Ectopic Testicle Research Articles

Familial cross-testicular ectopia: a clinical case report

Cross or transverse testicular ectopia is a rare congenital condition of the reproductive system that involves the migration of a testicle into the opposite inguinal canal, along with the presence of an inguinal hernia on the same side as the ectopic testicle. In the modern literature, there are discussions about diagnostic issues, particularly the use of ultrasound scanning and magnetic resonance imaging to diagnose this condition. However, it is the results of laparoscopic examination that determine the most accurate criteria for surgical treatment. Many publications discuss the choice of surgical tactics, including separate transabdominal orchiopexy, with or without laparoscopic assistance; transeptal orchiopexy on both sides of the scrotum; and rare cases of orchiopexy for both testicles on one side of the scrotum. Ultimately, the choice of surgery depends on the individual characteristics and needs of the patient, and the surgeon should make the decision based on these factors. The article describes, for the first time, a case of familial testicular ectopia with bilateral inguinal hernia in siblings who underwent surgery using laparoscopic assistance. The method used was single-trocar laparoscopic access with transscrotal transeptal orchiopexy and simultaneous bilateral puncture of the inguinal ring and suture. During the long-term follow-up period (50 and 20 months after surgery) in both siblings, there were no signs of malformation or atrophy of the gonads.

Perineal discomfort caused by the sitting position as a rare manifestation of ectopic testicle: About two cases

Background and importancePerineal ectopic testis (PET) is a rare congenital anomaly; the diagnosis is typically made by conducting a physical examination of the ectopic areas and noting an empty scrotum on the corresponding side. We report two pediatric cases of PET in whom this condition was diagnosed by a discomfort induced by the sitting position. Cases presentationTwo cases of PET were operated on in our pediatric surgery department over the past three years. Patients were referred for perineal discomfort in the sitting position. Children had difficulty staying seated at home or school, this was described by parents as an abnormal fussiness after sitting. The age at diagnosis was five and three years. The diagnosis of perineal testicular ectopia was made through physical examination. Orchidopexies to the corresponding scrotum were performed in both cases via an inguinal approach. No postoperative complication was noted with a follow-up of 24 months. Clinical discussionPET is typically diagnosed through clinical examination, characterized by an empty scrotum and a palpable perineal mass. The exact aetiology is unclear, but it involves abnormalities in testicular descent mechanisms, particularly the gubernaculum. PET can cause perineal discomfort when sitting, a symptom observed in the two pediatric cases presented. Early surgical intervention via orchidopexy is crucial to prevent complications. Both reported cases were successfully treated with no postoperative complications and resolution of discomfort. Prompt diagnosis and treatment are essential for preserving testicular function. ConclusionPerineal discomfort on sitting was the defining diagnostic element in our cases. In practice, this symptom should be a prompt for a thorough perineal examination in children with an empty scrotum. However, the patient's age and ability to express himself determine the significance of the symptom.

A spontaneous acute abdomen revealing testicular torsion of an undescended testicle

Torsion of an ectopic testicle is an exceptional condition, occurring mainly in young adults. Its etiopathogenesis is still poorly understood. The clinical picture consists of the sudden onset of abdominal pain without fever, associated with a palpable inguinal mass and an empty scrotum. Medical imaging appears to play a limited role. The management of torsion of an undescended testicle involves urgent surgical exploration. An inguinal incision allows diagnosis, detorsion, reduction and orchidopexy in dartos after lowering the testicle if the testicle is viable and the spermatic cord is of sufficient length.

Vaginoplasty on Androgen Insesibility Syndrome: A Props of A Case

Feminizing Testicular Syndrome is a very rare genetic disease of recessive transmission linked to the X chromosome, currently called Androgen Insensitivity Syndrome (AIS). The affected subjects are apparently normal women, but with a 46 XY male karyotype with ectopic testicles. Through a case of “AIS revealed” by a germ tumor (GT) on an ectopic testicle in a 33-year-old patient who underwent a bilateral orchidectomy. The patient received 10 sessions of chemotherapy declared in remission. Following a sexual desire, the patient received a sigmoid vaginoplasty 5 years later according to Schmid’s technique. The surgical follow-up was favorable and the patient quickly resumed a satisfactory sexual activity.

