Evaluation of testicular stiffness in boys with unilateral cryptorchidism after orchiopexy by ultrasound strain elastography

PURPOSE

We assessed the stiffness of unilateral undescended testes after orchiopexy, examining its value in tracking histopathological changes and fertility potential during postoperative follow-up. Additionally, we explored the optimal timing for surgery based on testicular stiffness.

PATIENTS AND METHODS

Thirty-six boys who had been diagnosed with unilateral undescended testis and treated with orchiopexy were included in the study. Testicular stiffness was evaluated several times over respective follow-up periods by ultrasound strain elastography after orchiopexy. The strain ratios were measured as the ratios of the elasticities of the descended testis to those of the operated testes. The patients were divided into two groups based on the age at which they underwent orchiopexy:under < 2 years (Group A) and ≥ 2 years (Group B).

RESULTS

The mean strain ratios were 0.90 ± 0.32 and 0.92 ± 0.20 in Groups A and B, respectively. In Group A, the strain ratio was constant regardless of postoperative months (r = 0.01, p = 0.99); however, in Group B, it tended to increase with postoperative months (r = 0.42, p = 0.07).

CONCLUSIONS

Evaluation of testicular stiffness may be useful for the estimation of histopathological changes and fertility potential in boys with unilateral undescended testes at follow-up appointments after orchiopexy. Our data indicate that performing orchiopexy as early as possible may be recommended to avoid testicular damage.

Coincidental occurrence of bilateral neonatal testicular torsion, with an extravaginal and a contralateral intravaginal testicular torsion

Introduction

We report a case of bilateral neonatal testicular torsion, with an extravaginal and a contralateral intravaginal testicular torsion.

Case presentation

A 5-day-old boy with bilateral scrotal swelling and palpable induration was diagnosed with bilateral neonatal testicular torsion by color Doppler ultrasonography. The right testis was black with 360-degree extravaginal torsion of the spermatic cord, and the left testis was brown with 90-degree intravaginal torsion. We repaired the torsion and incised the tunica albuginea to reduce intratesticular pressure. The left testis became pink in color, but the right testis remained unchanged. Based on the pathological findings of the intraoperative biopsy of tissue specimens from both testes, we performed a right orchiectomy and preserved the left testis.

Conclusions

Our experience suggests that testicular color improvement after fasciotomy and pathological findings of intraoperative testicular biopsy may indicate testicular preservation.

Case of vaginal cuff dehiscence and small bowel evisceration after laparoscopic radical cystectomy

INTRODUCTION

Vaginal cuff dehiscence and small bowel evisceration after laparoscopic radical cystectomy, although rare, can be a critical complication. However, little has been reported about it by urologists.

CASE PRESENTATION

A 79-year-old woman underwent laparoscopic radical cystectomy for invasive bladder carcinoma. Thirteen months postoperatively, she experienced vaginal cuff dehiscence and small bowel evisceration, and underwent emergency surgery. Intraoperatively, we detached the vaginal apex from the surrounding tissue to lengthen it and performed vaginal uterosacral ligament suspension, with no subsequent recurrence.

CONCLUSION

Urologists should pay attention to vaginal cuff dehiscence and small bowel evisceration after laparoscopic radical cystectomy in female patients. In this case, the short vaginal length without vaginal uterosacral ligament suspension might have led to vaginal dehiscence.