Niedzielski Jerzy, Miodek Mieczysław, Krakós Marek
Department of Pediatric Surgery and Urology, Chair of Pediatric Surgery, University School of Medicine in Łódź, University Children's Hospital, No 4 in Łódź.
Pol Przegl Chir. 2012 Aug;84(8):406-10. doi: 10.2478/v10035-012-0068-2.
To decide on the accurate way of treatment and to establish criteria for operation in boys with pubertal epididymal cysts (ECs).
Results of scrotal ultrasound of 363 boys and adolescents, aged 2 months to 18 years, were reviewed retrospectively.
Of all 363 patients with scrotal ultrasound 59 (16.2%) at mean age of 14.03 yrs had ECs. The EC incidence increased with age and 42 out of 124 boys (33.8%) older than 14 yrs had cysts (chi2=27.627, p=0.000). Out of 59 patients, in 30 (50.8%) cysts were diagnosed incidentally at the time of scrotal US, 29 boys (49.2%) presented with scrotal mass and/or pain. 31 patients with ECs (52.5%) underwent elective surgery and the remaining 28 boys (47.5%) received conservative treatment. The age of boys with ECs who underwent surgery ranged from 8 to 18 years (mean 14.32). The age range of patients treated conservatively was 7-18 (mean 13.71). There was no statistical difference in age between boys treated surgically and conservatively (t=0.924, p=0.36). ECs resolved in 17 patients out of 28 boys treated conservatively, in remaining 11 boys the size of cysts was stabile and they remain asymptomatic. Clinical and ultrasonographic follow-up were carried out from 11 months to 5 years.
ECs are more common in older boys (over 14 years). Management of ECs smaller than 10 mm should be conservative with clinical and ultrasound controls, leaving surgery for cysts increasing in size over 10 mm which did not involute with time.
确定青春期附睾囊肿（ECs）男孩的准确治疗方法并制定手术标准。
回顾性分析363名年龄在2个月至18岁的男孩和青少年的阴囊超声检查结果。
在所有363例行阴囊超声检查的患者中，59例（16.2%）平均年龄14.03岁的患者患有附睾囊肿。附睾囊肿的发病率随年龄增长而增加，124名14岁以上男孩中有42例（33.8%）患有囊肿（χ2=27.627，p=0.000）。在59例患者中，30例（50.8%）的囊肿在阴囊超声检查时偶然发现，29例男孩（49.2%）表现为阴囊肿块和/或疼痛。31例附睾囊肿患者（52.5%）接受了择期手术，其余28例男孩（47.5%）接受了保守治疗。接受手术的附睾囊肿男孩年龄在8至18岁之间（平均14.32岁）。接受保守治疗的患者年龄范围为7 - 18岁（平均13.71岁）。接受手术治疗和保守治疗的男孩在年龄上无统计学差异（t=0.924，p=0.36）。28例接受保守治疗的男孩中有17例囊肿消退，其余11例男孩囊肿大小稳定且无症状。临床和超声随访时间为11个月至5年。
附睾囊肿在年龄较大的男孩（14岁以上）中更常见。对于小于10 mm的附睾囊肿应采取保守治疗并进行临床和超声检查，对于大小超过10 mm且未随时间消退的囊肿则应进行手术治疗。
