgery
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Testis/abnormalities/embryology
7.Combined treatment applied to advanced cancer of abdominal cryptorchidism (report of 12 cases).
Ming-Shan YANG ; Xi-Ming LI ; Hai-Tao LIU ; Xiao-Wen SUN ; Bang-Min HAN ; Jun LU ; Shu-Jie XIA ; Xiao-Da TANG
National Journal of Andrology 2006;12(5):408-412
OBJECTIVETo discuss the treatment of advanced cancer of abdominal cryptorchidism.
METHODSThe combined method, including preoperation chemotherapy + surgery + postoperation radiotherapy and chemotherapy, was used to treat 12 cases of the advanced cancer of abdominal cryptorchidism and the effects were evaluated.
RESULTSThe patients recovered smoothly without complications of operation. The side effect of chemotherapy and radiotherapy was very slight. Eleven out of 12 cases were followed up. All 11 cases survived and had no recurrence.
CONCLUSIONThe results of combined method to treat advanced cancer of abdominal cryptorchidism is very perfect.
Adolescent ; Adult ; Cryptorchidism ; complications ; pathology ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Testicular Neoplasms ; drug therapy ; etiology ; radiotherapy ; surgery
8.Orchidopexy increases the levels of serum anti-Müllerian hormone and inhibin B in cryptorchidism patients.
Shun-Shun CAO ; Yang-Yang HU ; Cun-Jin NAN
National Journal of Andrology 2017;23(8):713-716
Objective:
To investigate the levels of serum anti-Müllerian hormone (AMH) and inhibin B (INHB) in patients with unilateral cryptorchidism before and after orchidopexy.
METHODS:
This study included 58 cases of unilateral cryptorchidism treated by orchidopexy and 32 healthy controls. Before and at 6 months after surgery, we measured the length and circumference of the penis, the volume of the undescended testis, and levels of serum AMH and INHB.
RESULTS:
There were statistically significant differences between the unilateral cryptorchidism and healthy control groups in the levels of serum AMH ([102.80 ± 17.35 vs 108.76 ± 13.64] ng/ml, P<0.05) and INHB ([70.24 ± 5.73] vs [ 77.72 ± 5.94] pg/ml, P<0.05) at the baseline, but not at 6 months after orchidopexy (AMH: [109.76 ± 17.25] vs [108.03 ± 14.13] ng/ml, P>0.05; INHB: [75.76 ± 5.94] vs [77.63 ± 5.99] pg/ml, P>0.05). No remarkable differences were observed between the unilateral cryptorchidism and healthy control groups in the preoperative penile length ([2.05 ± 0.23] vs [2.11 ± 0.22] cm, P>0.05), penile circumference ([3.91 ± 0.23] vs [3.99 ± 0.20] cm, P>0.05) and volume of the undescended testis ([0.45 ± 0.02] vs [0.46 ± 0.02] ml, P>0.05), or in the postoperative penile length ([2.09 ± 0.23] vs [2.16 ± 0.22] cm, P>0.05), penile circumference ([4.00 ± 0.25] vs [3.98 ± 0.19] cm, P>0.05) and volume of the undescended testis ([0.45 ± 0.02] vs [0.45 ± 0.02] ml, P>0.05). Compared with the baseline, the cryptorchidism patients showed markedly increased levels of serum AMH ([102.80 ± 17.35] vs [109.76 ± 17.25] ng/ml, P<0.05) and INHB ([70.24 ± 5.73] vs [75.76 ± 5.94] pg/ml, P<0.05) after orchidopexy.
CONCLUSIONS
Orchidopexy can elevate the levels of serum AMH and INHB and protect the testicular function of cryptorchidism patients.
Anti-Mullerian Hormone
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blood
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Case-Control Studies
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Cryptorchidism
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blood
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pathology
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surgery
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Humans
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Inhibins
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blood
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Male
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Orchiopexy
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Organ Size
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Penis
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anatomy & histology
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Postoperative Period
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Preoperative Period
9.Single port laparoscopic orchidopexy in children using surgical glove port and conventional rigid instruments.
Ben Dhaou MAHDI ; Chtourou RAHMA ; Jallouli MOHAMED ; Zitouni HAYET ; Mhiri RIADH
Korean Journal of Urology 2015;56(11):781-784
PURPOSE: We review the literature and describe our technique for laparoendoscopic single-site orchidopexy using a glove port and rigid instruments. We assessed the feasibility and outcomes of this procedure. MATERIALS AND METHODS: We retrospectively reviewed the case records of all children who had undergone laparoendoscopic single-site orchidopexy by use of a surgical glove port and conventional rigid instruments for a nonpalpable intraabdominal testis between January 2013 and September 2014. RESULTS: Data from a total of 20 patients were collected. The patients' mean age was 18 months. All cases had a nonpalpable unilateral undescended testis. Fourteen patients (70%) had an undescended testis on the right side and six patients (30%) had an undescended testis on the left side. Seventeen patients underwent primary orchidopexy. Three patients underwent single-port laparoscopic Fowler-Stephens orchidopexy for the first and the second stage. Average operating time was 57 minutes (range, 40 to 80 minutes). No patient was lost to follow-up. At follow-up, 2 testes were found to have retracted out of the scrotum and these were successfully dealt with in a second operation. One testis was hypoplastic in the scrotal pouch. There were no signs of umbilical hernia. CONCLUSIONS: Single-port laparoscopic orchidopexy using a glove port and rigid instruments is technically feasible and safe for various nonpalpable intraabdominal testes. However, surgical experience and long-term follow-up are needed to confirm the superiority of this technique.
Cryptorchidism/pathology/*surgery
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Equipment Design
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Feasibility Studies
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Follow-Up Studies
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Gloves, Surgical
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Humans
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Infant
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Laparoscopy/instrumentation/methods
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Male
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Orchiopexy/*instrumentation/methods
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Retrospective Studies
10.Incidence of depression and its related factors in cryptorchidism patients after surgical treatment.
Ming XI ; Lu CHENG ; Yue-ping WAN ; Wei HUA
National Journal of Andrology 2015;21(1):57-60
OBJECTIVETo investigate the incidence of depression and its etiological factors in patients with cryptorchidism 6-16 years after surgical treatment.
METHODSUsing Self-Rating Depression Scale and Correlation Factor Questionnaire, we investigated the incidence of depression symptoms among 70 patients with cryptorchidism 6-16 years after surgical treatment and another 70 healthy males as controls, and analyzed the related factors of depression symptoms.
RESULTSThe incidence rate of depression symptoms was 50% in the cryptorchidism patients postoperatively, extremely significantly higher than 4.3% in the control group (χ2 = 23.5, P <0.01). Multiple stepwise regression analysis showed that the main risk factors of depression symptoms were worries about natural fertility (F = 15.8992, P <0.01), dissatisfaction with scrotal appearance (F = 4.6003, P <0.05), and the status of being married (F = 4.1002, P <0.05).
CONCLUSIONSymptoms of depression often occur in cryptorchidism patients after operation, and the major etiological factors are infertility, dissatisfaction with scrotal appearance, and the status of being married.
Adult ; Body Image ; psychology ; Case-Control Studies ; Cryptorchidism ; psychology ; surgery ; Depression ; epidemiology ; etiology ; Female ; Humans ; Incidence ; Infertility, Male ; psychology ; Male ; Marital Status ; Multivariate Analysis ; Risk Factors ; Scrotum ; pathology ; Surveys and Questionnaires ; Time Factors