Optimal Management of Undescended Testis in Boys with Cerebral Palsy. A Debate

Springer, Alexander

doi:10.1159/000496463

Cited by 5 publications

(10 citation statements)

References 53 publications

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“…Usually, caregivers' wishes regarding treatment options are taken into account. It appears that especially non-palpable and high positioned testes are associated with a potentially higher risk of the negative consequences of this disorder (35), which confirms Allin et al, reporting that atrophy and complication rates do not appear different between early and delayed orchidopexy (36). Therefore, the positioning of the gonad in the subcutaneous area in the inguinal canal enables further control.…”

Section: Discussionsupporting

confidence: 56%

Is Testicular Torsion a Real Problem in Pediatric Patients With Cryptorchidism?

et al. 2021

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Purpose: To present management and outcomes of patients with cryptorchidism suffering from testicular torsion.Methods: This is a retrospective review of pediatric patients with torsion of undescended testes, who were treated between 2009 and 2019. We recorded: the age, symptoms, duration of torsion, results of physical examination, surgery findings, and additional treatment. Additionally, an extensive online literature search, from 2015–2020, was performed to identify other similar case series.Results: We identified 9 boys with torsion of the undescended gonad, which represented 4.7% of all 192 boys with testicular torsion. The mean age of boys with torsion of undescended testis was 8.7 years. The mean duration of symptoms in our study group was long and it was up to 28.5 h. All patients had inguinal canal exploration. In eight cases, testicular necrosis and primary orchidectomy was performed. Furthermore, 45 cases were identified in the literature and reviewed.Conclusion: According to clinical experience and available studies, torsion of male undescended gonads is a comparatively rare condition. Nevertheless, diagnosis is still delayed and connected with inevitable orchidectomy.

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Section: Discussionsupporting

confidence: 56%

Is Testicular Torsion a Real Problem in Pediatric Patients With Cryptorchidism?

et al. 2021

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“…Sometimes, a disagreement might exist between the CP family, care provider, and medical specialist. 8 In the present case, the prognosis of hydranencephaly was generally so poor that it seemed obvious that UDT was not a prioritized physical problem. However, once the patient developed testicular cancer, we could not find any reviews or case reports providing the optimal management of testicular cancer in severe CP patients.…”

Section: Discussionmentioning

confidence: 52%

“…These rationales should not be different between boys with CP and those without neurological impairment. However, the decision‐making process in cases of UDT with CP is sometimes difficult, not only because the risk of anesthesia and life expectancy vary among patients, but also because such cases usually involve challenging ethical issues 8 . To practice in the best interest of the patient, clinicians, and family members should consider all options and weigh the potential benefit of treatment (orchiopexy or orchiectomy) against its risks.…”

Section: Discussionmentioning

confidence: 99%

A case of testicular cancer in a long‐term hydranencephaly survivor with undescended testes

Hirata,

Shinojima,

Yokota

et al. 2024

IJU Case Reports

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IntroductionThe development of malignant tumors in patients with hydranencephaly is extremely rare. We describe the first case of testicular cancer that developed in the undescended testes of a long‐term survivor of hydranencephaly.Case presentationA 32‐year‐old man with severe cerebral palsy due to hydranencephaly was referred to our department for the evaluation of a subcutaneous lump in the lower right abdomen. He was a long‐term survivor of hydranencephaly. After confirming the diagnosis of right testicular cancer originating in his undescended testes, surgical resection was performed. Pathological examination revealed a mixed‐type germ cell tumor.ConclusionThe decision‐making process for treating malignant tumors, like testicular cancer, in adults with severe cerebral palsy can be challenging. Clinical ethics consultation could be helpful in avoiding treatment delays.

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“…Usually, caregivers' wishes regarding treatment options are taken into account. It appears that especially nonpalpable and high positioned testes are associated with a potentially higher risk of the negative consequences of this disorder (31). Therefore, the positioning of the gonad in the subcutaneous area in the inguinal canal enables further control.…”

Section: Discussionmentioning

confidence: 99%

Is testicular torsion a real problem in pediatric patients with cryptorchidism?

Komarowska

Pawelczyk

Matuszczak

et al. 2020

Preprint

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PurposeTo present management and outcomes of patients with cryptorchidism suffering from testicular torsion.MethodsThis is a retrospective review of pediatric patients with torsion of undescended testes, who were treated between 2009 and 2019. On the medical charts, we recorded: the age, symptoms, duration of torsion, physical examination, surgery findings, and additional treatment.ResultsWe identified 9 boys with torsion of the undescended gonad, which represented 4.7% of all 192 boys with testicular torsion. The mean age of boys with torsion of undescended testis was 8.7 years. The mean duration of symptoms in our study group was long and it was up to 28.5 hours. All patients had inguinal canal exploration. In 8 cases, testicular necrosis and primary orchidectomy was performed.ConclusionAccording to clinical experience and available studies, torsion of male undescended gonads is a comparatively rare condition. Nevertheless, diagnosis is still delayed and connected with inevitable orchidectomy.Plain English summaryAuthors present 9 cases of boys with torsion of undescended testes. They represented 4.7% of all boys with testicular torsion treated during 10 years in Pediatric Surgery Department. The mean age of boys with torsion of undescended testis was 8.7 years. The mean duration of symptoms was long and it was up to 28.5 hours. All patients were operated on, in 8 cases necrotic testicle was removed. Even though torsion of undescended testicle is quite rare, diagnosis is delayed and because of that, boys are subjected to removal of the testicle.

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Optimal Management of Undescended Testis in Boys with Cerebral Palsy. A Debate

Cited by 5 publications

References 53 publications

Is Testicular Torsion a Real Problem in Pediatric Patients With Cryptorchidism?

Is Testicular Torsion a Real Problem in Pediatric Patients With Cryptorchidism?

A case of testicular cancer in a long‐term hydranencephaly survivor with undescended testes

Is testicular torsion a real problem in pediatric patients with cryptorchidism?

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