Surgery For Undescended Testes Research Articles

Management of undescended testes in adolescents and young adults

Background: The undescended testes (UDT) are at risk of torsion, trauma and pathologic changes leading to subfertility and malignant transformation. Surgery for UDT should be performed before the age of 2 years.Methods: This was a 5-year retrospective study conducted on patients who presented with features of UDT in Port Harcourt. Ethical approval for the study was sought and gotten from the hospital ethical committee. Data was obtained from ward admission registers, theatre, and discharge records. The information gotten included history, examination findings and treatment received. Patients who had ectopic testes, retractile testes and incomplete records were excluded from the study. The information was collected and analysed. Categorical data was presented in the form of frequencies and percentages using tables. Continuous variables were presented in means and standard deviation. Results were presented in tables and charts.Results: The 15-19-year age group had the highest frequency. The median age was 19 years. Most subjects had at least secondary school education (71.43%). The right testes alone were undescended in 11 cases while the left alone was undescended in 7 cases. Three patients presented with undescended testes. Most (15) patients had their testes located in the inguinal canal. Poverty was the most common reason for late presentation. Orchidopexy was most commonly carried out via an inguinal approach.Conclusions: Late presentation of patients with UDT is common. Inguinal orchidopexy was the most common surgery performed. Health education on the need for scrotal examination after birth can aid earlier presentation.

Day Surgery in Paediatric Urology in Private Practice for Paediatric Surgery: Treatment of Undescended Testis in Our Private Practice for Paediatric Surgery

This article describes the reality of paediatric urology treatment in a private practice for paediatric surgery based on the example of undescended testis. It stresses the importance of a paediatric setting as well as treatment according to the guidelines for diagnostic evaluation, treatment and follow-up. German paediatric surgeons in private practise are mostly organised in the BNKD e.V. ("Berufsverband der niedergelassenen Kinderchirurgen Deutschlands", Professional Association of Private-Practice Paediatric Surgeons in Germany) and they have long-standing experience in the treatment of undescended testis. Reactions to guideline developments and changes in therapy have become evident in the statistical data of the BNKD, which shows that the age of children at the time of day surgery for undescended testis has decreased in keeping with the guideline. Further improvement is necessary in this regard. High-quality day-surgical treatment in paediatric urology cases depends on the quality and expertise of the treating teams and treatment continuity in the paediatric setting. Private practices of paediatric surgery in Germany can contribute greatly to the treatment of undescended testis.

Factors which delay surgery for undescended testis in Ontario: A retrospective population based cohort study on timing of orchidopexy between 2006 and 2012

Delays in performing orchidopexy (OP) for undescended testis (UDT) result in loss of germ cells. Despite practice guidelines recommending OP by 18 months of age, significant delays in OP occur. This delay may impact fertility and increase the risk of testicular malignancy in boys with UDT. The objective of this study is to identify factors associated with delayed OP with the goal of identifying modifiable risk factors. A population-based, retrospective cohort study was conducted using linked databases held at ICES to evaluate factors associated with timing of OP in Ontario for 4339 male newborns undergoing their first OP between 2006 and 2012. Primary outcome was delayed OP (>18 months). Multivariable logistic regression analysis was performed to identify patient, physician, and hospital risk factors for delayed OP. Median age at OP was 24 months, while median age at first surgical consult was 20 months (IQR 10-60 months). Older age at first surgical consult (>12 months vs. <9 months, OR 17.83) was identified as the primary risk factor for delayed OP, besides ICU hospitalization (OR 3.42), associated hypospadias (OR 2.30), higher hospital OP volume (OR 1.91), more healthcare visits in first year of life (OR 1.05), and older surgeon age (OR 1.02). Our findings support reports that OP is often performed past guideline recommendations. Interventions that result in earlier referral for UDT (<6 months) may result in timely OP. Limitations for this study include potential misclassification or missing data within the utilized databases. The most important barrier to timely OP is delay in first surgical consultation. Aiming for an earlier referral through guideline modifications or education to referring providers may help achieve the goal of timely OP.

