Shilpa Sharma1, Amita Sen. 1. Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Dr RML Hospital, New Delhi, India. Electronic address: drshilpas@gmail.com.
Abstract
AIM: To document the incidence of complete testicular epididymal dissociation (CTED) in the cryptorchid testis and evaluate its operative outcome. METHODS: The presence of CTED was noted prospectively in cases of undescended testis and the operative findings were studied. RESULTS: CTED was encountered in 11 testes in 10 boys out of 29 intra-abdominal testes among the 142 undescended testes (8%) operated. Ages of patients varied from 18 months-14 years (median 4.5 years). All 11 testes were intra-abdominal. In 5 out of 11 testes, the dissociation was associated with a wide separation of the epididymis and testis. The dissociated epididymis was in the scrotum attached to the gubernaculum while the testis was intra-abdominal. One case had bilateral CTED. Successful subdartos orchidopexy was done for 8 testes, 6 after Prentiss maneuver. Two gonads were fixed just below the pubic tubercle. Orchiectomy was done in one case with a small sized testis with a short gonadal vessel. CONCLUSION: CTED was encountered in 8% of cases of cryptorchidism. A palpable nubbin-like tissue in the scrotal sac in the presence of CTED may suggest a descended dissociated epididymis with an intra-abdominal testis. Successful subdartos orchidopexy was possible in 73% of testes with CTED.
AIM: To document the incidence of complete testicular epididymal dissociation (CTED) in the cryptorchid testis and evaluate its operative outcome. METHODS: The presence of CTED was noted prospectively in cases of undescended testis and the operative findings were studied. RESULTS: CTED was encountered in 11 testes in 10 boys out of 29 intra-abdominal testes among the 142 undescended testes (8%) operated. Ages of patients varied from 18 months-14 years (median 4.5 years). All 11 testes were intra-abdominal. In 5 out of 11 testes, the dissociation was associated with a wide separation of the epididymis and testis. The dissociated epididymis was in the scrotum attached to the gubernaculum while the testis was intra-abdominal. One case had bilateral CTED. Successful subdartos orchidopexy was done for 8 testes, 6 after Prentiss maneuver. Two gonads were fixed just below the pubic tubercle. Orchiectomy was done in one case with a small sized testis with a short gonadal vessel. CONCLUSION: CTED was encountered in 8% of cases of cryptorchidism. A palpable nubbin-like tissue in the scrotal sac in the presence of CTED may suggest a descended dissociated epididymis with an intra-abdominal testis. Successful subdartos orchidopexy was possible in 73% of testes with CTED.
Authors: Rômulo A L de Vasconcelos; Ricardo A A Ximenes; Adriano A Calado; Celina M T Martelli; Andreia V Gonçalves; Elizabeth B Brickley; Thalia V B de Araújo; Maria A W Rocha; Demócrito de B Miranda-Filho Journal: BMC Urol Date: 2020-11-23 Impact factor: 2.264