Objective:To evaluate the management and outcomes of patients who presented with torsion of an undescended testis and review the reported series in the literature.Methods:The case records of 13 patients operated for t...Objective:To evaluate the management and outcomes of patients who presented with torsion of an undescended testis and review the reported series in the literature.Methods:The case records of 13 patients operated for testicular torsion involving undescended testis were retrospectively reviewed.The medical records included age at presentation,medical history,physical examination,operative findings and the results of follow-up.The diagnosis of torsion of undescended testis was made clinically and confirmed by inguinal exploration.Results:In six cases the testis was preserved and orchiopexy was performed,while in seven cases orchidectomy was performed due to testicular gangrene in six patients and testicular tumor discovered peroperatively in one case.Mean duration of symptoms at time of surgery in the orchiopexy group was 6.5 h and in the orchidectomy group was 21.2 h.From six patients treated by orchiopexy,two patients suffered from testicular atrophy at a mean of 24 months.Conclusion:Testicular torsion in undescended testis is still diagnosed with delay which may affect testicular salvage.The importance of examination of external genital organs is highlighted which should be routinely included by emergency physicians in physical examination for abdominal or groin pain.展开更多
Purpose: To present our experience with laparoscopic management of the non-palpable undescended testis. Patients and Methods: Between Nov. 2010 and Oct. 2012, 47 non-palpable testes in 41 patients were evaluated prosp...Purpose: To present our experience with laparoscopic management of the non-palpable undescended testis. Patients and Methods: Between Nov. 2010 and Oct. 2012, 47 non-palpable testes in 41 patients were evaluated prospectively by laparoscopy. The age of the patients at the time of surgery varied from 1 to 9 years with a mean age of 2.85 years. Testicular viability and location were evaluated by physical examination and Doppler ultrasonography after 1 and 3 months. Results: Out of 49 testicular units, 47 (95.9%) were successfully treated by laparoscopic orchiopexy. 45 testicular units (91.8%) were treated by one-stage laparoscopic orchiopexy, 2 (4.1%) were treated by two-stage laparoscopic orchiopexy and 2 (4.1%) diagnosed as vanishing testis with detection of blind end spermatic vessels and vas deferens during laparoscopy. Physical examination and Doppler study demonstrated that 46 of 47 testes (97.9%) were viable and 45 of 47 (95.7%) were located in the lower scrotum and 2 of 47 (4.3%) in the upper scrotum at the end of follow-up. Conclusion: The laparoscopy is a reliable technique for diagnosis and treatment of the non-palpable intra-abdominal testis with high success and survival rates of the testes.展开更多
Introduction: Undescended testis is a genital pathology of pediatric age. But it is not rare that the diagnosis of this pathology is made in adults, especially in low income countries with management problems as Benin...Introduction: Undescended testis is a genital pathology of pediatric age. But it is not rare that the diagnosis of this pathology is made in adults, especially in low income countries with management problems as Benin Republic. The purpose of this study was to describe the epidemiology and therapeutic aspects of this congenital malformation in adults, in HKM University Teaching Hospital of Cotonou. Material and Method: It was a retrospective, cross-sectional and descriptive study, conducted from January 1, 2007 to December 31, 2016. Patient files served as data collecting support. All the patients aged 16 years and older were included in this study, treated and followed in the urology clinic department for undescended testis. Results: Twenty-three files were selected. The most represented age group was 16 to 20 years of age. The average consultation time from the observation of the anomaly was 213.6 months. The vacuity of the scrotum was the main reason for consultation. The absence of an intra-scrotal testis was the most clinical finding. The testis was found in the inguinal canal in 15 patients. Surgical re-positioning testis in scrotal location had been conducted for all patients and the open surgery was the only modality. Orchiectomy was performed in presence of atrophic testis. Any complication was reported in postoperative time. Later, two retractions of the testis and two testicular hypotrophies were seen. Semen control (spermograms) revealed persistence of azoospermia in three patients and astheno-zoospermia in another. Conclusion: Cryptorchidism is a pathology of the child but can still be seen in adults in our context. The main reason for consultation is the vacuity of scrotum but also paternity desire. Surgical lowering is the rule. In adults, its main purpose is the surveillance for the easy and early detection of a testicular tumor.展开更多