Early Experience with Laparoscopic Surgery for Undescended Testis at a Tertiary Hospital in Ibadan (2015-2019)

Background: Undescended testis (UDT) is of concern to the patient. If not treated may be complicated by trauma, torsion, male sub-fertility, and testicular cancer. In Nigeria it is commonly treated by open orchidopexy or orchidectomy. We report our experience with the laparoscopic management of undescended testes in the Western part of Nigeria.&#x0D; Methodology: The aim of this study was to report our early experience with the laparoscopic treatment of undescended testis in our centre. The study was conducted between January 2015 and December 2019. The data studied were age, unilateral or bilateral UDT, operation performed, pre-and intra-operative findings, operation time, and the outcome. The data were represented in tables and with operative pictures. Ethical clearance was obtained.&#x0D; Results: A total 12 patients were treated which consisted of 7 children and 5 adults with a mean age of 11 (6-17) years and 35.2 (29-42) years respectively. Preoperatively, 9 patients had transperitoneal laparoscopic orchidopexy, orchidectomy or varicocelectomy. The laparoscopic findings were peeping testis (5), intraabdominal testis (8), intracanalicular (5), and one absent testis. All the post-orchidopexy testes remained in the scrotum at 18 months of follow up. In the adults, there was improvement in the semen parameters in 2 men while 3 had persistent azoospermia.&#x0D; Conclusion: In our setting, laparoscopy for undescended testis is feasible, safe, diagnostic, and therapeutic. In infertile men with undescended testis and unilateral varicocele, laparoscopic varicocelectomy results in improved semen quality.

Van İlinin Sosyo-Ekonomik Gelişmişlik Düzeyi ile İnmemiş Testisli Hastalarımızdaki Orşiopeksi Yaşı Arasındaki İlişkinin Araştırılması

Objective: To preserve testicular functions, surgery for undescended testis is recommended between 6 and 18 months of age. However, many patients undergo orchiopexy later than recommended ages. In this paper we aimed to assess influence of socio-economic development level of Van province on age at orchiopexy in our center.

Surgery for no palpable testis before the age of one year: a risk for the testis?

Surgery for undescended testisis now commonly recommended before the age of one year. However, the risk of testicular atrophy or miss location after surgery at a young age has not been clearly evaluated. The objective of this study is to evaluate the rate of testicular atrophy after surgery for non-palpable testis before the age of one year. Fifty-five patients operated between 2005 and 2014 for non-palpable testes were reviewed for clinical and ultrasound (US) evaluation. Median follow-up after surgery was of 68.5 months (range 26-130 months). The median age at surgery was ofmonths (5-12 months). Eight patients (14.5%) had bilateral non-palpable testis; thus, 63 testes were evaluated. At surgery, 38 (60%) testes were located in the high inguinal canal; 25 (40%), in the abdominal cavity. Orchiopexy was performed with preservation of the testicular vessels for 58 testes. Fowler-Stephens (FS) procedure was performed for 5 testes. Testicular location was clinically evaluated, and testicular volume was measured using a standard sonogram technique in our pediatric radiology department. Ratio comparing the volume of the descended testis to the spontaneously scrotal located testis was calculated in unilateral forms. After surgery, testes had scrotal location in 62 cases and inguinal location in one case. Seven cases of atrophy were confirmed after US control (11%), more frequently (odds ratio, OR 11.68 [1.9-72.5]) in abdominal testis (24%) than in inguinal testis (2.6%). Atrophy testicular was more frequent with FS technique (OR 7.1 [1.3-40.1]), but the population was weak (N=5). Median volume ratio for unilateral form was 0.88 [0-1.8]; 14 patients presented a ratio greater than 1. The influence of the young age at surgery and the risk of post operative testicular atrophy had not been clearly evaluated. The term of 'no palpable testis' supports an heterogeneous group mixing abdominal and extra-abdominal testis sharing a uniform clinical presentation. Our rate of atrophy in the group of abdominal testes (24%) and inguinal testes (2.6%) is similar to the literature, which concerns older patients. The long-term sonogram assessment demonstrated a good development of the testis after surgery, especially in inguinal cases. Surgery for no palpable testis before the age of one year does not lead to a superior risk of testicular atrophy compared with surgery at an older age and allows a good development of the testis.

