1.Surgical treatment of undescended testis by elongating the spermatic vessel and cord
Journal of Vietnamese Medicine 1998;231(12):113-119
In the Urological Department of Cho Ray hospital 1n 1998, 10 cases with non-palpable testis were operated. The lowest age of patients was 6 years old, the highest age was 27, the average was 14. Eight testes were in iliac fossae, 2 testes were in internal inguinal ring. Authors used technique liberating testicular vessels: elongating spermatic vessel and cord long enough to allow the testis to be placed into scrotum; creating a direct path to scrotum and thus, it is able to descend the testis into the scrotum by single stage orchidopexy, without traction on the vessels and damaging the blood supplying for testis. Six of ten cases were followed-up after operation by Doppler Ultrasonography. All receive good blood supply, no atrophy of testis was seen after operation
Cryptorchidism
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Spermatic Cord
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surgery
2.Ipsilateral and contralateral patent processus vaginalis in pediatric patients with a unilateral nonpalpable testis.
Ming-Ming YU ; Hua XIE ; Yi-Chen HUANG ; Yi-Qing LV ; Fang CHEN ; Xiao-Xi LI
Asian Journal of Andrology 2023;25(6):695-698
This study aimed to investigate the incidence of patent processus vaginalis (PPV) in pediatric patients with a unilateral nonpalpable testis and explore the associated factors. From May 2014 to April 2017, 152 boys who were diagnosed with a unilateral nonpalpable testis and underwent laparoscopy in Shanghai Children's Hospital (Shanghai, China) were included in this study. The data were collected and reviewed, and the results were analyzed regarding the age at operation, side, development, and position of the nonpalpable testis. The mean age of the patients was 2.6 (standard deviation: 2.3) years. The testis was absent in 14 cases, nonviable in 81 cases, and viable in 57 cases. The incidence of PPV was 37.5% (57 of 152) on the ipsilateral side and 16.4% (25 of 152) on the contralateral side. The ipsilateral PPV was more prevalent when the nonpalpable testis occurred on the right side ( P < 0.01). Besides, patients with a viable testis had a greater incidence of ipsilateral PPV than those with a nonviable or absent testis ( P < 0.01). Moreover, this rate was the highest when the testis was in the abdominal cavity and the lowest when the testis was in the scrotum (both P < 0.01). However, the incidence of contralateral PPV was independent of all the factors. In conclusion, in children with a nonpalpable testis, the incidence of an ipsilateral PPV was significantly related to the side, development, and position of the testis, while it was independent of these factors on the contralateral side.
Male
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Child
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Humans
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Infant
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Child, Preschool
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Testis
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China
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Testicular Hydrocele/surgery*
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Laparoscopy
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Scrotum
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Hernia, Inguinal/surgery*
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Cryptorchidism/surgery*
3.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
4.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
5.Laparoscopic diagnosis and treatment of cryptorchidism with impalpable testis.
De-hua WU ; Sai-chun ZHANG ; Min-ju LI ; Shui-heng YAN ; Chang TAO
Journal of Zhejiang University. Medical sciences 2004;33(1):83-84
Child
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Child, Preschool
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Cryptorchidism
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diagnosis
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surgery
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Humans
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Infant
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Laparoscopy
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methods
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Male
6.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
7.The effect of scrotal versus inguinal orchiopexy on the testicular function of children with clinically palpable, inguinal undescended testis: a randomized controlled trial.
Wen-Hua HUANG ; Long-Yao XU ; Shu-Shen CHEN ; Zhi-Qiang CHEN ; Xu CUI ; Chao-Ming ZHOU
Asian Journal of Andrology 2023;25(6):745-749
To compare the impact of the scrotal vs inguinal orchidopexy approach on the testicular function of infants with cryptorchidism, a randomized controlled trial was conducted involving boys who were 6-12 months old at surgery and were diagnosed with clinically palpable, inguinal undescended testis. Between June 2021 and December 2021, these boys at Fujian Maternity and Child Health Hospital (Fuzhou, China) and Fujian Children's Hospital (Fuzhou, China) were enrolled. Block randomization with a 1:1 allocation ratio was employed. The primary outcome was testicular function assessed by testicular volume, serum testosterone, anti-Müllerian hormone (AMH), and inhibin B (InhB) levels. Secondary outcomes included operative time, amount of intraoperative bleeding, and postoperative complications. Among 577 screened patients, 100 (17.3%) were considered eligible and enrolled in the study. Of the 100 children who completed the 1-year follow-up, 50 underwent scrotal orchidopexy and 50 underwent inguinal orchidopexy. The testicular volume, serum testosterone, AMH, and InhB levels in both groups increased markedly after surgery (all P < 0.05), but there were no apparent differences between groups at 6 months and 12 months after operation (all P > 0.05). No differences between the scrotal and inguinal groups were noted regarding the operative time ( P = 0.987) and amount of intraoperative bleeding ( P = 0.746). The overall complication rate (2.0%) of the scrotal group was slightly lower than that of the inguinal group (8.0%), although this difference was not statistically significant ( P > 0.05). Both scrotal and inguinal orchiopexy exerted protective effects on testicular function in children with cryptorchidism, with similar operative status and postoperative complications. Scrotal orchiopexy is an effective alternative to inguinal orchiopexy in children with cryptorchidism.
Female
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Pregnancy
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Male
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Infant
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Humans
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Child
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Cryptorchidism/surgery*
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Orchiopexy
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Scrotum/surgery*
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Postoperative Complications
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Anti-Mullerian Hormone
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Testosterone
8.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
9.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