<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Undescended testis is the commonest disorder affecting the male urogenital t...<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Undescended testis is the commonest disorder affecting the male urogenital tract. Late presentation has significant socio-medical impact on the individual’s quality of life. </span><b><span style="font-family:Verdana;">Aim:</span></b><span style="font-family:Verdana;"> To evaluate the presentation of undescended testis and age at surgery in our centre. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">A 9-year retrospective analysis of the clinical records of patients < 18 years managed for undescended testis in our centre. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> A total of 73 records were analysed, 58 (79.5%) presented > 1 year. Median age at presentation was 4 years, range 1 day - 16 years. Males 73 (100%), only 17 (23.3%) were referred by health personnel, while 56 (76.7%) self-referred. Commonest site involved was the left 33 (45.2%), 29 (39.7%) right and 11 (15.1%) bilateral. There were 13 </span><span style="font-family:Verdana;">(17.4%) who had associated congenital malformations. Hypospadias 7</span><span style="font-family:Verdana;"> (53.8%), isolated micropenis 4 (30.8%) and 1 each (7.7%) had myelomeningocele and hernia. Median age at presentation for bilateral involvement was 30 days, with associated hypospadias was 12 days, while those with isolated micropenis was 7.5 years. Median age at surgery for bilateral involvement was 2 years, overall median age at surgery was 4 years. </span><b><span style="font-family:Verdana;">Surgery Findings:</span></b><span style="font-family:Verdana;"> Supra-scrotal testis 47, canalicular 25 (34.2%), and bilateral abdominal 1 (1.4%). </span><b><span style="font-family:Verdana;">Outcome:</span></b><span style="font-family:Verdana;"> Wound infections 4 (5.5%), scrotal wound breakdown 1, Recurrence 3 and testicular atrophy 1. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Our patients presented very late beyond the recommended age for surgery, evaluating for DSD also contributed to delay in intervention even when these patients presented early. We advocate for </span><span style="font-family:Verdana;">early screening at birth, during routine child immunization and school</span><span style="font-family:Verdana;"> enrollment, with prompt referral.</span></span>展开更多
Aim: This study aimed to evaluate the results of the laparoscopic treatment of high and intra-abdominal undescended testes. Methods: A retrospective study was carried out from 2014 to 2021 at the Centre medico-chirugi...Aim: This study aimed to evaluate the results of the laparoscopic treatment of high and intra-abdominal undescended testes. Methods: A retrospective study was carried out from 2014 to 2021 at the Centre medico-chirugicale d’urologie in Douala. We consulted the clinical records of 27 patients aged 6 - 15 years who underwent laparoscopic orchiopexy at our hospital. We included patients with unilateral or bilateral undescended testes as detected by palpation and excluded patients with incomplete clinical records. The data collected were entered into Microsoft Excel 2016 and exported to Epi info 7 for analysis. Continuous variables were presented as mean values and standard deviations while categorical variables were presented as frequencies and percentages. The threshold for statistical significance was set at p Results: The ages of the 27 participants ranged from 6 years to 15 years, with a mean age of 10.22 ± 2.68 years. Hypospadias was an associated abnormality in 7.41% of participants. The mean duration of the surgical procedure was 80.56 ± 30.30 minutes. The overall success rate of the laparoscopic procedure was 95.83%. The mean duration of postoperative hospital stay was 26.67 ± 7.69 hours. The only postoperative complication we encountered was testicular atrophy, which occurred in 7.41% of participants. All our patients underwent single-stage laparoscopic procedures. Conclusion: Laparoscopy, which is the technique of choice for the diagnosis and management of undescended testis, is more rapid, more effective, and characterized by a shorter hospital stay and fewer postoperative complications compared to open surgery. Single-stage procedures are as effective and safe as two-stage procedures.展开更多
