睾丸横过异位畸形的诊断和治疗(附1例报告并文献复习)

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1、睾丸横过异位畸形的诊断和治疗（附1例报告并文献复习）罗勇，张克勤，李波军，张勇，张超，徐光辉，刘扬，李彦锋(400042重庆，第三军医大学大坪医院野战外科研究所泌尿外科)[摘要]目的结合1例睾丸横过异位患者的诊治过程，复习有关文献探讨其病因学、诊断方法和治疗措施。方法本院收治1例青年男性患者存在左侧睾丸横过异位伴同侧精索鞘膜积液，右侧腹股沟斜疝，右侧附睾囊肿，手术证实右侧腹股沟2根输精管和2根精索，右侧阴囊内2个睾丸。将异位的左侧睾丸通过阴囊纵隔复位固定于对侧阴囊肉膜下，并行左侧精索鞘膜大部切除，右侧腹股沟疝修补术，右侧附睾囊肿切除术。根据该患者的临床表现、诊断和治疗过程，

2、结合相关文献对该病的整体临床特征进行分析。结果本例患者术后诊断为：(1)左侧睾丸横过异位；(2)左侧精索鞘膜积液；(3)右侧腹股沟复发疝；(4)右侧附睾囊肿；(5)弱精症。术后患者病情恢复顺利，术后随访3个月，复查见患者双侧睾丸位置良好，形态大小和血供正常。其他伴随异常均消失。结论睾丸横过异位作为一种罕见的生殖系发育畸形，常伴有腹股沟疝、精索鞘膜积液甚至苗勒氏管持续存在综合征等多种异常，宜及早采取手术治疗并同时纠正伴随病变。为避免伴随的胚胎发育残迹的远期癌变，术后需长期随访。[关键词]睾丸横过异位；畸形；隐睾；诊断；治疗[中图法分类号][文献标志码]ADiagnosisan

3、dtreatmentoftransversetesticularectopia:acasereportwithliteraturereviewLuoYong,ZhangKeqin,LiBoJun,ZhangYong,ZhangChao,XuGuangHui,LiuYang,LiYanFeng（DepartmentofUrology,DapingHospital,InstituteofSurgeryResearch,ThirdMilitaryMedicalUniversity,Chongqing400042,China）[Abstract]ObjectivesTodiscus

4、stheetiology，diagnosisandtreatmentoftransversetesticularectopia(TTE).MethodsHerereportsacaseoftransversetesticularectopia，whichwasfoundtwovasdeferensandtwospermaticcord，twotestesontherightsideoftheinguinalcanalandthescrotumduringtheoperation.Thespermaticcordswerefullyfree，andtheectopictest

5、iswasfixedbytraversethescrotalmediastinum.Theassociatedanomalysuchastherightinguinalherniawasrepairedandthehydroceleofspermaticcordwastreatedbyresectionoftheredundanttunicavaginalisatthesametime.ResultsBilateraltesteswereinproperpositionswithnormalvascularsupplybythreemonthsfollowupafterth

6、eoperation.ConclusionTTEisararecongenitalabnormalityoftesticularmaldescent.Itusuallyaccompaniedbyotheranormaliessuchasinguinalhernia,hydroceleandpersistentorrudimentaryMullerianremnants.Earlyoperationisthebestoptionforitstreatment.Long-termpostoperativefollow-upishighlyrecommendedforpreven

7、ttheriskofmalignancyintheembryonicremnants.[Keywords]Transversetesticularectopia；malformation；Undescendedtestis;diagnosis;treatmentCorrespondingauthor:LiYanFeng,Tel:86-23-68757942，E-mail：lyf1000@aliyun.com[通信作者]李彦锋，电话：（023）68757942，E-mail：lyf1000@aliyun.com睾丸横