Scrotal nubbins associated with blind-ending spermatic vessels and a normal vas deferens on laparoscopy.
OBJECTIVE
To determine whether a scrotal nubbin is present in children with unilateral non-palpable testis when diagnostic laparoscopy demonstrates blind-ending vessels and a normal vas deferens entering a closed internal ring.


METHODS
Eighty consecutive patients with a unilateral nonpalpable testis were retrospectively reviewed. Patients underwent initial diagnostic laparoscopy, and, if needed, subsequent inguinal exploration was performed. On inguinal exploration, any testicular remnant or nubbin-like tissue was removed and evaluated histologically. Patients with a patent processus vaginalis were excluded from this analysis.


RESULTS
Overall, 60 of the 80 patients had neither an abdominal testis nor a patent processus vaginalis. Of these 60, 34 patients had both a vas deferens and spermatic vessels entering a closed internal ring, and all of these underwent inguinal exploration. A total of 17 patients had both a blind-ending vas deferens and blind-ending spermatic vessels; no inguinal exploration was attempted. In nine patients, laparoscopy revealed blind-ending vessels with a normal vas deferens entering the closed internal ring. Of these nine, six underwent inguinal exploration, and a scrotal nubbins was found in three. At histological examination, hemosiderin deposit and calcification were seen in the nubbin tissue. No viable germ cell was detected in these specimens.


CONCLUSIONS
A laparoscopic finding of blind-ending vessels above the closed internal ring does not mean intra-abdominal vanished testis, regardless of the appearance of the vas deferens.
Department of Urology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan. yyamazaki@kcmc.jp
Yuichiro
Y
Yamazaki
Mari
M
Suzuki
Yoshiyuki
Y
Shiroyanagi
Daisuke
D
Matsuno
Yukichi
Y
Tanaka
D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000473:pathology*; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D012189:Retrospective Studies; D012611:Scrotum / Q000473:pathology*; D013085:Spermatic Cord / Q000002:abnormalities*