The role of parents in delayed surgery of undescended testis

Aim: Undescended testis (UDT) is the most common congenital urinary system disease. Delayed treatment increases the risk of infertility or malignancy. The aim of this study was to evaluate the effect of educational status and geographical location of the parents (rural vs. urban) on the timing of surgery in patients with UDT.Material and Methods: The retrospective study included 248 patients that underwent surgery due to UDT between 2014 and 2018. The patients were divided into two groups based on age at surgery: (I) >1 year and (II) ≤1 year. Data regarding the educational status and geographical location of the parents were obtained via telephone interviews. Results: Of the 248 patients, 67% (n=166) of them were aged over 1 year (Group I) and 33% (n=82) of them were aged below 1 year (Group II). Mean age at surgery was 48.98±29.25 months in Group I and 9.68±1.98 months in Group II. The educational status of the parents was higher in the patients aged below 1 year than in patients aged over 1 year. In addition, the patients living in urban areas admitted to the hospital earlier than those living in rural areas. Conclusion: Both the parental educational status and the geographical location of the parents had a significant effect on the timing of surgery in UDT patients. Keywords: Undescended testis; education status; geographical location

Practice of timely surgery for undescended testis during infancy to minimize risks of testicular malignancy and subfertility in adulthood

The Journal is the primary organ of Continuing Paediatric Medical Education in Sri Lanka. The journal also has a website. Free full text access is available for all readers.The Sri Lanka Journal of Child Health is now indexed in SciVerse Scopus (Source Record ID 19900193609), Index Medicus for South-East Asia Region (IMSEAR), CABI (Centre for Agriculture and Bioscience International Global Health Database), DOAJ and is available in Google, as well as Google Scholar.The policies of the journal are modelled on the Committee on Publication Ethics (COPE) Guidelines on Principles of Transparency and Best Practice in Scholarly Publishing. Sri Lanka Journal of Child Health is recognised by the International Committee of Medical Journal Editors (ICMJE) as a publication following the ICMJE Recommendations.

THE EFFECT OF A HYPNOTIC-BASED ANIMATED VIDEO ON STRESS AND PAIN REDUCTION IN PEDIATRIC SURGERY

Presurgical stress and its negative influences on postsurgical recovery and pain are well documented in the medical literature. Hence, the reduction of stress is advisable. The present study aimed to reduce stress using a hypnotic-based animated video. Thirty children aged 3 to 16 years hospitalized for ambulatory surgery for undescended testes or umbilical/inguinal hernia were recruited for the study. They watched the video 1 time prior to surgery in the presence of their parents and reported their anxiety and pain pre- and postvideo watching on a visual analogue scale. The results show a statistically significant reduction in both anxiety and pain. The article describes the structuring of the animated video and includes links to English, Hebrew, and Arabic versions of it.

Nonpalpable testes: Ultrasound and contralateral testicular hypertrophy predict the surgical access, avoiding unnecessary laparoscopy

In up to 20% of patients presenting with undescended testes, one or both are non-palpable. Whereas the most reliable means to exclude an abdominal testis is laparoscopy, there has been a lot of debate about the role of inguinal ultrasound (US) in detecting non-palpable inguinal testis. While we do not aim to add another paper claiming the benefits of US, we wanted to determine the excess capability of US to determine the correct surgical approach - inguinal or laparoscopy. In the light of avoiding unnecessary diagnostic laparoscopies, even the cost-effectiveness raised in many current papers might be called into question. Of a total of 684 boys who underwent surgery for undescended testes at our department between 2011 and 2014, in 58 (8.5%), one or both testes were neither palpable preoperatively nor under general anesthesia. These boys were examined by two experienced pediatric urologists clinically as well as by US. Besides the size of the contralateral testis, the presence of a testis in the inguinal channel was investigated. The additional impact of US over clinical exam and consideration of the size of the contralateral testis was assessed by means of intra-individual comparisons using Cochran-Q as well as McNemar tests. Clinical exam without considering the size of the contralateral testis had a sensitivity of 9% (95% CI 2-24%) and a specificity of 100% (95% CI 86-100%) to accurately predict the surgical approach deemed appropriate postoperatively. The consideration of the size of the contralateral testis - taken as an isolated factor - accurately predicted the surgical approach with a sensitivity of 21% (95% CI 9-38%) and a specificity of 88% (95% CI 68-97%). Ultrasound accounted for a sensitivity of 53% (95% CI 35-70%) and a specificity of 100% (95% CI 86-100%). The addition of US increased the sensitivity to correctly predict an inguinal incision from 29% to 71% and specificity slightly increased from 88% to 92%. This difference is significant (p=0.008) in the bilateral McNemar test (Figure). Inguinal US of non-palpable testes and measurement of the contralateral testis are synergistic in predicting the surgical approach. The addition of ultrasound to a clinical exam, performed also under general anesthesia and by an experienced pediatric urologist significantly increases the prediction of the correct surgical approach. Our results translate into five boys needing an US of the NPT to prevent one laparoscopy. Whereas cost-effectiveness of US might be debatable in regard to different healthcare systems, it is proven to be an effective, non-harmful tool to avoid unnecessary diagnostic laparoscopies.

