Is the vanished testis always a scrotal event?

Objective To determine if perinatal testicular torsion resulting in a vanished testis is an event that primarily occurs in the scrotum. Patients and methods The records of 54 boys identified as having a solitary testis were reviewed. The side of absence, size of the solitary testis, method of surgic...

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Bibliographic Details
Published in:BJU international 2001-04, Vol.87 (6), p.480-483
Main Authors: Belman, A.B., Rushton, H.G.
Format: Article
Language:English
Subjects:
Atrophy
Biological and medical sciences
Humans
Infant, Newborn
laparoscopy
Laparoscopy - methods
Male
Malformations of the urinary system
Medical sciences
Nephrology. Urinary tract diseases
Scrotum
Spermatic Cord Torsion - pathology
Spermatic Cord Torsion - surgery
Testis - pathology
unilateral anorchia
Urinary tract. Prostate gland
vanished testis
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Summary:Objective To determine if perinatal testicular torsion resulting in a vanished testis is an event that primarily occurs in the scrotum. Patients and methods The records of 54 boys identified as having a solitary testis were reviewed. The side of absence, size of the solitary testis, method of surgical evaluation (scrotal, inguinal or abdominal), surgical findings and histology of the tissue removed were noted. Results The testis was absent twice as often on the left side, the solitary testis was hypertrophic in 25 of 42 boys in whom it was evaluated, and tissue grossly or histologically consistent with a testicular ‘nubbin’ was removed in 52 boys. Scrotal (47) or inguinal (seven) exploration was carried out in all. Laparoscopy (28) or abdominal exploration (two) was undertaken to confirm that no testicular tissue was present in the abdomen in 30 boys, including the two in whom no tissue was found on scrotal or inguinal exploration. Conclusions Perinatal testicular torsion occurs after descent but before fixation of the tunica vaginalis to the scrotal wall. These testes atrophy, leaving a remnant of tissue in the scrotum that can be identified on scrotal exploration in almost all cases. Therefore, it is recommended that the evaluation of the child with a solitary palpable testis start with scrotal exploration. Laparoscopy should be reserved for those in whom no tissue consistent with a testicular nubbin is found in the scrotum.
ISSN:1464-4096
1464-410X
DOI:10.1046/j.1464-410X.2001.00101.x