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Is Pathological Exam for Disorders of the Appendix Testis Necessary?
John M Pickering1, H William Hunt1, S Dave Bhattacharya2
1Department of Surgery, 14733University of Tennessee at Chattanooga, Chattanooga, TN, USA.
The American Surgeon
|November 15, 2021
Summary
Incidental testicular appendages found during pediatric surgery are always benign and small. Pathological analysis is unnecessary, potentially saving resources while still preventing appendage torsion.
Area of Science:
- Pediatric Surgery
- Urology
- Embryology
Background:
- Testicular appendages are embryologic remnants frequently found during pediatric surgeries.
- Current literature lacks clear guidelines for managing incidentally discovered testicular appendages.
- These findings are common during procedures like inguinal hernia repair and cryptorchidism surgery.
Purpose of the Study:
- To evaluate the nature and management of incidentally discovered testicular appendages in pediatric patients.
- To determine the necessity of pathological analysis for these incidental findings.
- To assess the risk of torsion in incidentally found testicular appendages.
Main Methods:
- Retrospective review of 93 pediatric patients from December 2017 to June 2020.
- Analysis of cases involving incidental testicular appendages during inguinal hernia repair, cryptorchidism, or testicular torsion procedures.
- Review of pathology results and specimen sizes for all incidental testicular appendages.
Main Results:
- All incidentally discovered testicular appendages (100%) were benign.
- All specimens measured 1.0 cm or less in their largest dimension.
- Appendage torsion is a significant cause of acute scrotum in children.
Conclusions:
- Pathological analysis of incidentally discovered testicular appendages is unnecessary and resource-intensive.
- Standard care involves removal to prevent testicular appendage torsion.
- Benign, small incidental findings do not require further pathological examination.
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