Expérience de l’abord scrotal unique dans les abaissements testiculaires après chirurgie inguinale ou échec d’orchidopexie préalable

To report our experience of the unique scrotal incision for the redo cases of orchiopexy after previous inguinal surgery or orchiopexy for undescended testis with a special attention regarding the place of the single scrotal approach. Thirty-six patients operated between January 2003 and September 2015 in our surgical unit for secondary orchiopexy after previous inguinal surgery or orchiopexy for undescended testis (UDT) were included in a retrospective study. The secondary surgical procedure was initiated by a scrotal incision (Bianchi). In cases of difficulty by the scrotal incision an inguinal approach by the prior skin inguinal incision was performed. Patients were divided in two groups a group 1 of 10 patients with reascending testis following inguinal hernia repair and a group 2 of 26 patients with reascending testis after previous orchiopexy for UDT. A good result was defined as testis in scrotal position without evidence of atrophy. All the patients of group 1 were treated by a unique scrotal incision. In group 2, seven patients required a complementary inguinal approach. One hematoma complicated a scrotal procedure leading to a testicular atrophy. A good result was achieved in 35/36 patients (97%). Single scrotal incision is an efficient and easy way to perform secondary orchiopexy after hernia repair. After surgery for UDT, as for primary cases, it cannot be an exclusive approach, higher testis need a combined or an inguinal approach. 5.

Educational survey of regional general practitioner's management of paediatric patients with undescended testis

Recent recommendations have lowered the ideal age of surgery for undescended testis (UDT) to 3-6 months of age. However, many publications demonstrate that age at surgery is still above the recommended age of 1 year as originally suggested in 1996. Through a web-based educational survey, we aimed to combine questions regarding General Practioner's (GPs) management of these patients with educational slides with advice to update them with current recommendations. The regional GPs were invited by email and letter to undertake the web-based questionnaire devised using SurveyMonkey(®). Educational slides were shown after each questionnaire slide. Feedback was immediate and a one-page summary was emailed to the GP on completion. A pre- and post-educational intervention audit was undertaken to ascertain the change in age of referral for patients <5 years of age. 144 (36%) of 401 GPs undertook this survey. 84% were happy assessing infants (<1year) with UDT. 16% were unhappy discussing management with parents for palpable UDT. 52% were happy discussing malignant risk with parents. 80% thought that ultrasonography was routinely used. Optimal referral time was thought to be 6-12 months (42%) and time of surgery was 1-2 years (50%). 72% would refer a patient with palpable UDT after 6 months of age. Only 41% were happy to assess testicular size at puberty. 98% found this format of an educational survey was helpful. The average age of referral for patients <5 years improved significantly after educational intervention from 2.8 years in 2010 to 1.25 years in 2013 (p<0.01). With an interactive survey, we were able assess and also educate the regional GPs with regard to management of paediatric patients with UDT. There is a varied range of knowledge and practice demonstrated which we hoped to standardise and thereby increase efficiency and decrease the age of referral. A large majority would refer patients with UDT after 6 months of age that would make the target of surgery <6 months unachievable unless they are aware of current recommendations. This study is limited by a 36% response rate but that is comparable to other surveys. Also, referrals come from other sources that were not included. The causal effect of the educational survey is hypothesised. This educational survey has confirmed the varied management by GPs. The referral age was demonstrated to be reduced after this intervention and this process was widely accepted by GPs that undertook the educational survey.

