Findings concerning testis, vas deference, and epididymis in adult cases with nonpalpable testes

Şahin, Coşkun; Kalkan, Mehmet; Yalcinkaya, Soner

doi:10.1590/s1677-55382011000600007

Cited by 8 publications

(4 citation statements)

References 14 publications

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“…This finding of ours support the viewpoint which asserts that intraabdominal testes are more severely affected. [9] In our clinic age of the patients at the time of operation ranges between 9-12 months, however in our study it varied between 10 months, and 17 years (median, 66 months). This means that patients present to the health centers at an advanced age.…”

Section: Discussionmentioning

confidence: 55%

Laparoscopic management and its outcomes in cases with nonpalpable testis

Erdoğan¹,

Bahadır²,

Taşkınlar³

et al. 2017

Turkish Journal of Urology

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Objective: Diagnostic laparoscopy is the gold standard in the algorithm of nonpalpable testis. Testicular tissue is examined and treatment is planned accordingly. In this study we reviewed the place of diagnostic laparoscopy, and evaluated the results and effectiveness of laparoscopy in the diagnosis and management of nonpalpable testis. Material and methods:Children who had diagnostic laparoscopy for nonpalpable testes were included in the study. Physical examination results, ultrasonography (USG) reports, age at surgery, laparoscopic and inguinal exploration findings, surgical procedures, orchiopexy results, early and late-term complications were evaluated. Follow-up visits were performed at 3-month intervals for the first, at 6-month intervals for the 2. year, then at yearly intervals. Testicular size and location was evaluated by during control examination.Results: Overall 58 boys, and 68 testes (26 left: 44.8%; 22 right: 37.9%, and 10 bilateral: 17.2%) were included in the study. Mean age at surgery was 5.5 years (10 months-17 years). Diagnostic value of USG was 15.7%. Diagnostic laparoscopy findings were as follows: Group 1: blind-ended vessels, n=7 (10.2%); Group 2: intraabdominal testes, n=8 (11.7%); Group 3: vas and vessels entering internal ring, n=53 (77.9%). Overall 43 testes underwent orchiopexy, which were normal (n=8) or hypoplastic (n=35). Mean follow-up period was 19 months (1-12 years), and on an average 7 visits were performed (5-14). On follow-up, 5 testes were normal-sized and located in the scrotum, while 4 testes were atrophic and underwent orchiectomy. Two testes were found in the inguinal canal and redo orchiopexy was performed. Control USG revealed reduced testicular blood supply and volume. Conclusion:Laparoscopic surgery is safe and effective in the management of nonpalpable testes. In the majority, routine use of diagnostic laparoscopy in the algorithma does not confer any additional contributions in many patients.

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Section: Discussionmentioning

confidence: 55%

Laparoscopic management and its outcomes in cases with nonpalpable testis

Erdoğan¹,

Bahadır²,

Taşkınlar³

et al. 2017

Turkish Journal of Urology

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“…The undescended testis was found to show atropic changes in a study by Sahin and his coworker in 2011 5 . However, in the present case, part of the testes within the inguinal canal was narrower and did not show any different histological changes than the part of the testes in the abdominal cavity near the deep inguinal ring.…”

Section: Discussionmentioning

confidence: 99%

“…It was attached to the testis only at the head and tail locations in 61.53% of cases and was totally attached to the testis in 37.76% of cases. Interestingly, it was shown that in case of absence of epididymis, testis did not descend from its embryonic position 5 . However, in the present case, the most of the parts of the epididymis was closer to the upper pole of the testis and more than half of proximal part of the testis towards the lower pole was free from the attachment of epididymis.…”

