OBJECTIVES
There is controversy surrounding the optimal management of the testicular remnant associated with the vanishing testes syndrome. Some urologists advocate the need for surgical exploration, whereas others believe this is unnecessary. These differing opinions are based on the variable reports of viable germ cell elements found within the testicular remnants. To better understand the pathology associated with this syndrome and the need for surgical management, we reviewed our experience regarding the incidence of viable germ cell elements within the testicular remnant.


METHODS
An institutional review board-approved, retrospective review was performed of all consecutive patients undergoing exploration for a nonpalpable testis at Eastern Virginia Medical School and Geisinger Medical Center between 1994 and 2006. Patients who were found to have spermatic vessels and a vas deferens exiting a closed internal inguinal ring were included in this analysis.


RESULTS
Fifty-six patients underwent removal of the testicular remnant. Patient age ranged from 11 to 216 months. In 8 of the specimens (14%), we identified viable germ cell elements. In an additional 4 patients (7%), we identified seminiferous tubules without germ cell elements.


CONCLUSIONS
In our review, we identified that a significant number of testicular remnants associated with the vanishing testes syndrome can harbor viable germ cell elements or seminiferous tubules. The exact fate of these residual elements remains unknown; however, there may exist the potential for malignant transformation. Given the potential for malignant degeneration, we believe that these remnants should be removed.

Iconografías adicionales del artículo : Histologic Evaluation of the Testicular Remnant Associated with the Vanishing Testes Syndrome: Is Surgical Management Necessary?

Management of the undescended testis in children: An American pediatric surgical association outcomes and evidence based practice committee systematic review.

Testicular regression syndrome: practice variation in diagnosis and management.

[This corrects the article DOI: 10.1155/2018/3143412.].

/pdf/corrigendum-to-impalpable-testis-evaluation-of-diagnostic-2yiinglmn8.pdf

Corrigendum to "Impalpable Testis: Evaluation of Diagnostic and Treatment Procedures and Our Treatment Protocol"

Türkiye’de Ele Gelmeyen Testis Hastalarına Güncel Yaklaşım Farklılıkları

Introduction. The aim of this study is to present our treatment protocol for impalpable testis. Material and Methods. In a retrospective study we analyzed clinical data including diagnostic procedures, intraoperative findings, final diagnosis, treatment modality, and outcome of patients with impalpable testis who underwent surgery from January 2010 until December 2015. Results. Ninety-one patients were admitted under the diagnosis of impalpable testis. In 39 patients ultrasound detected testis in the inguinal canal and orchidopexy was done. In 25 patients (48.08%) laparoscopy showed the entrance of the spermatic cord into the inguinal canal. Open exploration of the inguinal canal was done, testicular remnant removed, and appropriate testicular prosthesis implanted. Twenty patients (20/52) underwent orchidopexy of the abdominal testis (46.51%), 4 of which underwent Fowler-Stevens procedure in two stages, and in 16 patients deliberation of the testis and spermatic cord was sufficient to place the testis into the scrotum. Conclusions. Excision of the testicular nubbin is highly recommendable, as well as implantation of the testicular prosthesis at the time of orchiectomy.

/pdf/impalpable-testis-evaluation-of-diagnostic-and-treatment-qgpfx7h20y.pdf

Impalpable Testis: Evaluation of Diagnostic and Treatment Procedures and Our Treatment Protocol

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Impalpable Testis: Evaluation of Diagnostic and Treatment Procedures and Our Treatment Protocol

Corrigendum to "Impalpable Testis: Evaluation of Diagnostic and Treatment Procedures and Our Treatment Protocol"