Background: Splenogonadal fusion is a rare congenitalanomaly which is characterized by fusion formationbetween the spleen and gonad.Methods: We report a case of a 14-month boy withspleongonadal fusion-limb deformity s...Background: Splenogonadal fusion is a rare congenitalanomaly which is characterized by fusion formationbetween the spleen and gonad.Methods: We report a case of a 14-month boy withspleongonadal fusion-limb deformity syndrome focusingon the importance of awareness of this syndrome.Results: The patient was admitted to our clinic becauseof a left undescended testis, and preoperative diagnosiswas not made. During the operation, "spleen-like" tissueattached to the gonad induced splenogonadal fusion, whichwas confi rmed by laparoscopy. The patient also had a shortright femur, hip dysplasia and a syndromic face.Conclusion: Splenogonadal fusion anomaly shouldbe considered in the evaluation of undescended testis,especially in patients with facial and limb deformities.展开更多
目的探讨经脐单一切口腹腔镜联合2 mm trocar治疗腹腔型隐睾的应用价值。方法 2009年11月~2011年1月,采用经脐单一切口腹腔镜联合2 mm trocar治疗11例腹腔型隐睾。脐下缘1.5 cm弧形切口,置入自制多通道trocar,置入5 mm腹腔镜和操作器械...目的探讨经脐单一切口腹腔镜联合2 mm trocar治疗腹腔型隐睾的应用价值。方法 2009年11月~2011年1月,采用经脐单一切口腹腔镜联合2 mm trocar治疗11例腹腔型隐睾。脐下缘1.5 cm弧形切口,置入自制多通道trocar,置入5 mm腹腔镜和操作器械1把,脐与耻骨联合连线中点处直接穿刺置入2 mm trocar,置入2 mm腹腔镜抓钳,进行手术。结果 10例11侧成功将隐睾下降固定于阴囊;1例1侧行隐睾切除术。手术时间30~70 min,平均45 min。无手术并发症发生。10例随访3~14个月,平均8.8月,未发现下降的睾丸萎缩。结论经脐单一切口腹腔镜联合2 mm trocar治疗操作不复杂的腹腔型隐睾可行。展开更多
Background: Cryptorchidism is one of the most common genitourinary disorders in young boys. About 1% - 2% of boys at age of 1 year have an undescended testis (UDT);this disorder is unilateral in about 90% of individua...Background: Cryptorchidism is one of the most common genitourinary disorders in young boys. About 1% - 2% of boys at age of 1 year have an undescended testis (UDT);this disorder is unilateral in about 90% of individuals and bilateral in about 10%. However, bilateral impalpable testes represent a special category that should be differentiated from anorchidism as well as male pseudohermaphroditism. We investigated whether bilateral impalpable testes with its inherent hormonal and genetic factors has different outcomes in terms of success of orchiopexies compared to unilateral impalpable testes. Methods: We retrospectively analyzed the demographic and clinical findings, as well as immediate and 6 month outcomes, in patients diagnosed with bilateral impalpable undescended testes between 2006 and 2010. Findings were reported after a minimum of 6 months from the last surgical intervention. Results: Nine patients underwent laparoscopy for bilateral impalpable testes, 7 of whom had testes in the region of the internal inguinal ring. The success rate after laparoscopic exploration and open orchiopexy was 60% while the success rate with unilateral impalpable testes was 63.3% in the same study. Conclusion: Although laparoscopy is extremely useful in both the diagnosis and treatment of patients with bilateral impalpable testes, laparoscopy should be preceded by careful cytogenetic and hormonal workup for this particular group of patients. We found that the success rates of laparoscopic management of bilateral and unilateral impalpable testes were similar, as shown by testicular size clinically sassed during serial postoperative outpatient visits.展开更多
文摘Objective:To evaluate the management and outcomes of patients who presented with torsion of an undescended testis and review the reported series in the literature.Methods:The case records of 13 patients operated for testicular torsion involving undescended testis were retrospectively reviewed.The medical records included age at presentation,medical history,physical examination,operative findings and the results of follow-up.The diagnosis of torsion of undescended testis was made clinically and confirmed by inguinal exploration.Results:In six cases the testis was preserved and orchiopexy was performed,while in seven cases orchidectomy was performed due to testicular gangrene in six patients and testicular tumor discovered peroperatively in one case.Mean duration of symptoms at time of surgery in the orchiopexy group was 6.5 h and in the orchidectomy group was 21.2 h.From six patients treated by orchiopexy,two patients suffered from testicular atrophy at a mean of 24 months.Conclusion:Testicular torsion in undescended testis is still diagnosed with delay which may affect testicular salvage.The importance of examination of external genital organs is highlighted which should be routinely included by emergency physicians in physical examination for abdominal or groin pain.
