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TH
CONGRESS OF THE ESPU
MATERIAL AND METHODS
Retrospective study of 39 patients with HC treated at our institution between January 2010 and
October 2016. We analysed demographics, underlying diagnosis and treatment modalities.
RESULTS
We treated 39 patients with HC. Mean age was 9.4 years (SD:4.20) and 64% were males. Acute
leukemia was the most common underlying diagnosis in 27(69%). Mean time from HSCT to HC
onset was 55.46 days (SD:112.35). CH grades were: I (3), II (21), III (8) and IV (7). BK-viuria was
present in 34 (87.2%) of patients.
Noninvasive treatment was performed in 28 (71.8%). The remaining 11 (28.2%) required urological
intervention (all were high-grade cystitis), consisting of bladder irrigation in all of them. Additional
treatments consisted of: intravesical cidofovir (3), intravesical hyaluronic acid (5), cystoscopy and
clot evacuation (4), selective angioembolization (2) and cutaneous vesicostomy (1).
Overall, 8 patients (20.5%) died as a result of the malignancy (3 in the urological intervention group),
4 had active HC at death. Mean follow-up was 36.2 months (SD: 24.9).
CONCLUSIONS
HC is associated with high morbidity and mortality. Treatment should be individualized and designed
to preserve the patient’s life. However, bladder function should try to be preserved for the future.
S19-12 (P without presentation)
TESTICULAR REMNANTS: TO EXCISE OR NOT?
THE DEBATE GOES ON
Lee SMITH
1
, Haitham DAGASH
1
, Nitin PATWARDHAN
1
, Bala ERADI
1
and Ashok RAJIMWALE
2
1) The Children Hospital, Paediatric Surgery, Leicester, UNITED KINGDOM - 2) The Children Hospital, Paediatric
Urology, Leicester, UNITED KINGDOM
PURPOSE
There is controversy as to the need for surgical management of the testicular remnant for im-
palpable testis or “vanishing testis”. This controversy is based on the variable reports of viable
germ cell elements found within the testicular remnants and the inferred risk of possible malignant
transformation if left in situ.
MATERIAL AND METHODS
A retrospective review of all testicular tissue remnants excised in boys with an impalpable testis
during the period from January 1995 - September 2016 using the histology database. Patients with
evidence of acute torsion, ambiguous genitalia, testicular biopsy and those who had previous ingui-
nal surgery were excluded. Pathology reports were analysed for presence of seminiferous tubules,
Leydig or Sertoli cells, vas, epididymal structures, haemosiderin laden macrophages, calcification
and germ cell elements.
RESULTS
A total of 234 testicular remnants were excised from 233 boys, with the average age at operation
being 2.8yrs (3mths-13.9yrs). These had been analysed by 10 Consultant Histopathologists over
the specified period.
Testicular or paratesticular tissue was confirmed in 181 (77%) specimens. Sixty eight percent of
cases were left sided. Seminiferous tubules were identified in 49 (20%) remnants. In 12 (5.1%)
germ cells were present in combination with seminiferous tubules; however, there was no germ
cell atypia or dysplasia. The average age of boys with germ cells present was 6.8 years (1.4-13.3).
Other findings were the presence of calcification (38%), haemosiderin laiden macrophages (27%),
fibrosis (13.6%), hyaline deposits (4.7%), giant cells (2.1%) and ectopic adrenal rests (1.7%).