Blind ending vessels on diagnostic laparoscopy for nonpalpable testis: Is a nubbin present?

Kurzrock, Eric A.; Amend, Gregory; Shannon, Rachel; Gong, Edward M.; Cheng, Earl Y.

doi:10.1016/j.jpurol.2017.04.010

Cited by 12 publications

(9 citation statements)

References 24 publications

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“…In all our patients, laparoscopic abdominal exploration was performed first when the testis was not palpable under anesthesia. Intra-abdominal testis frequency in NPT patients has been defined as 40-61% in some studies [9,12,14,15]. In our study, 25 (46.2%) of the 54 NPTs were found to have testis in the abdomen.…”

Section: Discussionsupporting

confidence: 50%

“…An important evaluation step in patients without testis in intra-abdominal exploration is the evaluation of the testicular artery. The AUA and EAU/ESPU guidelines recommend inguinal exploration if the testicular vessels appear to have entered the inguinal canal, while further processing is not recommended in the presence of a vessel with a blind-ending [15,19]. However, Sturm et al reported that inguinal/scrotal nubbin was present in 72% of 36 cases whose testicular vessels ended blindly in laparoscopic exploration [15].…”

Section: Discussionmentioning

confidence: 99%

“…The AUA and EAU/ESPU guidelines recommend inguinal exploration if the testicular vessels appear to have entered the inguinal canal, while further processing is not recommended in the presence of a vessel with a blind-ending [15,19]. However, Sturm et al reported that inguinal/scrotal nubbin was present in 72% of 36 cases whose testicular vessels ended blindly in laparoscopic exploration [15]. Excision of nubbin tissue, if present, is the approach generally used in inguinal or scrotal exploration.…”

Section: Discussionmentioning

confidence: 99%

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Üçüncü basamak bir çocuk cerrahisi merkezinde çocuklarda palpe edilemeyen testislerin laparoskopik tedavisinin klinik sonuçları

et al. 2021

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Amaç: Palpe edilemeyen testis, erkek bir hastada testisin inguinal kanal ve skrotum içerisinde bulunmaması şeklinde tanımlanır. Hastada infertilite ve testiste malign transformasyon gelişim riskini engellemek için palpe edilemeyen testisin yerleşimi ve durumunun tanımlanması önemlidir. Amacımız, palpe edilemeyen testis tanılı çocuk hastalarda tedavide uyguladığımız laparoskopik yaklaşımın sonuçlarını değerlendirmekti. Yöntemler: Üçüncü basamak bir çocuk cerrahisi merkezinde palpe edilemeyen testis tanısı konulmuş ve laparoskopik yaklaşım ile tedavi edilmiş hastalar geriye dönük olarak incelendi. Hastaların özelliklerine göre tedavi protokolünde, laparoskopik abdominal eksplorasyon, iki aşamalı Fowler-Stephens laparoskopik orşiopeksi, primer laparoskopik orşiopeksi ve inguinal eksplorasyon uygulandı. Bulgular: Kırk beş çocuk hastadaki 54 testise ait veriler incelendi. Vakaların %46.2'sinde intra abdominal yerleşimli saptanan testislerin %88'i internal inguinal ring girişinde yerleşimliydi. Laparoskopik abdominal eksplorasyondan sonra testislerin 7 (%28)'sine iki aşamalı Fowler-Stephens, 18 (%72)'ine primer laparoskopik orşiopeksi uygulandı. Testis bulunamayan 27 (%50) vakaya inguinal eksplorasyon uygulandı. Skrotuma indirilen 23 testisin 17 (%73.9)'si normal iken, 6 (%26)'sında atrofi gelişti. Eksize edilen 27 inguinal nubbinde testis ait canlı hücreler saptanmadı. Sonuçlar: Palpe edilemeyen testisin tanı konulması ve tedavisinde laparaskopi güvenilir ve etkili bir yöntemdir. Abdomen içi testislerin yerleşim yeri, öncelikli cerrahi yaklaşım olarak inguinal eksplorasyonun düşünülmesini destekleyebilir.

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Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Üçüncü basamak bir çocuk cerrahisi merkezinde çocuklarda palpe edilemeyen testislerin laparoskopik tedavisinin klinik sonuçları

et al. 2021

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“…The debate over the management of boys with testicular regression syndrome is still ongoing. The exploration and excision of testicular remnants, as well as blind ending vessels associated with a nubbin, are recommended by many authors, as seminiferous tubules and germ cells may be found in them [ 31 , 32 ]. However, only single cases of germ cell neoplasia in a testicular remnant are reported in the literature [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

The effect of the two-stage laparoscopic Fowler-Stevens operation on testicular growth and risk of atrophy in boys with intra-abdominal testes

et al. 2019

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Introduction: The aim of our study was to evaluate testicular growth and risk of atrophy at different lengths of time from the 2SLF-SO in boys with intra-abdominal cryptorchidism. Material and methods: Twenty-seven boys aged one to 24 months were treated for 35 non-palpable testes. Twenty-one boys with 29 IAT underwent a two-stage laparoscopic Fowler-Stephens operation. The patients underwent ultrasound examination of the TV at six time points: before treatment (TP1), 3 months (TP2) and 9-12 months after laparoscopic F-S operation (TP3), 3 months after inguinal orchidopexy (TP4), 3-6 years of age (TP5) and 7-9 years of age (TP6). The testicular atrophy index (TAI) of the affected testicle was calculated. Results: The overall success rate of treatment was 93.1% (27/29). The median volume of the affected testicles before treatment was less than the median TV of the healthy gonad, but increased systematically at the successive time points, showing significant growth between the second and sixth time points (p < 0.02, R = 2.75). The median TAI value decreased at the subsequent time points from the level of 26% at TP1 to 5.4% at TP6, with no significant difference. Conclusions: Two-stage laparoscopic Fowler-Stevens operation proved to be an effective procedure for the treatment of intra-abdominal testicles. The undescended testis had a chance to grow and to equalize with the healthy testis after this procedure. The incidence of testicular atrophy was low.

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“…At the end of the laparoscopy, given that the internal ring was closed, the testicular nubbin was excised through a small inguinal incision. 4 The histological exam revealed fibrous–muscular–adipose tissue.…”

Section: Case Reportmentioning

confidence: 98%

Laparoscopic Finding of Ectopic Adrenocortical Tissue in a 2-Year-Old Boy with Vanishing Testis

Marte

2018

European J Pediatr Surg Rep

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Blind ending vessels on diagnostic laparoscopy for nonpalpable testis: Is a nubbin present?

Cited by 12 publications

References 24 publications

Üçüncü basamak bir çocuk cerrahisi merkezinde çocuklarda palpe edilemeyen testislerin laparoskopik tedavisinin klinik sonuçları

Üçüncü basamak bir çocuk cerrahisi merkezinde çocuklarda palpe edilemeyen testislerin laparoskopik tedavisinin klinik sonuçları

The effect of the two-stage laparoscopic Fowler-Stevens operation on testicular growth and risk of atrophy in boys with intra-abdominal testes

Laparoscopic Finding of Ectopic Adrenocortical Tissue in a 2-Year-Old Boy with Vanishing Testis

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