Section: Discussionmentioning

confidence: 99%

Anormal İnmemiş Testis Tespit Edilen Bir Yetişkin Hasta

Sushma¹,

Yk²,

Bhat³

2014

Cukurova Medical Journal

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Normally testis is developed in the abdomen and descends in to the designated scrotal sac at the time of birth or within one or two years after birth. Several factors are associated with proper descent of the testis. Failure to descend, may lead to undescended testis or cryptorchidism. In the present case, we found an undescended testis partly in the inguinal canal and partly in the abdomen in a 71-year-old male cadaver. The epididymis descended first and its major portion was outside the superficial inguinal ring. The rest of the flattened epididymis was found inside the canal attached to the upper tapered pole of the testis and the vas deferens was found arising from this portion. The testicular vessels traversing through the deep inguinal ring then entered the postero-lateral portion of the tapered portion of the testis within the canal. No torsion and necrotic changes were observed in the undescended testis. Histological examination revealed a normal pattern in the epididymis which was outside the canal and a primitive duct system in the part of the epididymis within the canal. However, the entire testis showed only non-canalized smaller seminiferous tubules with very few cellular components and large inter-tubular spaces. The most common problems associated with such undescended testes are altered fertility, testicular cancer, inguinal hernia and testicular torsion with necrosis. Therefore, identifying the condition, evaluating the associated syndromes, proper diagnosis and therapeutic strategies are very important to prevent the adverse consequences mentioned above. Key Words: Undescended testis, epididymis, inguinal canal, cryptorchidism, testicular torsion. ÖZETNormalde testis abdomende gelişir ve doğum sırasında yada 1 veya 2 yıl içinde skrotal kese içine iner. Farklı faktörler testisin inmesi ile ilişkilendirilir. İnmede meydana gelen hata inmemiş testise veya kriptorşidizme neden olabilir. Sunulan bu vakada, 71 yaşında ki erkek bir kadavrada kısmen abdomende ve inguinal kanalda inmemiş testisini tespit ettik. İlk olarak inen epididimis ve onun büyük parçası yüzeysel inguinal halkanın dışında idi. Derin inguinal halkalar boyunca ilerleyen testiküler damarlar kanal içinde testisin konik kısmının postero-lateral kısmına dahil oldu. Bükülme (torsiyon) veya nekrotik değişimler inmemiş testiste gözlendi. Histolojik inceleme, kanal içinde epididimis kısmında birincil kanal sisteminde ve kanalın dışında olan epididimiste normal görüntüyü ortaya çıkardı ancak; tüm testis incelemeleri, sadece büyük inter-tübüler boşluklar ve hücresel yapılar ile kanalize olmayan küçük seminifer tübülleri ortaya çıkardı. Bunun gibi inmemiş testis ile ilişkili en yaygın problemler fertilite, testiküler kanser, inguinal hernia ve nekroz ile testiküler torsiyondur. Dolayısıyla; bu durumların doğru tespiti, ilişkili sendromların uygun teşhis ve tedavisel stratejileri yukarıda bahsedilen olumsuz sonuçları önlemede oldukça önemlidir.

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“…Complete absence of the epididymis is a frequent anomaly in anorchidism and monorchidism, but seen in only 0.69% of undescended testes [9] (Fig. 12.2).…”

Section: Epididymal Anomaliesmentioning

confidence: 99%

Perspectives in Pediatric Pathology, Chapter 12. Congenital Epididymal Anomalies

et al. 2016

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Congenital anomalies of the epididymis are frequent. Their understanding requires familiarity with their embryological origins. They are important given their impact on fertility. INTRODUCTION. EMBRYOLOGIC REMARKS John Hunter (1728-1793), the great Scottish surgeon whose many contributions advanced medicine in general and pathology in particular, was among the first to provide detailed descriptions of the male genital system in many species, including his elegant account of absent ductus deferens in a man: ''In dissecting a male subject, in the year 1755, for a side view of the contents of the pelvis, I found a bag on the left side, lying contiguous to the peritonaeum, just on the side of the pelvis where the internal iliac vessels divide above the angle of reflection of the peritonaeum at the union of the bladder and rectum. The left vas deferens was seen passing on to this bag; and what is very singular, that of the right, or opposite side, crossed the bladder, near its union with the rectum, to join it. I traced the left vas deferens down to the testicle; but, on following the right through the ring of the external oblique muscle, I discovered that it terminated at once, about an inch from its passage out of the abdomen, in a blunt point, which was impervious. On examining the spermatic chord from this point to the testicle, I could not find any vas deferens; but, by beginning at the testicle, and tracing the epididymis from its origin, about halfway along where it lies upon the body of the testicle, I perceived that it at first became straight, and soon after seemed to terminate in a point" [1]. Malformations of sperm excretory ducts have been recorded in the medical literature for more than two centuries. Mainly in the last two decades has interest in this field increased, thanks to new medical developments. These include a more complete assessment of infertile patients and modern techniques, such as transrectal

show abstract

Findings concerning testis, vas deference, and epididymis in adult cases with nonpalpable testes

Cited by 8 publications

References 14 publications

Laparoscopic management and its outcomes in cases with nonpalpable testis

Laparoscopic management and its outcomes in cases with nonpalpable testis

Anormal İnmemiş Testis Tespit Edilen Bir Yetişkin Hasta

Perspectives in Pediatric Pathology, Chapter 12. Congenital Epididymal Anomalies

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