Clinical and pathological features of ascending testis.

Osaka city medical journal Pub Date : 2009-12-01
Tatsuyuki Yoshida, Koichi Ohno, Yoshiki Morotomi, Tetsuro Nakamura, Takashi Azuma, Hiroto Yamada, Hiroaki Hayashi, Shigefumi Suehiro
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Abstract

Background: The clinical features and principles of surgery of the Ascending Testis (AT), in which the testis ascends from the scrotum with age, are controversial. We selected AT that met the treatment guidelines and examined the clinical features and principles of surgery.

Methods: We retrospectively reviewed the medical charts of 12 AT and 530 Congenital Undescended Testis (CUDT) patients to investigate the statistics of AT among all CUDT, the side of the maldescent, the associated disorders, and the clinical course. The patients were compared in terms of testicular volume (TV), mean tubular diameter (MTD), and testicular fertility index (TFI) between the AT group and the CUDT group.

Results: AT was observed in 2.2% of all CUDT patients: 10 had left AT and 2 had bilateral AT. Among the 12 AT patients, 8 patients had associated disorders. The TV, MTD, and TFI of 7 AT and 7 CUDT were 0.74 +/- 0.20 and 0.77 +/- 0.59 cm3, 38.7 +/- 3.7 and 35.9 +/- 9.1 microm, and 0.19 +/- 0.07 and 0.11 +/- 0.11, respectively.

Conclusions: In order to examine the clinical features of AT, it is essential to strictly rule out CUDT and retractile testis. In our study, the clinical features are that AT is a rare disorder, occurs more frequently on the left side, and many patients with AT have associated disorders. Since AT causes histological damage equivalent to that caused by CUDT, we should perform orchidopexy for patients with AT immediately after diagnosis.

升睾丸的临床与病理特征。
背景:睾丸随年龄增长而从阴囊上升的升睾丸的临床特征和手术原则存在争议。我们选择了符合治疗指南的AT,并检查了临床特征和手术原则。方法:回顾性分析12例先天性隐睾(AT)和530例先天性隐睾(CUDT)患者的病历资料,探讨所有先天性隐睾(CUDT)患者的AT情况、畸形侧、相关疾病及临床病程。比较AT组和CUDT组患者的睾丸体积(TV)、平均睾丸管直径(MTD)和睾丸生育指数(TFI)。结果:2.2%的CUDT患者出现AT,左侧AT 10例,双侧AT 2例。在12例AT患者中,8例患者有相关疾病。7个AT和7个CUDT的TV、MTD和TFI分别为0.74 +/- 0.20和0.77 +/- 0.59 cm3, 38.7 +/- 3.7和35.9 +/- 9.1微米,0.19 +/- 0.07和0.11 +/- 0.11。结论:严格排除CUDT和睾丸回缩的可能是诊断AT的临床特点。在我们的研究中,临床特征是AT是一种罕见的疾病,多发生在左侧,许多AT患者伴有相关疾病。由于AT造成的组织学损伤与CUDT相当,因此对AT患者应在确诊后立即行睾丸切除术。
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