在单侧不可触及的隐睾症病例中，对侧睾丸体积是否决定了是否需要进行诊断性腹腔镜检查？
Does the contralateral testicular volume decide the need for diagnostic laparoscopy in cases of unilateral impalpable undescended testis?
机构信息
Department of Pediatric Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Department of Radiology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
出版信息
BMC Urol. 2024 Mar 26;24(1):68. doi: 10.1186/s12894-024-01455-2.
BACKGROUND
This study aimed the evaluation of the value of the calculated volume of a normal testis to predict the status of its contralateral impalpable side and hence decide the importance of laparoscopic exploration.
METHODS
Patients with unilateral impalpable undescended testis - as confirmed by clinical and sonographic examination- were enrolled in our prospective interventional study between November 2018 and August 2022 at Elshatby University Hospital, Faculty of Medicine, Alexandria University. The volume and three-dimensional diameter of the normal contralateral testis were measured by the pre-operative US using the formula: Volume = L x W x H x π/6, where L is the length, W is the width, H is the height, and was correlated with the intra-operative laparoscopic findings.
RESULTS
Seventy-six patients were included in our study. The age of the studied patients ranged between 6 months and 4 years with a mean of 2.17 ± 1.30 years; most of them were between one and three years old. Forty-six patients (60.5%) have left-sided impalpable testis and 30 patients (39.5%) have right-sided impalpable testis. The calculated volume of the contralateral normal testis was significantly larger in those patients who had both blind ending vas and vessels (0.89 ± 0.16) and in those who had an atrophic testis passing through the deep inguinal ring (DIR) -which was excised through the inguinal region- (0.83 ± 0.20) than in those patients who had their testes intra-abdominal (0.53 ± 0.18) or passing through the DIR to the inguinal region (0.80 ± 0.19). (Kruskal Wallis test; p < 0.001*).
CONCLUSIONS
The calculated sonographic volume of a normal testis can predict the status of its contralateral impalpable side significantly with sensitivity & specificity of 75.0% & 88.89% respectively and a cut-off point of ≤ 0.674; hence, helps in parent counselling preoperatively.
TRIAL REGISTRATION
Name of the registry: Clinicaltrials.gov PRS.
TRIAL REGISTRATION NUMBER
NCT05933811. Date of registration: 10-7-2023 (retrospectively registered). URL of trial registry record: https://clinicaltrials.gov .
背景
本研究旨在评估正常睾丸的计算体积在预测其对侧不可触及侧状态方面的价值，从而决定腹腔镜探查的重要性。
方法
2018 年 11 月至 2022 年 8 月，在亚历山大大学医学院 Elshatby 大学医院，我们对单侧不可触及未降睾丸（经临床和超声检查证实）的患者进行了这项前瞻性干预研究。使用公式：体积= L x W x H x π/6 测量正常对侧睾丸的体积和三维直径，其中 L 为长度，W 为宽度，H 为高度，并与术中腹腔镜检查结果相关联。
结果
本研究共纳入 76 例患者。研究患者的年龄在 6 个月至 4 岁之间，平均年龄为 2.17 ± 1.30 岁；大多数年龄在 1 至 3 岁之间。46 例（60.5%）患者为左侧不可触及睾丸，30 例（39.5%）为右侧不可触及睾丸。在那些双侧盲端输精管和血管（0.89 ± 0.16）以及通过深部腹股沟环（DIR）进入腹股沟区的萎缩睾丸（0.83 ± 0.20）的患者中，对侧正常睾丸的计算体积明显大于那些睾丸位于腹腔内（0.53 ± 0.18）或通过 DIR 进入腹股沟区（0.80 ± 0.19）的患者。（Kruskal Wallis 检验；p<0.001*）。
结论
正常睾丸的超声计算体积可以显著预测其对侧不可触及侧的状态，其敏感性和特异性分别为 75.0%和 88.89%，截断值为≤0.674；因此，有助于术前家长咨询。
试验注册
名称：Clinicaltrials.gov PRS。
试验注册号
NCT05933811。注册日期：2023 年 7 月 10 日（回顾性注册）。试验注册网址：https://clinicaltrials.gov。
Zotero 插件