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• W3020922079 abstract "You have accessJournal of UrologyPediatrics: Andrology-Cryptorchidism & Varicoceles1 Apr 2011328 ONE THIRD OF PATIENTS WITH A UNILATERAL PALPABLE UNDESCENDED TESTES HAVE A CONTRALATERAL PATENT PROCESSUS Himanshu Aggarwal, Paul Feustel, and Barry Kogan Himanshu AggarwalHimanshu Aggarwal Albany, NY More articles by this author , Paul FeustelPaul Feustel Albany, NY More articles by this author , and Barry KoganBarry Kogan Albany, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.411AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The incidence of an ipsilateral patent processus vaginalis associated with unilateral palpable undescended testis ranges between 62–90%. However the rate of a contralateral patent processus vaginalis is unknown. The aim of this study was to determine the incidence of and any predictive factors associated with a contralateral patent processus vaginalis discovered during orchiopexy for a unilateral palpable testis. METHODS We retrospectively reviewed the records of 77 consecutive patients who had undergone orchiopexy for a unilateral palpable testis from June 2007 to May 2010. Orchiopexy was performed using an inguinal incision and the hernia sac was dissected to allow full mobilization of the testis. The initial 6 patients underwent CO2 insufflation alone. The presence of crepitance in the contralateral groin and scrotum constituted a positive test. All other patients underwent laparoscopy through the hernia sac that included introduction of an 8Fr feeding tube, followed by a 70° adult cystoscope lens. The contralateral internal ring was visualized and inspected to determine patency. If found to be patent, the contralateral inguinal canal was explored and high ligation of the patent processus vaginalis was performed. Univariate logistic regression followed by a stepwise multivariate logistic regression analysis was done to determine the factors that might predict the presence of a contralateral patent processus vaginalis. RESULTS Seventy seven consecutive boys with a median age of 14.9 months (range 5.1 months to 17.7 years) underwent an unilateral orchiopexy for a palpable undescended testis. In 6 cases, the ipsilateral hernia sac was either absent or too tiny to pass an 8Fr feeding tube into the peritoneum. The overall rate of a contralateral patent processus vaginalis was 34% in those with a significant ipsilateral hernia sac. After considering age, testicular volume, side of unilateral palpable testis (left vs. right) and location of testis (low lying vs. high lying) only the boys with a testis distal to the external ring had increased odds of a patent contralateral processus vaginalis vs. those lying within the inguinal canal (odds ratio = 3.1 with 95% confidence interval 1.1 to 9.1; p=0.036). CONCLUSIONS The incidence of a contralateral patent processus vaginalis is considerable in patients presenting with a unilateral palpable testis. This can be detected with the help of laparoscopy using a technique similar to that used for unilateral inguinal hernia. So, this should be considered especially in boys with an undescended testis below the external ring. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e132-e133 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Himanshu Aggarwal Albany, NY More articles by this author Paul Feustel Albany, NY More articles by this author Barry Kogan Albany, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W3020922079 title "328 ONE THIRD OF PATIENTS WITH A UNILATERAL PALPABLE UNDESCENDED TESTES HAVE A CONTRALATERAL PATENT PROCESSUS" @default.
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