First one with correct answer with justification win.

 

A two-year old presents with a right scrotal mass and thickened inguinal cord suggestive of an inguinal hernia. His left testicle is normal and descended. On exploration of the right groin, two testes and two vas deferens are identified along with the hernia sac.

 

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[size=20px]In addition to high ligation of the hernia sac, this patient should have

 

A both testes placed in the right scrotum.

 

B removal of both testes.

 

C yearly ultrasounds to evaluate the testes.

 

D biopsy of both testes.[/size]

A placed in the scrotum

A placed in the scrotum

Correct

 

Polyorchidism is defined as the presence of more than two testes. Conservative management is recommended if polyorchidism is identified on preoperative imaging. If it is identified at the time of surgery, preservation of the both testes are recommended if possible for sperm and testosterone production. Biopsy and yearly ultrasound are not recommended.

This clinical scenario should not be confused with crossed testicular ectopia or transverse testicular ectopia where both gonads migrate in one hemiscrotum. For this entity, transseptal orchiopexy is the operative procedure of choice.

Edited October 16, 20206 yr by Admin