■Polyorchidism,或多余的睾丸,是一种罕见的泌尿生殖系统先天性疾病.因为它的稀有性,没有批准的标准治疗方案来保存或切除额外的睾丸,然而,在大多数医疗机构中,睾丸固定术通常是首选治疗方法。
方法:我们介绍了一名23岁的单身男性,双侧阴囊空。他没有意识到自己的病情,在被送往我们的外科病房之前没有看过医生。在他年轻的兄弟姐妹被当地割礼医生(一名医务人员,理想的护士,他们的职责是进行包皮环切术,最好在家),他看到了一些不同的东西(他空虚的阴囊),带着他的问题来找我们。实验室发现严重的少精子症,和肿瘤标志物(甲胎蛋白,β-人绒毛膜促性腺激素,和乳酸脱氢酶)均为恶性肿瘤。患者接受了所有六个睾丸的双侧疝修补术和睾丸固定术(每个腹股沟管中三个),并且恢复顺利。
■由于多睾丸不是一个常见的问题,由于缺乏基于证据的共识,其管理仍然是一个有争议的问题。然而,随着新的成像模式和台式冰冻切片活检的引入,继续进行睾丸固定术或睾丸切除术的决定很容易证明是合理的;然而,在没有共存异常的情况下,保守治疗是可取的,尤其是隐睾。
结论:多睾丸可能会在多年内被忽视,特别是如果没有直接和一致地进入医疗机构。如果在影像学检查或手术探查过程中意外发现了多精子症,治疗必须相应地合理。
UNASSIGNED: Polyorchidism, or supernumerary
testis, is a rare urogenital congenital disorder. Because of its rarity, there is no approved standard treatment protocol for preserving or removing the extra testicle, yet orchiopexy is frequently performed as a preferred treatment in most medical facilities.
METHODS: We present a 23-year-old single male with a bilaterally empty scrotum. He was unaware of his condition and had not seen a doctor before being admitted to our surgical unit. During his younger sibling\'s circumcision by a local circumcisionist (a medical staff member, idealy a nurse, whose duty is to perform circumcision, preferably at home), he saw something different (his emptey scrotum) and came to us with his problem. Laboratory findings revealed severe oligospermia, and tumor markers (Alpha fetoprotein, beta-human chorionic gonadotropin, and lactate dehydrogenase) were negative for malignancy. The patient underwent bilateral herniorrhaphy and orchiopexy of all six testicles (three in each inguinal canal) and had an uneventful recovery.
UNASSIGNED: As polyorchidism is not a common problem, its management remains a contentious issue due to the lack of evidence-based consensus. However, with the introduction of new imaging modalities and on-table frozen section biopsy, the decision to continue with orchiopexy or orchiectomy can be easily justified; however, conservative treatment is preferable in cases of no coexisting anomalies, particularly cryptorchidism.
CONCLUSIONS: Polyorchidism could run unnoticed for years, especially if there is no direct and consistent access to a medical facility. In cases where polyorchidism is detected accidentally by imaging or during surgical exploration, the treatment must be justified accordingly.