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Scrotal nubbins associated with blind‐ending spermatic vessels and a normal vas deferens on laparoscopy
Author(s) -
Yamazaki Yuichiro,
Suzuki Mari,
Shiroyanagi Yoshiyuki,
Matsuno Daisuke,
Tanaka Yukichi
Publication year - 2009
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2009.02388.x
Subject(s) - vas deferens , medicine , laparoscopy , surgery , scrotum , anatomy , urology
Objectives: To determine whether a scrotal nubbin is present in children with unilateral non‐palpable testis when diagnostic laparoscopy demonstrates blind‐ending vessels and a normal vas deferens entering a closed internal ring. Methods: Eighty consecutive patients with a unilateral nonpalpable testis were retrospectively reviewed. Patients underwent initial diagnostic laparoscopy, and, if needed, subsequent inguinal exploration was performed. On inguinal exploration, any testicular remnant or nubbin‐like tissue was removed and evaluated histologically. Patients with a patent processus vaginalis were excluded from this analysis. Results: Overall, 60 of the 80 patients had neither an abdominal testis nor a patent processus vaginalis. Of these 60, 34 patients had both a vas deferens and spermatic vessels entering a closed internal ring, and all of these underwent inguinal exploration. A total of 17 patients had both a blind‐ending vas deferens and blind‐ending spermatic vessels; no inguinal exploration was attempted. In nine patients, laparoscopy revealed blind‐ending vessels with a normal vas deferens entering the closed internal ring. Of these nine, six underwent inguinal exploration, and a scrotal nubbins was found in three. At histological examination, hemosiderin deposit and calcification were seen in the nubbin tissue. No viable germ cell was detected in these specimens. Conclusions: A laparoscopic finding of blind‐ending vessels above the closed internal ring does not mean intra‐abdominal vanished testis, regardless of the appearance of the vas deferens.