Kehoe John E, Christman Matthew S
Department of Urology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA, 92134, USA.
Curr Urol Rep. 2017 Feb;18(2):9. doi: 10.1007/s11934-017-0657-z.
Testicular remnants or nubbins are commonly found in the evaluation and treatment of cryptorchidism. While much debate focuses on the management of the nubbin itself, there is also great uncertainty and variation in the management of the contralateral descended testis. Herein, we review the relevant literature informing the decision to perform a contralateral orchiopexy.
Although there is very little recent literature directly addressing the question, some studies have better characterized differences in practice, the risk of intravaginal torsion in the contralateral testis and potential consequences in the selection of technique. The etiology of a vanishing testis remains obscure, but appears more likely to be the result of a prenatal extravaginal torsion. While indeterminate, the risk of contralateral torsion of a descended testis appears to concentrate around the neonatal period with no substantially increased risk in later years. Contralateral orchiopexy, although a low-risk procedure, likely benefits very few and may carry an as yet poorly described risk to the contralateral testicle depending on the technique of fixation.
在隐睾症的评估和治疗中，常可发现睾丸残余组织或小结节。尽管关于小结节本身的处理存在诸多争议，但对侧已降入阴囊的睾丸的处理也存在很大的不确定性和差异。在此，我们回顾相关文献，为对侧睾丸固定术的决策提供依据。
尽管近期直接针对该问题的文献很少，但一些研究更好地描述了实践中的差异、对侧睾丸鞘膜内扭转的风险以及技术选择的潜在后果。睾丸消失的病因仍不清楚，但似乎更可能是产前鞘膜外扭转的结果。虽然不确定，但已降入阴囊的睾丸发生对侧扭转的风险似乎集中在新生儿期，之后几年风险并无显著增加。对侧睾丸固定术虽然是一种低风险手术，但可能受益的患者很少，并且根据固定技术的不同，可能会对侧睾丸带来尚未明确描述的风险。
