Assaf George J
Division of Urology, St Georges Hospital, University of Balamand, Beirut, Lebanon.
Can J Urol. 2006 Apr;13(2):3034-8.
To report our experience in the management of patients with non-palpable lesions of the testis with a review of published studies. Even though radical orchiectomy remains the golden standard treatment for solid testicular masses there is an increasing role for testes-sparing surgery in a select group of patients with non-palpable tumors.
Between April 2000 and October 2004, a non-palpable testicular lesion was discovered on ultrasonography in six patients. Ultrasonography was performed for infertility in two patients, for testicular pain in three patients, and in one case for previous history of seminoma in the contra-lateral testis.
Radical orchiectomy was performed in two patients, testis-sparing surgery with microsurgical excision and frozen-section examination (FSE) in two patients, and a conservative watchful waiting attitude was adopted in two patients.
In a select group of patients, testis-sparing surgery with microsurgical dissection and FSE or a watchful waiting attitude can be safely adopted as an alternative to radical orchiectomy in the presence of incidentally discovered non-palpable testicular lesion.
报告我们对睾丸不可触及性病变患者的治疗经验，并对已发表的研究进行综述。尽管根治性睾丸切除术仍是实性睾丸肿块的金标准治疗方法，但对于一组不可触及性肿瘤的特定患者，保留睾丸手术的作用日益增加。
2000年4月至2004年10月期间，6例患者经超声检查发现睾丸存在不可触及性病变。其中2例患者因不育进行超声检查，3例因睾丸疼痛，1例因对侧睾丸曾有精原细胞瘤病史。
2例患者接受了根治性睾丸切除术，2例患者接受了保留睾丸手术及显微手术切除和冰冻切片检查（FSE），2例患者采取了保守的观察等待态度。
对于一组特定患者，在偶然发现不可触及性睾丸病变时，采用显微手术解剖和FSE的保留睾丸手术或观察等待态度可作为根治性睾丸切除术的安全替代方案。