Torsion of an inguinal canal testis

The clinical diagnosis of a torsion of an ectopic testicle is difficult. Lack of knowledge on this pathology is often a cause of late diagnosis and can have serious consequences. This diagnosis should be made in front of any acute pelvic or inguinal pain in children with an ectopic testicle, regardless of age. We report a case of late presentation of a 6 month-old infant with torsion of an ectopic testicle leading to testicular necrosis.

Neglected Spermatic Cord Twisting: Experience of the University Hospital Center of Casablanca

Introduction: Spermatic cord twisting (SCT) is a life-threatening emergency of the testis, causing testicular ischemic lesions by vascular constriction. Neglected SCT is an atypical variant of torsion with a late diagnostic delay. It is characterized by the presence of testicular necrosis, requiring an orchiectomy. The objective of our study is to investigate possible factors that may be responsible for the delayed diagnosis of TCS, and thus favor the occurrence of the neglected form. In order to act on these factors and prevent the harmful consequences of SCT, in particular testicular necrosis.
 Material and methods: This is a retrospective and descriptive study, conducted over a period of 7 years (January 2013-December 2019). Interesting 34 patients admitted to the urology department of the CHU Ibn Rochd of Casablanca, in a neglected SCT picture. The collection of information was carried out from the patients' files through an exhaustive exploitation sheet.
 Results: A total of 34 cases of neglected SCT were collected. The mean age was 17.97 years (extremes: 14-37 years). 94% of the subjects were less than 25 years old. 15% of the subjects were from rural areas. 77% of cases occurred during the cold season. The absence of employment characterized 61.5% of the major subjects and 42.8% of the guardians of the minor patients. Only 26.5% of subjects had health coverage. Non-education characterized 62% of adult patients and 65% of guardians of minor patients. The occurrence of neglected SCT was on an ectopic testicle in 1 case (3%) and on an oscillating testicle in 1 case (3%). The involvement was on the left side in 70.6% of cases. The average time to visit the emergency room at the CHU was 86 hours with extremes of 12 hours and 12 days. 38% of the patients had consulted directly at the CHU, while 62% were referred from other health structures. All patients were admitted to the emergency room after the pain had disappeared (scrotal in 94% and inguinal with vacuity of the homolateral bursa in 6%). Echodoppler allowed the dg to be applied in 100% of cases. Delayed consultation of the patient was present in 82.4% of cases. A diagnostic delay due to anaberration in medical management was found in 17.6%. Therapeutic management was orchidectomy in 100% of the cases, and orchidopexy of the contralateral testis was immediate in 24% of the cases and delayed in 76% of the cases. 24% of the cases and delayed in 76% of the cases. Only 29.4% of patients presented for medical check-up at 6 months postoperatively. 80% of these patients had testicular atrophy on clinical and ultrasound examination, and frank oligospermia with asthenospermia on spermogram.
 Conclusion: Multiple factors are likely to act on the prolongation of the diagnostic delay of SCT and may be at the origin of the occurrence of its neglected form. The delay in the diagnosis of SCT may be related to a delay in patient consultation or to an aberration in medical management, thus favoring the development of testicular necrosis and consequently requiring an orchiectomy. Hence the interest in knowing these factors in order to act on them by raising public awareness of the importance of emergency consultation in the face of acute scrotal pain, as well as continuing education of physicians and medical staff to prevent the occurrence of neglected SCT.

Pseudo-hermafroditismo em cadela da raça buldogue-francês

Pseudohermaphroditism is a sexual anomaly, rare in dogs, in which the individual has both male and female characteristics; normally ambiguous external genitalia and male or female gonads. This report concerns a 5-month-old female French Bulldog, where the principal concern was the presence of a structure in the internal region of the genitalia with evolution of approximately 2 months. Upon clinical examination, it was found that the patient had a characteristically female phenotype and a vagina with no apparent changes, despite the presence of a hypertrophied structure inside, similar to a clitoris and a probable penile bone. A right lateral abdominal radiography revealed the presence of a probable atrophied penile bone located inside the vulva. An ultrasound examination showed the presence of two oval, coarse and hypoechogenic structures in the inguinal (subcutaneous) region, suggesting ectopic testicles; ovaries and uterus were not observed. However, during laparotomy the absence of ovaries and the presence of uterus and testicles in the subcutaneous tissue were observed.

