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Bilobed testis, also known as incomplete unilateral polyorchidism, is a very rare congenital variant in children, and considered to be an incomplete form of polyorchidism.
The exact etiology is unknown but is thought to be a form of incomplete polyorchidism. It has been proposed that bilobed testis results from the incomplete division of the urogenital ridge 1-3.
- lobulated testis with normal echotexture
- hemitesticular structure of similar echogenicity to that of the normal testis
Treatment and prognosis
The treatment depends on any underlying abnormality and the evidence is conflicting. Some papers suggest conservative management and imaging follow up (particularly if cancer suspected) 4,5. While others recommend surgical intervention of the affected testis and orchiopexy of the contralateral testis due to the significant risk of testicular torsion 6.
- 1. McAlister W, Manley C. Bilobed testicle. Pediatr Radiol. 1987;17 (1): 82-82. Pediatr Radiol (abstract) - doi:10.1007/BF02386606
- 2. Beiko D, Macneily AE. Torsion of bilobed testis and biopsy-proven ipsilateral supernumerary testis in an adolescent. Can Urol Assoc J. 2013;4 (3): E67-70. Free text at pubmed - Pubmed citation
- 3. De Carli C, Guerra L, Leonard M. Bilobed testicle in children: diagnosis and management. Can Urol Assoc J. 2011;3 (6): E87-8. Free text at pubmed - Pubmed citation
- 4. Thum G. Polyorchidism: case report and review of literature. (1991) The Journal of urology. 145 (2): 370-2. Pubmed
- 5. Khedis M, Nohra J, Dierickx L, Walschaerts M, Soulié M, Thonneau PF, Plante P, Huyghe E. Polyorchidism: presentation of 2 cases, review of the literature and a new management strategy. (2008) Urologia internationalis. 80 (1): 98-101. doi:10.1159/000111738 - Pubmed
- 6. Ferro F, Iacobelli B. Polyorchidism and torsion. A lesson from 2 cases. (2005) Journal of pediatric surgery. 40 (10): 1662-4. doi:10.1016/j.jpedsurg.2005.06.029 - Pubmed