The timing of surgery for undescended testis - a retrospective multicenter analysis.

n Germany, it is recommended that the surgical treatment of an undescended testis should be carried out between the ages of 6 months and 1 year to lower the risks of subfertility and testicular carcinoma. Although this recommendation has appeared in the German guidelines from 2007 onward, orchidopexy is still frequently performed at later ages. We retrospectively analyzed data from seven pediatric surgical services in the German state of Baden-Württemberg on all boys who underwent orchidopexy from 2009 to 2012. We classified the timing of surgery as Age Group I (before the first birthday), Age Group II (between the first and second birthdays), and Age Group III (after the second birthday). We determined whether preoperative hormonal treatment was given and distinguished primary from secondary undescended testis. Among 2213 boys who underwent orchidopexy, 1850 had primary and 363 had secondary undescended testis. Of those with primary undescended testis, the percentages of boys who underwent surgery in Age Groups I, II, and III were (respectively, with 95% confidence intervals): 18.7% (17-20.6%), 24.4% (22.5-26.5%), and 57% (54.6-59.2%). A small percentage of boys in each group also received preoperative hormonal treatment. From 2009 to 2012, there was a secular trend favoring earlier orchidopexy. In 2012, 28 boys (14.2% [9.7-20.0%]) had orchidopexy in outpatient pediatric surgery practices before their first birthday, while 68 did on hospital inpatient services (40.7% [33.2-48.6%]). Most of the patients studied had surgery at a later age than recommended. Adherence to the guidelines in this respect is nonetheless relatively good in Germany compared to other countries, as studies from abroad have yielded findings that are just as bad or worse.

Ultrasound guided transversus abdominis plane block in pediatric patients undergoing laparoscopic surgery

ObjectiveTo assess safety and effectiveness of ultrasound-guided TAP block in children undergoing laparoscopic surgery for undescended testis.Subjects and methodsThis randomized controlled trial involved 108 children, 3–7 years old, randomly allocated into one of two equal groups; TAP Group and Control Group. All children received general anesthesia using propofol 1.5–2.5 mg/kg, atracurium 0.5 mg/kg and fentanyl 2 μg/kg. TAP Group received 0.5 ml/kg of ropivacaine 0.375% bilaterally under ultrasound guidance and control group received regular analgesics. Quality of analgesia was assessed using Children’s Hospital Eastern Ontario Pain Scale (CHEOPS) and Objective behavioral pain score (OPS). The primary outcome measures were hemodynamic parameters and degree of pain. Secondary outcome measures were intraoperative fentanyl requirement, postoperative rescue analgesia (time and dose), complications, hospital stay and degree of satisfaction of patients and their parents.ResultsTAP block group had significantly lower intraoperative fentanyl dose (p < 0.001), significantly longer time to first postoperative request of analgesic (p < 0.001), lower analgesic dose during the first postoperative 24 h (p < 0.001) and lower pain scores along the whole 24 postoperative hours. Mean arterial pressure and heart rate were within the clinically accepted range in the two groups. Parents’ satisfaction was significantly higher (p < 0.001) in the TAP block group.ConclusionTAP block under ultrasound guidance was easy, safe, reliable and effective analgesic in children undergoing laparoscopic surgery for undescended testis.

Excision of Mullerian duct remnant for persistent Mullerian duct syndrome provides favorable short- and mid-term outcomes

ObjectiveIn dealing with persistent Mullerian duct syndrome (PMDS), excision of Mullerian duct remnant (MDR) has been rarely mentioned in the past, but recent discussions have taken place. This study aimed to evaluate the operative feasibility and outcomes. Materials and methodsThree patients with PMDS operated on with excision of MDR between 2000 and 2009 were enrolled. Medical records were retrospectively collected and reviewed. ResultsBilateral undescended testis was manifested in all cases. Two patients presented with incarcerated hernia, requiring emergency herniorrhaphy at the ages of 6 months and 10 days, respectively. Reconstruction comprising simultaneous MDR excision and orchiopexy was made at the age of 1 year. MDR was incidentally found in another patient during operation for undescended testis. Immediate reconstruction was accomplished. Follow-up periods were 12.0, 3.5, and 2.5 years, respectively. Worse outcomes were noted on the two testes with repeated operations for incarcerated hernias, whereas the outcomes on the other four testes with a single operation were favorable. ConclusionsExcision of MDR is technically feasible, and provides favorable outcomes in cases of a single operation. For experienced surgeons, immediate reconstruction should be the priority when this abnormality is incidentally encountered at an age suitable for orchiopexy.

