The return of the solitary testis

Harper, Lynda; Gatibelza, M.E.; Michel, Jean‐Luc; Bouty, Aurore; Sauvat, Frédérique

doi:10.1016/j.jpurol.2010.08.003

Cited by 10 publications

(7 citation statements)

References 24 publications

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“…Al-Zahem and Shun[ 20 ] examined contralateral testis associated with VTS and found that 71% had testicular abnormalities, whereas 16% had an abnormality that could directly predispose to metachronous torsion. In a survey by Harper et al ,[ 12 ] fixation of contralateral solitary testis was practiced by respondents in 100% of IVT, 57% of neonatal EVT, 46% of NPT, and 28% of those who underwent orchidectomy for tumor. Similarly, in the current survey also, the respondents favored fixation of contralateral solitary testis in 98% of childhood IVT, 78% of neonatal EVT, 62% of NPT, and 30% after orchidectomy for tumor.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, management of the solitary testis on the contralateral side is further debatable with several authors in favor of routine fixation, whereas some are not so keen. [ 12 13 14 ] Contralateral torsion after unilateral orchidopexy is reported[ 15 ] and several studies have shown the presence of abnormal fixation[ 16 ] of contralateral testis in those with TRS. Bell-clapper deformity, a known predisposition for testicular torsion is noted in as high as 12% of autopsy specimens[ 17 ] and several authors have stressed the importance of protecting solitary testis[ 13 ] from catastrophic loss.…”

Section: Introductionmentioning

confidence: 99%

“…However, there is no consensus in the literature regarding the fixation of the remaining testis. [ 12 ]…”

Section: Introductionmentioning

confidence: 99%

“…However, a survey of existing practices may throw some light on the current thinking of pediatric surgeons and their concerns regarding malignancy risk. So far, there are only two surveys published from UK and France[ 12 14 ] in this regard and there is no such survey from India. Practices which are contrary to information available in standard textbooks are fraught with the danger of litigation.…”

Section: Introductionmentioning

confidence: 99%

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Is Routine Excision of Dysplastic Testicular Remnants/Nubbins Associated with Nonpalpable Testis Necessary? Is Routine Fixation of Contralateral Solitary Testis Indicated? A Survey on the Prevalent Practice among Indian Pediatric Surgeons

Babu

Miglani²,

Shah

2022

Journal of Indian Association of Pediatric Surgeons

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Background and Aims: Dysplastic nubbin also referred to as testicular regression syndrome (TRS) is found in 5% of cases of the Non palpable testis (NPT). There is no consensus on the excision of the above and fixation of the contralateral solitary testis. We aimed to survey the prevalent practice of the same among members of the Indian Association of Pediatric Surgeons (IAPS). Methods: A structured questionnaire was sent through group e-mail and social media platforms to IAPS members to identify their practices in management. Results: A total of 132 surgeons responded to the questionnaire. Excision of intra-abdominal and inguinoscrotal TRS remnants was practiced by 84% (95% confidence interval [CI] 77%–89%) and 82% (95% CI 74%–87%). Fixation of contralateral solitary testis was practiced by 62% (95% CI 53%–70%) in the above scenario. Among the respondents, 30% reported encountering torsion of solitary testis during their career and this experience was a significant factor ( P = 0.01) in deciding contralateral orchidopexy. Scrotal infection/necrosis was not encountered by a majority (72%) and it was not a deterrent factor in preventing contralateral orchidopexy ( P = 0.68). Conclusions: The majority of pediatric surgeons favored the removal of intra-abdominal/inguinoscrotal TRS remnants identified during laparoscopy for NPT. A majority favored sutureless fixation of the contralateral solitary testis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…However, there is no consensus in the literature regarding the fixation of the remaining testis. [ 12 ]…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Is Routine Excision of Dysplastic Testicular Remnants/Nubbins Associated with Nonpalpable Testis Necessary? Is Routine Fixation of Contralateral Solitary Testis Indicated? A Survey on the Prevalent Practice among Indian Pediatric Surgeons

Babu

Miglani²,

Shah

2022

Journal of Indian Association of Pediatric Surgeons

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“…Hinsichtlich der Rationale einer kontralateralen prophylaktischen Orchidopexie eines Einzelhodens bei Patienten, bei denen die Laparoskopie ein Hodenrudiment zeigt, gibt es derzeit keine evidenzbasierten Empfehlungen [ 49 ] .…”

Section: Kontralaterale Orchidopexieunclassified

Diagnostik und Therapie des Maldeszensus testis – ein Update unter Berücksichtigung der Leitlinien

Rubenwolf

Stein

2013

Aktuel Urol

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Cryptorchidism, or undescended testis (UDT), occurs in 1-3% of male term infant births. At least two-thirds of UDTs will descend spontaneously, typically during the first 6 months of life. UDTs are associated with loss of spermatogenic potential and testicular malignancy in the long term. Orchiopexy performed prior to puberty may significantly reduce the malignant potential by up to 4-fold. Neoadjuvant hormonal therapy starting at 6 months of life has been shown to potentially improve the testicle's fertility index and should be part of the therapeutic concept. However, the use of hormonal treatment and HCG beyond the first year of life is to be challenged given a potentially negative impact on testicular function. Laparoscopic exploration and therapy is the method of choice for non-palpable testes. Ideally, surgical repair of the UDT should be completed by the age of 1 year.

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Orchidopexy and Orchidectomy

Hutton

2016

Handbook Series of Consent in Pediatric Surgical Subspecialities

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The return of the solitary testis

Cited by 10 publications

References 24 publications

Is Routine Excision of Dysplastic Testicular Remnants/Nubbins Associated with Nonpalpable Testis Necessary? Is Routine Fixation of Contralateral Solitary Testis Indicated? A Survey on the Prevalent Practice among Indian Pediatric Surgeons

Is Routine Excision of Dysplastic Testicular Remnants/Nubbins Associated with Nonpalpable Testis Necessary? Is Routine Fixation of Contralateral Solitary Testis Indicated? A Survey on the Prevalent Practice among Indian Pediatric Surgeons

Diagnostik und Therapie des Maldeszensus testis – ein Update unter Berücksichtigung der Leitlinien

Orchidopexy and Orchidectomy

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