Moyamoya syndrome in a male pseudohermaphrodite patient with congenital adrenal hyperplasia – a rare association. Case report and review of literature

Background and importance Moyamoya syndrome causes progressive stenosis of intracranial internal carotid arteries and may be associated with genetic disorders like Down’s or Turner’s syndromes. We treated a male pseudohermaphrodite patient with congenital adrenal hyperplasia (CAH) with clinical and radiological features of moyamoya vasculopathy. To our knowledge, this association has not been reported. Clinical presentation The 42-year-old patient presented with an intraventicular bleed. Cerebral angiography revealed moyamoya vasculopathy. He was hypertensive and had primary amenorrhea. Secondary sexual characteristics were poorly developed and he had ambiguous genitalia. Breast development was Tanner stage 3. Investigation revealed hypokalemia. With primary amenorrhea, persistent hypokalemia, hypertension and ambiguous genitalia, CAH was considered as a possibility and confirmed on hormone profile. Karyotyping revealed 46XY pattern. Abdominal ultrasound revealed hyperplasia of the adrenal glands, absent uterus and ovaries and ectopic testicles in inguinal canals. He was put on steroids and his blood pressure controlled. Conclusions To the best of our knowledge we report the first case of moyamoya syndrome occurring in association with CAH.

Semenoma Originated from an Ectopic Testis

The authors report an observation of a meta static seminoma on an ectopic testicle in a 23 years old patient and discuss the epidemiological, diagnostic, therapeutic and evolutionary aspects of this entity. Clinical diagnosis is often difficult due to the diversity of clinical symptoms, the use of imaging, biological markers and percutaneous biopsyis essential to make the diagnosis. The anatomopathology and therapeutic aspects are similar to the testis in normal situations. Early diagnosis of these tumors involves the lowering of the cryptorchid testicles, because even if this lowering does not prevent the setumors, it allows better monitoring.

Male Infertility as a Circumstance of Discovery of Adult Cryptorchidism: A Retrospective Analysis from the Region of Thies

Introduction: The aim of this work is to study the clinical aspects and the impact of cryptorchidism on male infertility in the region of Thies. Patients and methods: This is a retrospective study involving 28 patients followed up at the Saint Jean de Dieu, Barthimée and Tivaouane hospitals of the region of Thies between January 2007 and December 2016. Results: Among the 223 patients followed up for the undescended testicle, 13% (n = 28) were adults or at least 15 years old. 71% (n = 20) were married. Fourteen patients were followed up for primary infertility lasting for a period of time averaging 7 years. The mean age of the patients was 28 years (range: 17 years and 45 years). Cryptorchidism was unilateral in 82% (n = 23) and bilateral in 18% (n = 5). The mean delay of consultation varied from 1 to 13 years. The main reason for consultation was couple infertility (50%). The semen analysis was requested in all our patients. The levels of FSH, LH and testosterone were measured by immunoassay for the patients with azoospermia (n = 9). We noticed 2 cases of hypotestosteronemia and 3 cases of increased FSH serum level. Computed Tomography scans (CT) were performed in 28.5% of patients (n = 8) and ectopic testicles were found very high in the inguinal area in 5 cases. The open inguinal approach was used. In perioperative period, the testicle was found, high in the inguinal region in 5 patients (17.8% of the cases) and low in inguinal region in 19 patients (67.8%). In 4 cases the testicle was in abdominal position. The testicle was atrophied in 53.5% of the patients (n = 15) and 8 patients presented testicular hypotrophy. An orchidectomy was performed in 1 patient in whom it was impossible to lower the atrophied testicle. The postoperative period was uneventful and simple. The mean follow-up duration after the operation was 36 months (12 - 60 months).

