Is excision of testicular nubbin necessary in vanishing testis syndrome?
jpedsurg.org shows its articles on its own site.
Read the article on jpedsurg.org ↗Article · Dec 2018 · 1 min read
In brief
In brief
Retrospective study of 50 children with impalpable testes found that testicular nubbins in vanishing testis syndrome contain no viable germ cells and carry no malignant potential. The authors conclude routine excision of these remnants is unnecessary, challenging traditional surgical practice.
Written by the GCMD Library team from the article.
Background/Purpose
Vanishing Testes Syndrome11VTS: Vanishing Testes syndrome (VTS) is one of the most common causes of impalpable testes in children. The role of removal of testicular nubbins owing to malignant potential in VTS is unclear. We sought to evaluate whether testicular nubbins need to be excised owing to this potential.
Methods
We conducted a retrospective review of children with a clinical diagnosis of impalpable testes aged 0–18 who presented to our tertiary hospital between 2007 and 2017. VTS was defined as the presence of hypoplastic vas entering a closed internal inguinal ring or remnants of gonadal tissue distally. Data collected included: age at operation, need for laparoscopy, location of nubbin and histopathological findings.
Results
We identified 50 consecutive children (mean age 2.4 years, range: 7 months to 12 years) with a clinical diagnosis of impalpable testis. Forty-eight of the 50 underwent laparoscopy with no testicle palpable when examined under anesthesia. Thirty-three children had VTS confirmed at laparoscopy and testicular nubbins identified with three of these being bilateral. Thirty-two children had these nubbins excised with histopathology available for 31 individual testes. Thirty were confirmed testicular nubbins with no viable testicular tissue. No malignancies were identified.
Conclusion
Results from this study show that testicular nubbins do not have viable germ cells and therefore do not need to be excised on the basis of malignant potential of residual testicular tissue.
Level of evidence
Level IV treatment study.