Hydronephrosis secondary to a seminoma in abdominal cryptorchid testis

The incidence of testicular cancer in cryptorchidism is 30 to 50 times higher than in general population. We present a case of hydronephrosis caused by a seminoma in an abdominal cryptorchid testis. A 22 years old male presented abdominal and right flank pain, and haematuria. Despite the fact that he could not feel right testis since he was 7 years old, he had never looked for treatment. A huge mass was palpable in hypogastric, and IVP and CT Scan demonstrated functional exclusion of the right kidney, and a solid tumor localized at the right iliac fossa, near the bladder wall. The patient was submitted to laparotomy with resection of the mass, and the histopathologic study showed classic seminoma. Abdominal testes have higher incidence of malignancy than those in the inguinal position. The orchiopexy is recommended for abdominal testis after 2 years old to facilitate the investigation and identification of testicular cancer.     

Childhood gonadoblastoma and seminoma in a dysgenetic cryptorchid gonad.

A case of gonadoblastoma and seminoma occurring in a genotypic male child with ambiguous genitalia is presented. A review of the literature establishes that children with intersex disorders who possess a Y chromosome and undescended gonads stand a particularly high risk of having this type of gonadal neoplasm and should be explored.     

Role of laparoscopic hernia repair in men with a previous negative inguinal exploration for a cryptorchid testicle

OBJECTIVES: To evaluate the role of laparoscopy in adults presenting with indirect inguinal hernias with a previous negative inguinal exploration for nonpalpable testes in childhood who were diagnosed with a vanishing testis. MATERIALS AND METHODS: We present a case report of an individual who underwent a negative inguinal exploration in childhood for a nonpalpable testis. During laparoscopic repair of the defect, an intra-abdominal testicle was discovered. This was the basis for a literature search for the role of laparoscopy in adults with nonpalpable testes. A MEDLINE and PubMed online literature search was performed from 1980 to present. Search words such as adult nonpalpable testis, cryptorchidism, vanishing testis, and laparoscopy were used. RESULTS: Ten articles were found detailing the role of laparoscopy in the management of undescended testes in adult patients. CONCLUSIONS: When a patient presents with an indirect hernia and a history of inguinal exploration for an impalpable testicle and there is no clear prior negative inguinal exploration for a nonpalpable testis, laparoscopy has an important role in further evaluation of the patient. Owing to the risk of malignancy in the undescended testis and risk for subfertility, patients evaluated during the prelaparoscopic era need to have the diagnosis of an absent testis confirmed or refuted. Laparoscopy is a safe, effective, and sensitive procedure for evaluating and treating nonpalpable testes in adults.     

Spontaneous rupture of a Dacron prosthesis

This case report concerns a spontaneous rupture of a Dacron prosthesis 19 years after its insertion. The rupture occurRed in the mid-graft portion, remote from the anastomoses and was not associated with proved infection. It was the result of an intrinsic deterioration of the graft textile structure. The patient recovered after insertion of a new Dacron graft. The authors discuss the incidence of graft degeneration and the causative factors. Lesions on the frame of the graft could be due to a variety of factors such as intrinsic Dacron graft factors, manufacturing, inappropriate utilization, physical, enzymatic or immunological factors.     

Spontaneous rupture of a bladder diverticulum

A case of spontaneous rupture of an acquired bladder diverticulum is presented. Diagnosis was made preoperatively and full recovery followed surgical treatment. A review of the literature revealed 9 other cases of spontaneous rupture. Bladder outlet obstruction and urinary tract infection were present in the majority of cases. In the past misdiagnosis and delayed treatment led to significant mortality. However, the prognosis currently is better due to the use of broad-spectrum antibiotics, better radiological imaging studies, and earlier diagnosis and treatment.