文摘Purpose: To present our experience with laparoscopic management of the non-palpable undescended testis. Patients and Methods: Between Nov. 2010 and Oct. 2012, 47 non-palpable testes in 41 patients were evaluated prospectively by laparoscopy. The age of the patients at the time of surgery varied from 1 to 9 years with a mean age of 2.85 years. Testicular viability and location were evaluated by physical examination and Doppler ultrasonography after 1 and 3 months. Results: Out of 49 testicular units, 47 (95.9%) were successfully treated by laparoscopic orchiopexy. 45 testicular units (91.8%) were treated by one-stage laparoscopic orchiopexy, 2 (4.1%) were treated by two-stage laparoscopic orchiopexy and 2 (4.1%) diagnosed as vanishing testis with detection of blind end spermatic vessels and vas deferens during laparoscopy. Physical examination and Doppler study demonstrated that 46 of 47 testes (97.9%) were viable and 45 of 47 (95.7%) were located in the lower scrotum and 2 of 47 (4.3%) in the upper scrotum at the end of follow-up. Conclusion: The laparoscopy is a reliable technique for diagnosis and treatment of the non-palpable intra-abdominal testis with high success and survival rates of the testes.
文摘Introduction: Undescended testis is a genital pathology of pediatric age. But it is not rare that the diagnosis of this pathology is made in adults, especially in low income countries with management problems as Benin Republic. The purpose of this study was to describe the epidemiology and therapeutic aspects of this congenital malformation in adults, in HKM University Teaching Hospital of Cotonou. Material and Method: It was a retrospective, cross-sectional and descriptive study, conducted from January 1, 2007 to December 31, 2016. Patient files served as data collecting support. All the patients aged 16 years and older were included in this study, treated and followed in the urology clinic department for undescended testis. Results: Twenty-three files were selected. The most represented age group was 16 to 20 years of age. The average consultation time from the observation of the anomaly was 213.6 months. The vacuity of the scrotum was the main reason for consultation. The absence of an intra-scrotal testis was the most clinical finding. The testis was found in the inguinal canal in 15 patients. Surgical re-positioning testis in scrotal location had been conducted for all patients and the open surgery was the only modality. Orchiectomy was performed in presence of atrophic testis. Any complication was reported in postoperative time. Later, two retractions of the testis and two testicular hypotrophies were seen. Semen control (spermograms) revealed persistence of azoospermia in three patients and astheno-zoospermia in another. Conclusion: Cryptorchidism is a pathology of the child but can still be seen in adults in our context. The main reason for consultation is the vacuity of scrotum but also paternity desire. Surgical lowering is the rule. In adults, its main purpose is the surveillance for the easy and early detection of a testicular tumor.
文摘<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Undescended testis is the commonest disorder affecting the male urogenital tract. Late presentation has significant socio-medical impact on the individual’s quality of life. </span><b><span style="font-family:Verdana;">Aim:</span></b><span style="font-family:Verdana;"> To evaluate the presentation of undescended testis and age at surgery in our centre. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">A 9-year retrospective analysis of the clinical records of patients < 18 years managed for undescended testis in our centre. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> A total of 73 records were analysed, 58 (79.5%) presented > 1 year. Median age at presentation was 4 years, range 1 day - 16 years. Males 73 (100%), only 17 (23.3%) were referred by health personnel, while 56 (76.7%) self-referred. Commonest site involved was the left 33 (45.2%), 29 (39.7%) right and 11 (15.1%) bilateral. There were 13 </span><span style="font-family:Verdana;">(17.4%) who had associated congenital malformations. Hypospadias 7</span><span style="font-family:Verdana;"> (53.8%), isolated micropenis 4 (30.8%) and 1 each (7.7%) had myelomeningocele and hernia. Median age at presentation for bilateral involvement was 30 days, with associated hypospadias was 12 days, while those with isolated micropenis was 7.5 years. Median age at surgery for bilateral involvement was 2 years, overall median age at surgery was 4 years. </span><b><span style="font-family:Verdana;">Surgery Findings:</span></b><span style="font-family:Verdana;"> Supra-scrotal testis 47, canalicular 25 (34.2%), and bilateral abdominal 1 (1.4%). </span><b><span style="font-family:Verdana;">Outcome:</span></b><span style="font-family:Verdana;"> Wound infections 4 (5.5%), scrotal wound breakdown 1, Recurrence 3 and testicular atrophy 1. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Our patients presented very late beyond the recommended age for surgery, evaluating for DSD also contributed to delay in intervention even when these patients presented early. We advocate for </span><span style="font-family:Verdana;">early screening at birth, during routine child immunization and school</span><span style="font-family:Verdana;"> enrollment, with prompt referral.</span></span>
