title: To 'Pex or Not to 'Pex: What to Do for the Contralateral Testis When a Nubbin Is Discovered.
abstract: OBJECTIVE
  Testicular remnants or nubbins are commonly found in the evaluation and treatment of cryptorchidism. While much debate focuses on the management of the nubbin itself, there is also great uncertainty and variation in the management of the contralateral descended testis. Herein, we review the relevant literature informing the decision to perform a contralateral orchiopexy.
  
  
  RESULTS
  Although there is very little recent literature directly addressing the question, some studies have better characterized differences in practice, the risk of intravaginal torsion in the contralateral testis and potential consequences in the selection of technique. The etiology of a vanishing testis remains obscure, but appears more likely to be the result of a prenatal extravaginal torsion. While indeterminate, the risk of contralateral torsion of a descended testis appears to concentrate around the neonatal period with no substantially increased risk in later years. Contralateral orchiopexy, although a low-risk procedure, likely benefits very few and may carry an as yet poorly described risk to the contralateral testicle depending on the technique of fixation.
authors.affiliation: Department of Urology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA, 92134, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Kehoe
authors.affiliation: Department of Urology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA, 92134, USA. matthew.s.christman3.mil@mail.mil.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Christman
mesh_terms: D006061:Gonadal Dysgenesis, 46,XY / Q000628:therapy; D006801:Humans; D008297:Male; D056126:Orchiopexy; D012307:Risk Factors; D013733:Testicular Diseases / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D013737:Testis / Q000002:abnormalities / Q000473:pathology / Q000503:physiopathology
keywords: Contralateral orchiopexy; Nubbin; Perinatal torsion; Testicle