Related Experiment Video
Updated: Jul 9, 2025
Clinical Application of 24 G Cannula Needle and 3-0 Polypropylene Suture in Vas Deferens Exploration
Published on: February 10, 2023
Can we preserve the necrotic testis caused by incarcerated inguinal hernia in infants under 3 months?
Jinfeng Hou1,2, Wei Feng1,2, Qingshuang Liu1,2
1Department of General Surgery and Neonatal Surgery, Children's Hospital of Chongqing Medical University, Liangjiang Wing, Yubei District, Chongqing, 401122, China.
Insights
Testicular preservation in infants with necrotic testes from incarcerated inguinal hernias is possible. This approach may prevent testicular atrophy without affecting the contralateral testis, suggesting a conservative surgical strategy.
Area of Science:
- Pediatric Surgery
- Urology
- Neonatal Care
Background:
- Incarcerated inguinal hernias in infants can lead to testicular necrosis.
- The management of necrotic testes in this population is challenging, with traditional approaches often involving orchiectomy.
Purpose of the Study:
- To evaluate the feasibility and outcomes of preserving necrotic testes in infants under 3 months old with incarcerated inguinal hernias.
- To compare testicular volume, hormonal levels, and antibody formation in preserved testes versus those removed (orchiectomy) or in a control group.
Main Methods:
- Retrospective analysis of infants under 3 months with necrotic testes due to incarcerated inguinal hernias (2016-2020).
- Patients were categorized into orchiectomy and testicular preservation groups, with a control group of healthy males.
- Collected data included bilateral testicular volume, dihydrotestosterone, inhibin B, and antisperm antibodies.
Main Results:
- Out of 42 cases, 18 were followed for 6-54 months post-operation.
- Two infants in the testicular preservation group did not develop testicular atrophy.
- No significant difference in contralateral testicular volume between preservation and control groups; however, both were smaller than the orchiectomy group. Inhibin B levels were lower in both preservation and orchiectomy groups compared to controls. Dihydrotestosterone and antisperm antibody rates showed no significant intergroup differences.
Conclusions:
- Testicular preservation in infants with necrotic testes secondary to incarcerated inguinal hernias appears viable.
- This conservative approach may allow for testicular survival without adverse effects on the contralateral testis.
- Consideration of less aggressive surgical management, such as testicular preservation, is warranted in these cases.
Purpose:
This study aims to investigate whether necrotic testis resulting from incarcerated inguinal hernias can be preserved in infants under 3 months old.
Methods:
A retrospective analysis was conducted on data collected from infants under 3 months old who had necrotic testis caused by incarcerated inguinal hernias between 2016 and 2020. They were divided into two groups: the orchiectomy group and the testicular preservation group. The control group consisted of normal male children of the same age. Data regarding bilateral testicular volume, dihydrotestosterone, inhibin B, and antisperm antibodies were collected.
Results:
The study included 42 cases, with 18 patients being followed up for 6-54 months after the operation. In the testicular preservation group, 2 children did not experience testicular atrophy. There was no significant difference in the volume of the contralateral testes between the testicular preservation group and the control group; however, both groups had smaller testicular volumes compared to the orchiectomy group. There was no significant difference in the levels of inhibin B between the testicular preservation group and the orchiectomy group, although both were lower than the control group. Furthermore, no significant difference was observed in the levels of dihydrotestosterone and the positivity rate of antisperm antibodies among the three groups.
Conclusion:
Preserving the necrotic testis may allow it to survive without impacting the contralateral testis. Therefore, a more conservative approach should be considered for orchiectomy when dealing with testicular necrosis caused by incarcerated inguinal hernias in infants.
Related Concept Videos
01:27Testes: Histology
The spermatogenic cells, responsible for producing sperm, are...
01:19Testes: Gross Anatomy
Each testis is surrounded by the tunica albuginea, a dense connective tissue layer that provides structural support and protection. This layer is covered by an outer serous membrane called the tunica vaginalis, which helps reduce friction...
01:23Infertility in Males