The Vanishing Testis: Diagnosis and Histological Findings

Nishizawa, Shuji; Suzuki, Kaoru; Tachikawa, Nobuyuki; Nukui, Akinori; Kumamaru, Takatoshi; Shioji, Yasunobu; Misumi, Yoshifumi; Mitsu, Sumitaka; Tokue, Akihiko

doi:10.5980/jpnjurol1989.91.537

Cited by 6 publications

(7 citation statements)

References 18 publications

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“…Histopathological examination of testicular nubbins in nonpalpable testis demonstrated the presence of seminiferous tubules and viable germ cells with an incidence varied between 0 and 16% in the reported series [4,7,9,10,14,15,18,21,25]. Presence of testiculer tissue in a testicular nubbins has theoritical potential for malignancy in the long term.…”

Section: Discussionmentioning

confidence: 79%

“…Presence of testiculer tissue in a testicular nubbins has theoritical potential for malignancy in the long term. Based on these observations some authors suggest routine removal of testicular nubbins to prevent malignant transformation [9,14,18,25], but others did not accept this indication because they did not find testicular tissue in testicular nubbins [7,10,15].…”

Section: Discussionmentioning

confidence: 99%

“…This is theoritically potential for malign degeneration in the longterm and therefore removal of any remnant is a common practice to eleminate malignancy risk. However, a controversy exits in the litterature among the reported series about the presence of seminiferous tubules in testicular nubbins, and the related risk of testicular malignancy [7,10,15]. It is also controversial whether vanishing testis has the same etiopathogenesis and risk with true undescended testis.…”

Section: Introductionmentioning

confidence: 99%

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Histological evaluation of the testicular nubbins in patients with nonpalpable testis: assessment of etiology and surgical approach

et al. 2006

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There is a controversy in the literature whether testicular nubbins carry malignancy risk and excision of the nubbin is necessary in patients with nonpalpable testis. It is also controversial whether vanishing testis has the same etiopathogenesis and risk with true undescended testis. The aim of this study is to investigate the histological findings of testicular nubbins in patients with nonpalpable testis and to question etiology and surgical indications for vanishing testis. We reviewed the histopathological results of 44 testicular nubbins in 40 patients (mean age: 4.1 years, range 1-13 years) with nonpalpable testis between 1992 and 2004, retrospectively. Exploration revealed 5 intraabdominal and 39 inguinal testicular nubbins. Of 44 specimens only 5 (11.3%) from inquinal testicular nubbins were found to have seminiferous tubules. Two of the five had seminiferous tubule structures with viable germ cells showing maturation correlating with age. The other two with scarce seminiferous tubules were seen on only a single area and one had Sertoli cells only. None of the excised tissue had malignant degeneration. The vas deferens was identified in 23 (52.2%), vessels in 26 (59%), calcification in 14 (31.8%) and hemosiderin in 12 (27.2%) of excised tissue. Presence of calcification in one-third of the nubbins supports vascular accident thesis in the etiopathogenesis of vanishing testis. The possibility for the presence of seminiferous tubules and viable germ cells in the testicular nubbin is low. These facts decrease theoritical risk of malingnancy. Therefore, an inguinal exploration for testicular nubbin in patients with vas deferens and vessels entering into the inquinal canal diagnosed at laparoscopy can be postponed untill testicular prosthesis implantation and the nubbin can be removed at this operation.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Histological evaluation of the testicular nubbins in patients with nonpalpable testis: assessment of etiology and surgical approach

et al. 2006

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“…In 2 patients however, vas deference was observed to extend higher from the small pelvis and end over the common iliac vessels with the testicular vessels. In patients with vanishing testes, viable testicular tissue ratio was reported to be 0% to 16% (13). Some authors are recommending inguinal exploration for laparoscopically undetected testes in cases with nonpalpable testes (14).…”

Section: Figure 4 -Epididymis Is Completely Attached To the Testis (Tmentioning

confidence: 99%

Findings concerning testis, vas deference, and epididymis in adult cases with nonpalpable testes

Şahin¹,

Kalkan²,

Yalcinkaya³

2011

Int. braz j urol.

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In this study, we aimed to state the relationship between testis, epididymis and vas deference, in adult cases with nonpalpable testis. Between January 1996 and December 2009, we evaluated 154 adult cases with nonpalpable testes. Mean age was 23 years (20-27 years). Explorations were performed by open inguinal incision, laparoscopy, and by inguinal incision and laparoscopy together on 22, 131 and 1 patient, respectively. Of all the unilateral cases, 32 were accepted as vanishing testis. In five of these cases, vas deference was ending inside the abdomen, and in the others, it was ending inside the scrotum. In the remaining 99 unilateral and 22 bilateral cases, 143 testes were found in total. Testes were found in the inguinal canal as atrophic in one case, at the right renal pedicle level with dysmorphic testis in one case, and anterior to the internal ring between the bladder and the common iliac vessels at a smaller than normal size in 119 cases. One (0.69%) case did not have epididymis. While epididymis was attached to the testis only at the head and tail locations in 88 (61.53%) cases, it was totally attached to the testis in 54 (37.76%) cases. There is an obviously high incidence rate of testis and vas deference anomalies, where epididymis is the most frequent one. In cases with abdominal testes, this rate is highest for high localised abdominal testes.

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“…It affects 5 % of patients with cryptorchidism [5,12]. Histologically, at the very least the presence of a vascularized fibrous nodule (VFN) with calcification or hemosiderin, or VFN with cord element(s) is required for diagnosis [8,12].…”

Section: Introductionmentioning

confidence: 99%

Routine Contralateral Orchiopexy for Children with a Vanished Testis

Alzahem

Shun²

2006

Eur J Pediatr Surg

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Sixteen percent of patients had testicular abnormalities that could predispose them to metachronous torsion. There was no morbidity from the operation and no post-orchiopexy torsion on follow-up. Therefore, routine contralateral orchiopexy in a boy with a vanished testis appears to be safe and effective. A large multicenter trial should be done to investigate these preliminary findings. If confirmed, contralateral orchiopexy should be advocated.

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The Vanishing Testis: Diagnosis and Histological Findings

Cited by 6 publications

References 18 publications

Histological evaluation of the testicular nubbins in patients with nonpalpable testis: assessment of etiology and surgical approach

Histological evaluation of the testicular nubbins in patients with nonpalpable testis: assessment of etiology and surgical approach

Findings concerning testis, vas deference, and epididymis in adult cases with nonpalpable testes

Routine Contralateral Orchiopexy for Children with a Vanished Testis

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