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Ungureanu C, Stanculea F, Ginghina O, Cristian DA, Grigorean VT, Popescu R, Georgescu D, Iordache N. Laparoscopic approach of inguinal hernia associated with adult cryptorchidism: case series and literature review. J Surg Case Rep 2024; 2024:rjae232. [PMID: 38605699 PMCID: PMC11007635 DOI: 10.1093/jscr/rjae232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 03/23/2024] [Indexed: 04/13/2024] Open
Abstract
Cryptorchidism is defined as the extra-scrotal position of the testes. It is a common disorder in male children, but rarely in adult patients. The association of cryptorchidism with hernia is a common finding in childhood, but is not frequent in adults or the elderly. Herein, we report a series of three cases (28-, 24-, and 34-year-old men) of adult inguinal hernia combined with cryptorchidism successfully managed by laparoscopic surgery under the same operative view. Laparoscopic transabdominal preperitoneal repair and orchiectomy were performed in all patients. No complications occurred in the postoperative period, and the patients were discharged on the first or second postoperative day. Pathological examination of the specimens revealed atrophic testes without malignancy. No hernia recurrence was observed during follow-up. The laparoscopic approach in the combined pathology of inguinal hernia and cryptorchidism is feasible in adult patients and has multiple advantages in terms of diagnosis and management.
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Affiliation(s)
- Claudiu Ungureanu
- “Carol Davila” University of Medicine and Pharmacy, 37, Dionisie Lupu Street, 020021 Bucharest, Romania
- General Surgery Department, “Sf. Ioan” Clinical Emergency Hospital, 13, Vitan Barzesti Street, 042122 Bucharest, Romania
| | - Floris Stanculea
- “Carol Davila” University of Medicine and Pharmacy, 37, Dionisie Lupu Street, 020021 Bucharest, Romania
- General Surgery Department, “Sf. Ioan” Clinical Emergency Hospital, 13, Vitan Barzesti Street, 042122 Bucharest, Romania
| | - Octav Ginghina
- “Carol Davila” University of Medicine and Pharmacy, 37, Dionisie Lupu Street, 020021 Bucharest, Romania
- General Surgery Department, “Prof. Dr. Alexandru Trestioreanu” Oncological Institute, 252, Fundeni Street, 022328 Bucharest, Romania
| | - Daniel A Cristian
- “Carol Davila” University of Medicine and Pharmacy, 37, Dionisie Lupu Street, 020021 Bucharest, Romania
- General Surgery Department, “Coltea” Clinical Hospital, 1, I.C.Bratianu Street, 030171 Bucharest, Romania
| | - Valentin T Grigorean
- “Carol Davila” University of Medicine and Pharmacy, 37, Dionisie Lupu Street, 020021 Bucharest, Romania
- General Surgery Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12, Berceni Street, 041915 Bucharest, Romania
| | - Razvan Popescu
- “Carol Davila” University of Medicine and Pharmacy, 37, Dionisie Lupu Street, 020021 Bucharest, Romania
- Urology Department, “Th.Burghele” Clinical Hospital, 20, Panduri Street, 050659 Bucharest, Romania
| | - Dragos Georgescu
- “Carol Davila” University of Medicine and Pharmacy, 37, Dionisie Lupu Street, 020021 Bucharest, Romania
- General Surgery Department, “Dr. I. Cantacuzino” Clinical Hospital, 5-7, Ioan-Movila Street, 022904 Bucharest, Romania
| | - Niculae Iordache
- “Carol Davila” University of Medicine and Pharmacy, 37, Dionisie Lupu Street, 020021 Bucharest, Romania
- General Surgery Department, “Sf. Ioan” Clinical Emergency Hospital, 13, Vitan Barzesti Street, 042122 Bucharest, Romania
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Kimura D, Miyagawa Y, Miyao M, Matumura H, Koike S. An adult right inguinal hernia and cryptorchidism treated simultaneously with laparoscopic transabdominal preperitoneal repair and laparoscopic orchiectomy: a case report. J Surg Case Rep 2024; 2024:rjae096. [PMID: 38410527 PMCID: PMC10896068 DOI: 10.1093/jscr/rjae096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/04/2024] [Indexed: 02/28/2024] Open
Abstract
Pediatric health checkups have been mandatory for all citizens since 1966 based on the Maternal and Child Health Law in Japan, and cryptorchidism or undescended testis in adult males are rare. We report a case of an adult right inguinal hernia and cryptorchidism treated simultaneously with laparoscopic transabdominal preperitoneal repair and laparoscopic orchiectomy. A 35-year-old man came to our department with a chief complaint of bulging in the right inguinal region for several months. He was diagnosed with a right inguinal hernia and was scheduled for transabdominal preperitoneal repair. During intraoperative intraperitoneal observation, a white 30-mm mass was found in the hernia orifice. A diagnosis of right cryptorchidism was made, and transabdominal preperitoneal repair and laparoscopic orchiectomy were performed. Laparoscopic simultaneous surgery could be safely performed in an adult patient with a hernia complicated by a cryptorchidism. It can be recommended as a surgical option in such cases.