Ectopic testis in coati (Nasua nasua Linnaeus, 1766)

ABSTRACT: This paper reports a case of unilateral extracorporeal ectopic testes in a captive coati (Nasua nasua) in the State Park of Dois Irmãos Zoo, Recife/PE, Brazil. The testicle was located in the subcutaneous tissue of the inguinal region not adhered to the surrounding tissues. After bilateral orchiectomy, both testes were measured, fixed with 10% formalin buffered and embedded in paraffin for histopathological evaluation. The left testis measured 1.2 cm width by 1.7cm length, and the right one measured 1.5 cm width by 2.0 cm length. The ectopic testes had seminiferous epithelium without post-meiotic germ cell lines. The non-ectopic testis had several changes in the seminiferous epithelium that indicated degeneration. In both epididymis, the lumen did not contain sperm and the major epithelial structural alterations were more distinct in the epididymis associated to the ectopic testicle. In conclusion, the ectopic testis and epididymis had lesions compatible with testicular exposition to body temperature. Non-ectopic epididymis and testis had minor lesions but could be related to the infertility of the coati.

Testicular Neoplasms in Dogs in Rio Grande do Sul, Brazil

Testicular Neoplasms in Dogs in Rio Grande do Sul, Brazil

Laparoendoscopic Single-Site Surgery na realização de criptorquidectomia laparoscópica em um gato

A afecção congênita mais comum nos animais domésticos é denominada de criptorquidismo, sendo caracterizada pela não migração de um ou ambos os testículos até o escroto. O objetivo deste trabalho é relatar a técnica de criptorquidectomia videoassistida, através de um único acesso (LESS) sem dispositivos específicos, em um gato siamês com dois anos de idade e 3,9kg de massa corporal. Utilizou-se um único portal de 5 mm, inserido na linha média ventral na região pré-púbica. Por esse portal, a cavidade foi insuflada com CO2 medicinal, permitindo a obtenção do pneumoperitônio (8mmHg) a uma velocidade de 1 l/min. Após o inventário da cavidade abdominal, com o auxílio de um endoscópio de 5mm e 25o, identificou-se o testículo ectópico. Com a utilização de uma pinça de apreensão para mini laparoscopia (3mm), introduzida ao lado do trocarte (pelo mesmo acesso), o testículo foi fixado e tracionado para o exterior da cavidade abdominal para realização de hemostasia, não sendo necessária a ampliação da ferida cirúrgica. Após a secção dos vasos testiculares, o testículo foi totalmente liberado e o coto vascular devolvido à cavidade abdominal. O presente relato demonstra que a cirurgia laparoscópica por um único acesso (LESS) pode ser utilizada com sucesso no diagnóstico e tratamento de casos de criptorquidismo em gatos, com as possíveis vantagens que o acesso apresenta em relação à cirurgia convencional.

Palpable Undescended Testes: 15 Years of Experience and Outcome in Laparoscopic Orchiopexy.

Most of the current literature concerning laparoscopy in patients with cryptorchidism reports on those with nonpalpable testes. The purpose of this study is to share our experience and outcome in laparoscopic orchiopexy on patients with palpable undescended testes. From January 1999 to July 2014, 240 cryptorchid testes were treated of which 192 (155 patients) were palpable and were operated on by laparoscopy. Before starting, the bladder is emptied with a Foley catheter. Four trocars are used: One 5 mm for the lens (45 degree), one 10 mm (transscrotal), and two 3 mm placed at the subcostal midclavicular line for the instruments. We localize the deep inguinal ring and open the peritoneum. The spermatic vessels and vas deferens are dissected in a cephalic direction. The epigastric vessels are dissected and sectioned to facilitate the localization of the testicle inside the canal. Once found, the testis is dissected and taken into the abdominal cavity where the gubernaculum testis is cut. A 10-mm trocar is introduced through the scrotal sac into the peritoneal cavity. The testicle is grabbed and pulled down to the scrotum where it will be fixed with a 5-0 polypropylene suture in the usual manner. Of 192 cryptorchid palpable testes treated with laparoscopy, only one procedure was converted to conventional open orchiopexy because of an ectopic testicle (above the aponeurosis of the oblique muscle). The rest of the testicles could be moved down to the scrotal sac. Our follow-up ranges from 6 months to 15 years, and we have not found atrophy in any of the testicles. To date, only two (0.4%) testicles have reascended. Laparoscopy is a great and safe option for patients with palpable undescended testes, regardless of its position in the inguinal canal.

