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睾丸横位异位:三例报告并文献复习

Transverse testicular ectopia: a three-case report and review of the literature.

作者信息

Naouar Sahbi, Maazoun Kais, Sahnoun Lassaad, Jouini Riadh, Ksia Amine, Elezzi Oumama, Krichene Imed, Mekki Mongi, Belghith Mohsen, Nouri Abdellatif

机构信息

Pediatric Surgery Department, Fattouma Bourguiba Teaching Hospital, Monastir, Tunisia.

出版信息

Urology. 2008 Jun;71(6):1070-3. doi: 10.1016/j.urology.2007.11.133. Epub 2008 Feb 21.

Abstract

OBJECTIVES

To describe the embryologic, clinical, and therapeutic features of transverse testicular ectopia (TTE) and to review the literature on similar cases.

METHODS

Three cases of TTE were discovered accidentally during surgery for inguinal hernia and undescended testes; a persistent Müllerian duct syndrome (PMDS) was associated in 1 case. We also performed a literature search for other reports of TTE.

RESULTS

A conservative surgical approach was chosen: transseptal orchiopexy was preferred in 2 cases and the Müllerian remnant was preserved in the first case.

CONCLUSIONS

TTE is a rare anomaly that usually presents as a unilateral cryptorchidism and a contralateral descendent testis with an associated hernia. In suspected cases, laparoscopy and ultrasonographic evaluation may be helpful in diagnosing this condition before surgery. Surgery, transseptal orchiopexy, is highly recommended to manage TTE especially when vasa deferentia are fused. In case of PMDS, the authors preferred preserving Müllerian remnants because of the risk of vas deferens and testicular blood supply damage. Recently, laparoscopy is useful for both diagnosing and management of TTE and associated anomalies.

摘要

目的

描述睾丸横过异位(TTE)的胚胎学、临床及治疗特征,并对类似病例的文献进行综述。

方法

3例TTE在腹股沟疝及隐睾手术中意外发现;1例合并持续性苗勒管综合征(PMDS)。我们还对TTE的其他报道进行了文献检索。

结果

选择了保守的手术方法:2例首选经中隔睾丸固定术,第1例保留了苗勒管残余。

结论

TTE是一种罕见的异常,通常表现为单侧隐睾和对侧下降的睾丸并伴有相关疝。在疑似病例中,腹腔镜检查和超声评估可能有助于术前诊断此病。强烈推荐手术,即经中隔睾丸固定术来治疗TTE,尤其是在输精管融合的情况下。对于PMDS病例,由于存在输精管和睾丸血供受损的风险,作者倾向于保留苗勒管残余。近来,腹腔镜检查对TTE及相关异常的诊断和治疗均有用。

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