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Affiliation(s)
- Dai Kimura
- Department of Surgery, Matsumoto National Hospital, Matumoto City 399-0036, Japan
| | - Yusuke Miyagawa
- Department of Surgery, Matsumoto National Hospital, Matumoto City 399-0036, Japan
| | - Masafumi Miyao
- Department of Surgery, Matsumoto National Hospital, Matumoto City 399-0036, Japan
| | - Hideyasu Matumura
- Department of Surgery, Matsumoto National Hospital, Matumoto City 399-0036, Japan
| | - Shoichiro Koike
- Department of Surgery, Matsumoto National Hospital, Matumoto City 399-0036, Japan
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Han H, Li J, Lei HE, Yin H, Tian L. Laparoscopic orchidopexy for the treatment of cryptorchidism in adults: a description of the technique and outcomes. BMC Urol 2024; 24:1. [PMID: 38166868 PMCID: PMC10763021 DOI: 10.1186/s12894-023-01386-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND There are few studies on cryptorchidism in adults, and its treatment is still controversial. METHODS To summarize the surgical strategy and clinical efficacy of laparoscopic orchidopexy for the treatment of cryptorchidism in adults, 37 adult cryptorchidism patients were retrospectively analyzed between September 2017 and February 2022. All 37 patients underwent laparoscopic orchidopexy, of whom 33 underwent inguinal hernia repair without tension. The intraoperative procedures and surgical techniques were recorded in detail. Preoperative examination and regular postoperative review of color Doppler ultrasound, and reproductive hormone, alpha-fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase levels were performed. RESULTS All testes descended successfully into the scrotum, including 25 through the inguinal route and 12 through Hesselbach's triangle route. No intraoperative or postoperative complications were observed. The follow-up time was 38.6 (± 19.4) months, and no evidence of testicular malignancy was found during the follow-up period. After analyzing the reproductive hormone levels at 1 year postoperatively in 28 patients with more than 1 year of follow-up, it was found that the patients had a significant increase in testosterone levels and a decrease in follicle-stimulating hormone levels after surgery. None of the patients showed any significant improvement in semen quality after surgery. CONCLUSION Our study suggests that laparoscopic orchidopexy is a safe and feasible surgical procedure for the treatment of cryptorchidism in adults, especially high cryptorchidism, which is difficult to treat. After comprehensive consideration, preserving the testis should be preferred for treating cryptorchidism in adults to maximize the protection of the patient's reproductive hormone secretion function.
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Affiliation(s)
- Hu Han
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gong Ti Nan Road, Beijing, 100020, China
- Institute of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jiaxing Li
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gong Ti Nan Road, Beijing, 100020, China
- Institute of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Hong-En Lei
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gong Ti Nan Road, Beijing, 100020, China
- Institute of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Hang Yin
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gong Ti Nan Road, Beijing, 100020, China.
- Institute of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
| | - Long Tian
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gong Ti Nan Road, Beijing, 100020, China.
- Institute of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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Wakabayashi M, Aoki K, Yoshida H, Kimura T, Domoto Y, Hosaka M, Funatsu K, Aisaki K, Hokari T. Laparoscopic treatment for adult inguinal hernia with cryptorchidism: A case report. Int J Surg Case Rep 2020; 75:46-49. [PMID: 32919328 PMCID: PMC7490975 DOI: 10.1016/j.ijscr.2020.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 09/02/2020] [Indexed: 11/18/2022] Open
Abstract
Cryptorchidism is the most common disorder of male children, which is often diagnosed and treated during childhood. A case of adult inguinal hernia with cryptorchidism is rare condition. TAPP and simultaneous laparoscopic orchiectomy for inguinal hernia with cryptorchidism were safe and feasible.
Introduction Cryptorchidism or undescended testis is the most common disorder of male children, which is often diagnosed and treated during childhood. Adult patients with cryptorchidism are uncommon. Herein we report the case of adult inguinal hernia with cryptorchidism successfully treated by laparoscopic surgery simultaneously. Presentation of case We report a case of 68 year-old-man who was admitted to our hospital with a complaint of bulge and pain in the right groin area from 2 weeks before. CT or MRI revealed a right inguinal hernia and an undescended testis in the right inguinal canal. He was diagnosed with right inguinal hernia accompanied by cryptorchidism. Laparoscopic transabdominal preperitoneal repair (TAPP) and orchiectomy were performed simultaneously. Postoperative period was uneventful and he was discharged home on the 1st postoperative day. Pathological examination of the specimen was reported as atrophic testis with no malignancy. There has been no recurrence during a follow-up. Discussion To our Knowledge, the case report of adult inguinal hernia with cryptorchidism treated by laparoscopic surgery is rare. All cases recommended the feasibility of laparoscopic surgery. Conclusion Adult inguinal hernia with cryptorchidism is a rare condition. TAPP and simultaneous laparoscopic orchiectomy for inguinal hernia with cryptorchidism were safe and feasible. It could be the first surgical option for the treatment of such adult patients.
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Affiliation(s)
| | - Kana Aoki
- Department of Surgery, Sagamihara Kyodo Hospital, Japan
| | | | | | | | - Miki Hosaka
- Department of Surgery, Sagamihara Kyodo Hospital, Japan
| | | | - Kazuo Aisaki
- Department of Surgery, Sagamihara Kyodo Hospital, Japan
| | - Takeo Hokari
- Department of Surgery, Sagamihara Kyodo Hospital, Japan
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Rajapaksha K. Analysis of guideline conformity, surgical techniques, devices, consumables, and outcomes of the first 100 cases of laparoscopic inguinal hernia repair in adults during institutional hernia programme in a single surgical center. INTERNATIONAL JOURNAL OF ABDOMINAL WALL AND HERNIA SURGERY 2020. [DOI: 10.4103/ijawhs.ijawhs_40_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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