Ipsilateral Undescended Testis Research Articles

Proportion of Testicular Absence and Position of Testis in Unilateral Nonpalpable Undescended Testis in a Tertiary Teaching Hospital in South India

Introduction: Undescended testis is a common surgical problem in children which needs to be treated by one and a half year of age. When testis is non palpable, it could be either absent, and when present intra-abdominal or inguinal. Methodology: A hospital based retrospective study was conducted in department of paediatric surgery, Thiruvananthapuram. Study population consisted of children treated with nonpalpable undescended testis from January 2016 to June 2021. Results: Mean age of intervention was 43.7 months (range 7 to 153 months). Incidence of absent testis was 30.97%. in 156 children who had ipsilateral undescended testis, 92 had intra-abdominal testis and 43 had inguinal testis. Presence of nubbin of testis in ipsilateral scrotum and contralateral testicular hypertrophy were suggestive of absent ipsilateral testis (p <0.001). Testis is absent in 11.3% only when ipsilateral hemi scrotum is under developed. Conclusion: Proportion of absent testis is 30.97% in children with unilateral undescended testis. Presence of nubbin of testis in ipsilateral scrotum and contralateral testicular hypertrophy are predictive of ipsilateral testicular absence. Keywords: Undescended testis, atrophic testis, Contralateral hypertrophy.

Congenital spigelian hernia and ipsilateral undescended testis: An ongoing etiological debate - A case report

Congenital spigelian hernia and ipsilateral undescended testis: An ongoing etiological debate - A case report

Congenital Spigelian hernia in a neonate associated with several anomalies: A case report

Background: Spigelian hernia (SH) is a rare entity characterized by a defect of the anterior abdominal wall located along the Spigelian line, it may be congenital or acquired.Association with other anomalies is worth reporting. Case Presentation: A 22-day-old male newborn was admitted with strangulated right inguinal hernia and operated on emergently. Clinical examination also revealed a Spigelian hernia in the left lower abdominal quadrant with bilateral cryptorchidism, associated with polydactyly of the small right finger and anal stenosis. At surgery, the SH contained a part of the small intestine and the ipsilateral undescended testis. Conclusion: Pediatric SH is rare, but its association with undescended ipsilateral testis is frequent. Other abnormalities can be concomitant to this association.

Laparoscopic Abdominoscrortal Hydrocele: A Case Series

ObjectiveTo evaluate the effect of laparoscopic percutaneous extraperitoneal closure (LPEC) of the internal inguinal ring for the treatment in pediatric abdominoscrotal hydrocele (ASH) and to assess the feasibility and safety of the procedures. Patients and MethodsData were collected from the charts of patients with ASH who underwent surgery in Kokura Medical Center from April 2014 to December 2019. The patients’ characteristics, preoperative diagnosis, forms of abdominal components, presence of patent processus vaginalis (PPV), associated pathologies, and postoperative results were evaluated. ResultsThe study population included 10 patients (4.3% of all 230 hydroceles). The mean age of 10 patients was 3.5 years (range, 7 months to 7 years). A preoperative diagnosis of ASH was made in 3 patients. In the other 7 patients, ASH was detected during laparoscopic repair of the scrotal hydrocele. The abdominal forms of hydrocele were monolocular cysts (n = 6) and multilocular cysts (n = 4). PPV was detected by laparoscopy in all cases. Six patients had contralateral pathologies, including PPV (n = 4), inguinal hernia (n = 1), and scrotal hydrocele (n = 1). One patient had ipsilateral undescended testis. Preoperative ultrasonography showed some degree of testicular dysmorphism on the affected side in 4 cases. In all cases, treatment was accomplished by closing the PPV at the internal inguinal ring by LPEC procedures. No patients had postoperative complications, including recurrent ASH or hydrocele after ASH repair (mean follow-up, 2.6 years). ConclusionLPEC may be an adequate and minimally invasive method for the treatment of the pediatric ASH.

Management of supernumerary testis

Polyorchidism is a rare congenital abnormality described as the presence of three or more testicles. We report the case of a 2-year-old boy with intermittent left-sided scrotal swelling and an ipsilateral undescended testis. During the operation, a left cryptorchid testis was found at the external ring, with further dissection revealing a second vas deferens attached to an additional intrascrotal testis. The cryptorchid testis was pexied in the left hemiscrotum with the second descended testis left in place. A review of the literature reveals over 150 cases of supernumeracy testis. Triorchidism is the most common form with the third testis typically located within the scrotal sac. Supernumeracy testis is frequently associated with undescended testis, testicular torsion, inguinal hernia, and hydrocele. Management is controversial with some advocating for orchidectomy due to concerns of malignancy. The family was educated about the risk for malignancy and the importance of regular follow-up and testicular self examination starting at puberty. Keywords: orchidectomy, orchidopexy, polyorchidism, supernumerary testis