Age of surgery for undescended testes in the peripheric regions of Turkey

Age of surgery for undescended testes in the peripheric regions of Turkey

Impact of Anatomical and Socioeconomic Factors on Timing of Urological Consultation for Boys With Cryptorchidism

Cryptorchidism is a common finding in infants and young boys. Early repair lessens the extent of testicular injury. We hypothesized that anatomical and socioeconomic factors affect the timing of consultation and treatment for boys with cryptorchidism. Under an institutional review board approved protocol we reviewed the records at a single institution of children who underwent exploration for unilateral or bilateral cryptorchidism. Demographic and anatomical factors were recorded. The median age of 677 boys at consultation and surgery was 20.3 and 28.9 months, respectively. Median age at consultation for boys with nonpalpable and palpable testicles was 12.3 and 20.9 months, respectively (p = 0.03). Boys with a concomitant penile anomaly had a younger median age at consultation than boys without a penile anomaly (8.5 vs 20.3 months, p <0.01). Demographic factors did not vary with respect to time to consultation and surgery (p >0.05). Multivariate analysis showed that abdominal site and concomitant penile anomaly were associated with earlier time to consultation (p = 0.02 and <0.01, respectively). The timing of consultation for boys with undescended testicles does not vary in regard to race, language or insurance type at this tertiary care institution. Instead, anatomical factors influenced age at consultation for boys with cryptorchidism. This suggests that in some geographic regions access to care is not restricted for minorities or noncommercially insured children.

An Appraisal Of Undesecended Testis In A Developing Country

The aim of this study is to evaluate the presentation , management and outcome of UDT in Ilorin, Nigeria. Medical records of all the children whounderwent surgery for undescended testis at University of Ilorin teaching Hospital from January 1998 to December 2007 were retrospectively reviewed for demographic information; level of descent; age atsurgery; intra operative findings; type of procedure; associated anomalies and postoperative complications. Forty six children had forty-nine undescended testes. Median age at surgery was 44 months, range, 1 month to 15years. A total of 47 orchidopexies and 2 orchidectomies were done. Right testis was involved in 24 (52.2%), left 19 (41.3%) and bilateral 3 (6.5%). Eleven (23.9%) patients had surgery before 2years, 25(54.3%) before 5years and 21 (45.7%) had surgery at 5 years and above. Thirty-four (69.4%) testes were palpable. Of thirty- seven patients with records of level of descent, seventeen (45.9%) testes were in externalring and 16 (43.2%) inguinal canal. Twenty two (44.9%) testes were macroscopically atrophic , 19(86.4%) of the 22 were in patients older than 2 years(P=0.035). Post operatively, the testes retracted in two patients and there were scrotal hematoma in two that resolved with non operative management. This study showed that there is delayed presentation andtherefore surgery in this setting. There is a need for public enlightment and screening programme in this sub region, directed at early detection and referral.

Screening of testicular descent in older boys is worthwhile: an observational study

Testicular descent in boys is now routinely screened only once, at 6-8 weeks of age. Early surgery for undescended testes is recommended. To assess the value of screening for testicular descent at 6-8 weeks, 8-9 months, and 39-42 months of age. Observational study. Royal Hospital for Sick Children, Glasgow and the Scottish community-based Child Health Surveillance Programme. Screening data for boys undergoing surgery for abnormal testicular descent between April 2006 and September 2007 was reviewed. The main outcome measure was median age at first operation for abnormal testicular descent comparing attendance at screening with non-attendance. Boys who attended screening underwent surgery at a significantly younger median age than boys who did not attend screening at 6-8 weeks (2.7 versus 7.7 years; P<0.001); 8-9 months (4.5 versus 9.7 years; P<0.001); and 39-42 months (7.8 versus 10.8 years; P = 0.014). A new diagnosis was made in 33% (42 of 128 boys) at 6-8 weeks, 28% (21/74) at 8-9 months, and 39% (15/38) at 39-42 months. Detection on screening did not always trigger referral. Referral was triggered by screening in 48% (62/128) of cases, and by incidental examinations in 27% (34/128). The previous screening regimen was effective, but checks at 8-9 months and 39-42 months have recently been abolished. Reinstatement of screening for testicular descent in older boys is advocated because screened boys underwent surgery at a younger age. Doctors should be encouraged to check testicular descent in boys throughout childhood, and refer promptly when there is any concern.

Partial duplication of vas deferens: How important is it?

This study reports a 1-year-old boy with unilateral partial duplication of vas deferens, diagnosed during surgery for undescended testis. Pediatric surgeons need to be aware of this kind of anomaly in order to avoid injury to this vital structure.