327 PATHOLOGICAL ANALYSIS OF TESTICULAR REMANTS IN NONPALPABLE UNDESCENDED TESTIS

You have accessJournal of UrologyPediatrics: Andrology-Cryptorchidism & Varicoceles1 Apr 2011327 PATHOLOGICAL ANALYSIS OF TESTICULAR REMANTS IN NONPALPABLE UNDESCENDED TESTIS Neal Rowe, Michael Leonard, Joseph de Nanassy, and Luis Guerra Neal RoweNeal Rowe Ottawa, Canada More articles by this author , Michael LeonardMichael Leonard Ottawa, Canada More articles by this author , Joseph de NanassyJoseph de Nanassy Ottawa, Canada More articles by this author , and Luis GuerraLuis Guerra Ottawa, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.410AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Approximately one fifth of undescended testes (UDT) are impalpable. Surgical exploration often reveals a small testicular remnant distal to the internal inguinal ring. There is controversy in the literature as to whether these remnants contain any viable testicular tissue and whether they should be excised. Furthermore, it is unclear whether inguinal exploration is warranted when the vas deferens and vessels are visualized exiting the internal inguinal ring during laparoscopy. We reviewed the pathology of testicular remnants found distal to the internal inguinal ring on surgical exploration to determine the incidence of viable testicular tissue. METHODS Institutional review board approved our study. Between January 1st, 2000 and December 31st, 2009, 210 orchiectomy specimens were sent to pathology at our institution. We reviewed the histology and operative reports of 98 consecutive specimens that were excised during exploration for nonpalpable UDT. Nubbins were defined as remnants of tissue identified with a blind ending spermatic cord and consistent with vanishing testis syndrome. If laparoscopy was performed, the status of the vas, vessels, and internal inguinal ring were recorded. RESULTS 69 nubbins and 29 atrophic testes were identified at the time of surgery for non-palpable undescended testis. All 69 nubbins were identified distal to the internal inguinal ring during inguinal/scrotal exploration. 7.2% (5/69) of nubbins identified contained seminiferous tubules while 2.9% (2/69) contained viable germ cells. In addition to nubbins, 29 atrophic testes were identified and removed. Of these 7 were intra-abdominal with all having seminiferous tubules and 6 having viable germ cells. The remaining 22 atrophic testes were identified distal to the internal inguinal ring. 36.4% (8/22) had seminiferous tubules and 27.3% (6/22) had viable germ cells. A subgroup analysis of all 41 cases with initial laparoscopy found that 8.8% (3/34) of cases with both vas deferens and vessels exiting the internal inguinal ring had viable germ cells and seminiferous tubules. CONCLUSIONS The incidence of viable testicular tissue in all remnants removed at the time of inguinal/scrotal exploration for non-palpable UDT is 15.4% in our series. This data supports inguinal/scrotal exploration despite an impalpable testis when the vas deferens and vessels are visualized exiting an internal inguinal ring during laparoscopy. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e132 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Neal Rowe Ottawa, Canada More articles by this author Michael Leonard Ottawa, Canada More articles by this author Joseph de Nanassy Ottawa, Canada More articles by this author Luis Guerra Ottawa, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

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