Giant Seminoma in an Undescended Testis Presenting as a Mass in the Right Iliac Fossa

Seminoma in undescended testes may present as right iliac fossa mass. A seminoma in a 49 year old man with ipsilateral undescended testis is presented and relevant literature is reviewed. A 49 year old male presenting with a right iliac fossa mass was admitted to our hospital and initial diagnostic tests followed by abdominal computerized tomography (CT) were performed. Abdominal CT clearly demonstrated the tumor location. He underwent surgery and the tumor was not operable and biopsy was taken. Pathological diagnosis was consistent with classical seminoma. He was referred to oncology clinic after discharge. Tumors of undescended testis can present as a right iliac fossa mass and clinicians must be aware of their existence.

Congenital Spigelian Hernia and Ipsilateral Cryptorchidism: Raising Awareness Among Urologists

Spigelian hernias (SHs) are rare in the pediatric population. Although pediatric general surgeons often treat this defect, the increased association between a congenital SH and an ipsilateral undescended testis suggests that urologists may be the first provider encountering this entity. Knowledge of this condition is therefore important. We report one such case of a male infant referred to urology for an undescended testicle. Further investigation revealed the testicle to be within a congenital SH sac. Herein, we additionally review the literature concerning SHs associated with ipsilateral undescended testicles.

English

Occurrence of Spigelian Hernia is rare accounting for 0.12% of all ventral hernias 1 . It is most commonly reported in adults while pediatric cases are rare. Though the association of Spigelian-Cryptorchidism syndrome has been comprehensively reported in pediatric patients, the same has not been detailed so far for the adult patient population. We herein discuss two cases of Spigelian hernia, both adults in whom intra-operative exploration revealed associated ipsilateral undescended testis. Not only is the pre-operative diagnosis seldom if ever, the imaging studies may not be successful in differentiating the type of hernia2,3. Even in the present cases radiological studies were inconclusive and definitive diagnosis was only attained intra-operatively.

Giant seminoma in an undescended testis presenting as an abdominal wall mass.

Seminomas in undescended testes may present as abdominal wall tumours. A unilateral testis tumour in a 29 year old man with ipsilateral undescended testis is presented and relevant literature is reviewed.A 29 year old man presenting with a tender left lower abdominal mass was admitted to our clinic and initial diagnostic tests followed by abdominal computerized tomography (CT) and positron emission tomography/computerized tomography (PET/CT) were performed. Abdominal CT clearly demonstrated the tumour location between the lower left abdominal subcutaneous layer and the external oblique fascia. He underwent surgery and the tumour was resected via en-bloc excision.Pathological diagnosis of the resected specimen was consistent with classical seminoma and no distant metastasis was detected with PET/CT. He was referred to oncology clinic after discharge.Tumours of undescended testis can present as an abdominal wall mass and clinicians must be aware of their existence.

Intrascrotal Extratesticular Neurofibroma as a Possible Cause of Failed Descent in Ipsilateral Testis

Intrascrotal extratesticular neurofibromas (IEN) often originate from genitofemoral nerve (GFN) and present as a paratesticular mass. Synchronous presence of IEN and undescended testis has not been reported previously. A 12-year-old boy with neurocutaneous syndrome and congenital giant melanocytic nevi along with IEN and ipsilateral undescended testis is presented, to discuss the underlying pathophysiology of failed testicular descent in the presence of IEN.

Partial vesiculectomy in an infertile man with seminal vesicle cyst, ipsilateral renal agenesis, and cryptorchidism

Congenital seminal vesicle cysts associated with renal agenesis are uncommon, but are currently detected more frequently with the use of sectional imaging procedures. Approximately 200 cases have been reported. The unique feature of our case is the combination of this disorder with an ipsilateral undescended testis. Our patient underwent partial vesiculectomy, in which the cyst was removed and the seminal vesicle remnant with its vas deferens was preserved. A review of the infertile cases and the impact of surgical treatment on fertility are discussed. Features that render partial vesiculectomy applicable and the potential effect of this procedure on fertility are highlighted.

Poland syndrome in British Columbia: Incidence and reproductive experience of affected persons

Patients with Poland syndrome were ascertained through the British Columbia Health Surveillance Registry, through hospital records, and through practicing plastic and orthopedic surgeons. Of 44 patients who were ascertained, 28 had family histories taken and were examined. Physical findings were: absence of the sternal head of the pectoralis major in all patients, symbrachydactyly in most patients, and infrequent other associations such as ipsilateral undescended testis, Möbius syndrome, clubfoot, and submucous cleft palate. Family histories were "negative" in all cases. The 8 affected adults had 24 reportedly normal children. Mean paternal age was significantly higher than the paternal age in the population. The incidence was 1/32,000 livebirths in British Columbia. It was concluded that in the British Columbia population the syndrome is usually a sporadic event.