Urogenital Research Unit, Department of Anatomy, State University of Rio de Janeiro - UERJ, Rua Professor Gabizo, 104/201, Tijuca, Rio de Janeiro, RJ, CEP: 20271-320, Brazil.
Sci Rep. 2024 Feb 8;14(1):3249. doi: 10.1038/s41598-024-52734-9.
Twisted testicular appendages had difficult differential diagnosis with testicular torsion. The objective of this paper is to evaluate the number, shape, size and determine the laterality pattern of the testicular and epididymal hydatids and evaluate the correlations between the length and width of the testicular and epididymal hydatids with testicular measurements. We analyzed 60 fixed cadavers and 16 patients with prostate cancer without previous hormonal treatment undergoing bilateral orchiectomy, totalizing 76 units and 152 testicles. In relation to the testicular appendices, we analyzed the following situations: absence of testicular and epididymis appendages, presence of a testicular appendix, presence of epididymis appendix, and presence of testicular and epididymis appendix. We measured the length, width and thickness of the testis and classified the appendages as sessile or pedicled. Chi-square test was used to verify associations between categorical variables. McNemar Test was used to verify differences between the percentages of right and left appendages. Correlations between quantitative measures were evaluated using the Pearson Correlation Coefficient (p < 0.05). In 50 cases (65.78%) we observed the presence of some type of appendices, in 34 cases (44.72%) we observed the presence of testicular appendices and in 19 cases (25%) the presence of epididymal appendices. We observed the presence of pedicled appendices in 39 cases (51.32%), with 25 of the cases (32.89%) of pedicled testicular appendices and 14 of the cases (18.42%) of pedicled epididymal appendages, with a significant association between the occurrence of appendices on the right and left sides (p < 0.001). Testicular hydatids were present in around two thirds of our sample being pedunculated in almost half of the cases with bilateral similarity. There is a significant chance in cases of twisted appendices that the same anatomical characteristics are present on the opposite side, which is a factor that tends to indicate the need for contralateral surgical exploration in cases of torsion, however studies with larger samples are needed to confirm these findings.
扭转的睾丸附件与睾丸扭转的鉴别诊断较为困难。本文旨在评估睾丸和附睾囊肿的数量、形状、大小,并确定其左右侧模式,同时评估睾丸和附睾囊肿的长度和宽度与睾丸测量值之间的相关性。我们分析了 60 例固定尸体和 16 例未接受过激素治疗的前列腺癌患者双侧睾丸切除术,共 76 个单位和 152 个睾丸。关于睾丸附件,我们分析了以下情况:无睾丸和附睾附件、有睾丸附件、有附睾附件、有睾丸和附睾附件。我们测量了睾丸的长度、宽度和厚度,并将附件分为无蒂或有蒂。采用卡方检验来验证分类变量之间的关联。采用 McNemar 检验来验证左右附件百分比之间的差异。采用 Pearson 相关系数(p<0.05)评估定量测量之间的相关性。在 50 例(65.78%)中观察到存在某种类型的附件,在 34 例(44.72%)中观察到存在睾丸附件,在 19 例(25%)中观察到存在附睾附件。我们观察到有蒂附件 39 例(51.32%),其中有蒂睾丸附件 25 例(32.89%),有蒂附睾附件 14 例(18.42%),左右侧附件的发生有显著关联(p<0.001)。我们的样本中约有三分之二的睾丸囊肿为有蒂,近一半的病例为双侧相似。在扭转的附件中,另一侧存在相同解剖特征的可能性较大,这是一个表明在扭转时需要对另一侧进行手术探查的因素,但需要更大样本的研究来证实这些发现。