A Rare Clinical Case Of Double Scrotum With Ectopic Testicle In a Dog

A two-years old male mixed breed dog weighing 11 kg was brought to the Veterinary Teaching Hospital by its owner because he noticed a pigmented skin zone with a mass lateral to the penis. The patient was in good clinical condition. On clinical examination, only one testicle was found within the scrotum, and a mass lateral to the right site of the penis was present; upon palpation, the mass was presumed to be a testicle. An ultrasound examination confirmed the presence of an ectopic testicle in that position. The dog had normal fertility and testosterone levels were normal. The patient underwent bilateral orchiectomy and was discharged the following day. The peculiarity of this case is the presence of two independent scrota, an ectopic testicle and its adnexa passing through the abdominal wall, was not supposed to be due a migration along the typical male gonad path during descent.

Crossed-Fused Testicular Ectopia: A Case for the Use of Laparoscopy to Evaluate Nonpalpable Testicles

A 1-year-old male was referred for evaluation of a nonpalpable right testicle. In children with nonpalpable testicles, it our practice to proceed with diagnostic laparoscopy in an attempt to identify an intra-abdominal testicle or blind-ending spermatic vessels regardless of ultrasound findings. In the operating room, we performed diagnostic laparoscopy through the umbilical stump. We identified a vas deferens passing from the right side to the left side, and what appeared to be a testicle in the area of the left internal inguinal ring (Figures 1 and 2). In the left groin, we found both testicles fused together with a common blood supply, but a separate vas deferens. We placed the right testicle transseptally into the right hemiscrotum.Figure 2Right testicle entering the left inguinal ring.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Crossed testicular ectopia, or transverse testicular ectopia, is an extremely rare finding on exploration for an undescended testicle, with just slightly more than 100 cases reported in the literature to date.1Lam W.W. Le S.D. Chan K.L. Chan F.L. Tam P.K. Transverse testicular ectopia detected by MR imaging and MR venography.Pediatr Radiol. 2002; 32: 126-129Crossref PubMed Scopus (45) Google Scholar, 2Malik M.A. Iqbal Z. Chaudri K.M. Malik N.A. Ahmed A.J. Crossed testicular ectopia.Urology. 2008; 71 (984 e5-6)Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar A classification system has been proposed that accounts for accompanying anomalies, including hernias and mullerian duct structures.3Gauderer M.W. Grisoni E.R. Stellato T.A. Ponsky J.L. Izant Jr., R.J. Transverse testicular ectopia.J Pediatr Surg. 1982; 17: 43-47Abstract Full Text PDF PubMed Scopus (88) Google Scholar The ectopic testicle is usually structurally normal; however, it does carry a risk of malignancy, similar to that associated with other forms of intra-abdominal testicles.4Berkmen F. Persistent mullerian duct syndrome with or without transverse testicular ectopia and testis tumours.Br J Urol. 1997; 79: 122-126Crossref PubMed Google Scholar, 5Naouar S. Maazoun K. Sahnoun L. Jouini R. Ksia A. Elezzi O. et al.Transverse testicular ectopia: a three-case report and review of the literature.Urology. 2008; 71: 1070-1073Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar Although there are reports of successful diagnosis of this anomaly using ultrasonography6Pinto C.W. Toro R.C. Mansilla K.H. Castro T.A. Fuente-Alba C.S. Crossed testicular ectopia.J Ultrasound Med. 2010; 29: 847-849PubMed Google Scholar or magnetic resonance imaging1Lam W.W. Le S.D. Chan K.L. Chan F.L. Tam P.K. Transverse testicular ectopia detected by MR imaging and MR venography.Pediatr Radiol. 2002; 32: 126-129Crossref PubMed Scopus (45) Google Scholar during evaluation of nonpalpable testicles, neither of these studies is sufficiently sensitive to safely rule out an ectopic testicle.7Gokce M.I. Burgu B. Aydogdu O. Fitoz S. Soygur T. Transverse testicular ectopia associated with persistent Mullerian duct syndrome: another entity in which magnetic resonance imaging is unreliable.Urology. 2010; 76: 1475-1477Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar, 8Tasian G.E. Copp H.L. Diagnostic performance of ultrasound in nonpalpable cryptorchidism: a systematic review and meta-analysis.Pediatrics. 2011; 127: 119-128Crossref PubMed Scopus (93) Google Scholar Laparoscopy has consistently demonstrated superior diagnostic accuracy in nonpalpable testicles9Papparella A. Romano M. Noviello C. Cobellis G. Nino F. Del Monaco C. et al.The value of laparoscopy in the management of non-palpable testis.J Pediatr Urol. 2010; 6: 550-554Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar, 10Cortesi N. Ferrari P. Zambarda E. Manenti A. Baldini A. Morano F.P. Diagnosis of bilateral abdominal cryptorchidism by laparoscopy.Endoscopy. 1976; 8: 33-34Crossref PubMed Scopus (278) Google Scholar, 11Jordan G.H. Winslow B.H. Laparoscopic single-stage and staged orchiopexy.J Urol. 1994; 152: 1249-1252PubMed Google Scholar, 12Siemer S. Humke U. Uder M. Hildebrandt U. Karadiakos N. Ziegler M. Diagnosis of nonpalpable testes in childhood: comparison of magnetic resonance imaging and laparoscopy in a prospective study.Eur J Pediatr Surg. 2000; 10: 114-118Crossref PubMed Scopus (33) Google Scholar and is instrumental in their evaluation and treatment as underscored by this unusual finding on exploration.

