Division of Urology, Albany Medical College, Albany, NY 12208, USA.
J Pediatr Surg. 2012 Sep;47(9):1711-5. doi: 10.1016/j.jpedsurg.2012.01.003.
The purpose of this study was to determine the incidence and predictive factors associated with a contralateral patent processus vaginalis in boys with a unilateral palpable undescended testis.
We retrospectively reviewed the records of 77 consecutive boys (median age, 15 months; range, 5 months to 17.7 years) who had undergone orchiopexy for a unilateral palpable testis. At inguinal orchiopexy, an 8F feeding tube and a 70° adult cystoscope lens were placed into the peritoneum through the hernia sac, and the contralateral internal ring was inspected. The clinical factors that might predict the presence of a contralateral patent processus vaginalis were determined.
The overall rate of a contralateral patent processus vaginalis was 34% in those with a significant ipsilateral hernia sac. After considering age, side, prematurity, location, and volume of the undescended testis, only the boys with a testis distal to the external ring compared with those with testes lying within the inguinal canal had statistically increased odds of a patent contralateral processus vaginalis (odds ratio, 3.1; 95% confidence interval, 1.08-9.08).
Approximately one third of boys with a unilateral palpable undescended testis will have a contralateral patent processus vaginalis as determined by transinguinal laparoscopy. The rate is higher (52%) if the undescended testis was distal to the external ring. Both the etiology and significance of this contralateral finding are unknown.
本研究旨在确定患有单侧可触及未降睾丸的男孩中，对侧未闭鞘状突的发生率和相关预测因素。
我们回顾性分析了 77 例连续接受单侧可触及睾丸固定术的男孩（中位年龄 15 个月；范围 5 个月至 17.7 岁）的记录。在腹股沟睾丸固定术中，通过疝囊将 8F 喂养管和 70°成人膀胱镜镜片放入腹膜腔，并检查对侧内环。确定了可能预测对侧未闭鞘状突存在的临床因素。
在有明显同侧疝囊的患者中，对侧未闭鞘状突的总体发生率为 34%。在考虑年龄、侧别、早产、未降睾丸的位置和体积后，只有外环后睾丸的男孩与腹股沟管内睾丸的男孩相比，其对侧未闭鞘状突的可能性更高（比值比，3.1；95%置信区间，1.08-9.08）。
通过经腹股沟腹腔镜检查，约三分之一的单侧可触及未降睾丸的男孩会出现对侧未闭鞘状突。如果未降睾丸位于外环后，发生率更高（52%）。这种对侧发现的病因和意义尚不清楚。