文摘Aim: This study aimed to evaluate the results of the laparoscopic treatment of high and intra-abdominal undescended testes. Methods: A retrospective study was carried out from 2014 to 2021 at the Centre medico-chirugicale d’urologie in Douala. We consulted the clinical records of 27 patients aged 6 - 15 years who underwent laparoscopic orchiopexy at our hospital. We included patients with unilateral or bilateral undescended testes as detected by palpation and excluded patients with incomplete clinical records. The data collected were entered into Microsoft Excel 2016 and exported to Epi info 7 for analysis. Continuous variables were presented as mean values and standard deviations while categorical variables were presented as frequencies and percentages. The threshold for statistical significance was set at p Results: The ages of the 27 participants ranged from 6 years to 15 years, with a mean age of 10.22 ± 2.68 years. Hypospadias was an associated abnormality in 7.41% of participants. The mean duration of the surgical procedure was 80.56 ± 30.30 minutes. The overall success rate of the laparoscopic procedure was 95.83%. The mean duration of postoperative hospital stay was 26.67 ± 7.69 hours. The only postoperative complication we encountered was testicular atrophy, which occurred in 7.41% of participants. All our patients underwent single-stage laparoscopic procedures. Conclusion: Laparoscopy, which is the technique of choice for the diagnosis and management of undescended testis, is more rapid, more effective, and characterized by a shorter hospital stay and fewer postoperative complications compared to open surgery. Single-stage procedures are as effective and safe as two-stage procedures.
文摘Background: Splenogonadal fusion is a rare congenitalanomaly which is characterized by fusion formationbetween the spleen and gonad.Methods: We report a case of a 14-month boy withspleongonadal fusion-limb deformity syndrome focusingon the importance of awareness of this syndrome.Results: The patient was admitted to our clinic becauseof a left undescended testis, and preoperative diagnosiswas not made. During the operation, "spleen-like" tissueattached to the gonad induced splenogonadal fusion, whichwas confi rmed by laparoscopy. The patient also had a shortright femur, hip dysplasia and a syndromic face.Conclusion: Splenogonadal fusion anomaly shouldbe considered in the evaluation of undescended testis,especially in patients with facial and limb deformities.
文摘目的探讨经脐单一切口腹腔镜联合2 mm trocar治疗腹腔型隐睾的应用价值。方法 2009年11月~2011年1月,采用经脐单一切口腹腔镜联合2 mm trocar治疗11例腹腔型隐睾。脐下缘1.5 cm弧形切口,置入自制多通道trocar,置入5 mm腹腔镜和操作器械1把,脐与耻骨联合连线中点处直接穿刺置入2 mm trocar,置入2 mm腹腔镜抓钳,进行手术。结果 10例11侧成功将隐睾下降固定于阴囊;1例1侧行隐睾切除术。手术时间30~70 min,平均45 min。无手术并发症发生。10例随访3~14个月,平均8.8月,未发现下降的睾丸萎缩。结论经脐单一切口腹腔镜联合2 mm trocar治疗操作不复杂的腹腔型隐睾可行。
文摘Background: Cryptorchidism is one of the most common genitourinary disorders in young boys. About 1% - 2% of boys at age of 1 year have an undescended testis (UDT);this disorder is unilateral in about 90% of individuals and bilateral in about 10%. However, bilateral impalpable testes represent a special category that should be differentiated from anorchidism as well as male pseudohermaphroditism. We investigated whether bilateral impalpable testes with its inherent hormonal and genetic factors has different outcomes in terms of success of orchiopexies compared to unilateral impalpable testes. Methods: We retrospectively analyzed the demographic and clinical findings, as well as immediate and 6 month outcomes, in patients diagnosed with bilateral impalpable undescended testes between 2006 and 2010. Findings were reported after a minimum of 6 months from the last surgical intervention. Results: Nine patients underwent laparoscopy for bilateral impalpable testes, 7 of whom had testes in the region of the internal inguinal ring. The success rate after laparoscopic exploration and open orchiopexy was 60% while the success rate with unilateral impalpable testes was 63.3% in the same study. Conclusion: Although laparoscopy is extremely useful in both the diagnosis and treatment of patients with bilateral impalpable testes, laparoscopy should be preceded by careful cytogenetic and hormonal workup for this particular group of patients. We found that the success rates of laparoscopic management of bilateral and unilateral impalpable testes were similar, as shown by testicular size clinically sassed during serial postoperative outpatient visits.