Laparoscopy-insisted vaginoplasty with peritoneum in patients with androgen insensitivity syndrome

To investigate the technique and therapeutic effect of laparoscopy-insisted vaginoplasty with peritoneum in patients with androgen insensitivity syndrome. From May. in the Fifth People' s Hospital of Shenzhen. The therapeutic effect was retrospectively analyzed. Laparoscopy-insisted vaginoplasty was successfully completely with peritoneum in patients with androgen in 4 cases. Ileumtivity segyndroment was used instead of peritoneum in one case. Open operation was not adopted in any cases. The ectopic testicles were removed during operation in 4 cases. The average operation time and bleeding volume was 60 min and 20 ml, respectively. Rectum, bladder and urethra were not injured in any case. The average vaginal length was 9 cm (range 8-10 cm) 21-28 days after operation. 6 months after operation, the surface of reconstructed vagina was smooth, ruddy and flexible, with satisfactory anatomical and functional results. Normal sexual activity was achieved in 2 cases. Laparoscopy-insisted vaginoplasty with peritoneum could be used for female patients with androgen insensitivity syndrome. The ectopic testicles should be removed. Estrogen supplement and psychological guide after operation are also important.

Splenosis: a diagnosis to be considered

The term splenosis applies to the autotransplanted splenic tissue resulting from seeding in the context of past splenic trauma or surgery. We report a 42-year-old man with a history of splenectomy observed for an incidentally found retrovesical mass thought to be an ectopic testicle. The abdominal laparotomy revealed multiple focuses of pelvic splenosis. As splenosis can be diagnosed through specific imaging studies one should always consider it in differential diagnosis of a mass discovered years after splenic surgery or trauma.

Complete recovery after the removal of an ectopic testicle in a case of primary reninism and retroperitoneal hemangioma

A 32-year-old man recovered completely from hypokalemic hypertension that had been caused by primary reninism after the ablation of an ectopic left testis, epididymis and ductus deferens. For several years, severe hypertension has been resistant to treatment, even the concurrent administration of up to seven antihypertensive agents. In this case, cryptorchidism was associated with an indirect inguinal hernia and an open peritoneo-vaginal process on both sides, aplasia of the posterior wall of the inguinal canal on the right side, an umbilical hernia, and a retroperitoneal tendrillar hemangioma.

The effects of early experimental cryptorchidism and subsequent orchidopexy on the maturation of the guinea-pig testicle.

Abstract A histological study of experimental cryptorchidism in the immature guinea-pig and the results of subsequent orchidopexy are described. Arrest of development of a testis was produced by delaying its descent into the scrotum. Subsequent orchidopexy at ages up to and beyond puberty allowed development to continue to active spermatogenesis. The poor results following orchidopexy for natural cryptorchidism in man are discussed in relation to this experimental work and the existence of a primary testicular abnormality is suggested. The superficial inguinal pouch ectopic testicle and the retractile testicle are also discussed.