Pediatric surgery international · 2026
Testicular remnant phenotype, histology, and ultrasonographic findings in non-palpable testes: implications for surgical management.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
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Okur Özkan, Tantay Ayşe Gül Tavukcu, Can Mehmet, Şencan Arzu
Аннотация
BACKGROUND: In boys with non-palpable testes (NPT), the clinical significance of excised testicular remnants-and whether gross phenotype predicts histologic viability-remains uncertain. We evaluated remnant phenotype, histology, and ultrasonographic (US) findings to inform surgical management.
METHODS: We retrospectively reviewed boys undergoing surgical exploration for NPT (2010-2025) following examination under general anesthesia. Testes were classified as intra-abdominal (IAT) or excised remnants; remnants were categorized as nodular versus non-nodular and stratified by internal ring pattern. The primary outcome was residual testicular elements; secondary outcomes included US detection and contralateral testicular size.
RESULTS: Among 346 patients (370 testes), 120 were IAT and 250 excised remnants. Germ cells were identified in 7/250 (2.8%), exclusively in nodular specimens; seminiferous tubules in 38/250 (15.2%), and Leydig cells in 21/250 (8.4%). US detected a testicular structure in 39.3% of patients and missed 37.5% of IAT (62.5% vs. 24.4% for IAT vs. remnants, p < 0.001). Contralateral hypertrophy showed moderate discrimination in children < 6 years (AUC up to 0.820) but substantial overlap beyond 72 months.
CONCLUSION: Excised testicular remnants were predominantly degenerative, with viable germ cell-containing elements confined to macroscopically nodular specimens. Preoperative ultrasonography showed low diagnostic yield and did not alter operative management. Within the limitations of a single-center retrospective design, these findings suggest that the remnant excision strategy may be informed by macroscopic phenotype and intraoperative anatomy, while routine preoperative US warrants reconsideration.
METHODS: We retrospectively reviewed boys undergoing surgical exploration for NPT (2010-2025) following examination under general anesthesia. Testes were classified as intra-abdominal (IAT) or excised remnants; remnants were categorized as nodular versus non-nodular and stratified by internal ring pattern. The primary outcome was residual testicular elements; secondary outcomes included US detection and contralateral testicular size.
RESULTS: Among 346 patients (370 testes), 120 were IAT and 250 excised remnants. Germ cells were identified in 7/250 (2.8%), exclusively in nodular specimens; seminiferous tubules in 38/250 (15.2%), and Leydig cells in 21/250 (8.4%). US detected a testicular structure in 39.3% of patients and missed 37.5% of IAT (62.5% vs. 24.4% for IAT vs. remnants, p < 0.001). Contralateral hypertrophy showed moderate discrimination in children < 6 years (AUC up to 0.820) but substantial overlap beyond 72 months.
CONCLUSION: Excised testicular remnants were predominantly degenerative, with viable germ cell-containing elements confined to macroscopically nodular specimens. Preoperative ultrasonography showed low diagnostic yield and did not alter operative management. Within the limitations of a single-center retrospective design, these findings suggest that the remnant excision strategy may be informed by macroscopic phenotype and intraoperative anatomy, while routine preoperative US warrants reconsideration.