Patency Of The "Third Inguinal Ring" In Children With Unilateral Cryptorchidism: Fact Or Fiction?

Main Category: Pediatrics / Children's Health
Also Included In: Urology / Nephrology
Article Date: 17 Oct 2008 - 4:00 PST

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UroToday.com - A study by Dr. L.H. Braga, et al. evaluated the so-called "third inguinal ring" which is the entrance to the scrotum. It was thought to be an important finding and etiologic factor for undescended testes. Historical reports showed that it might be a true anatomic entity associated with undescended testes. The group assessed the patency of this "third inguinal ring" as an expected testicular path of decent into the scrotum with unilateral cryptorchidism.

Two-hundred consecutive children who underwent unilateral orchiopexy were prospectively evaluated at the time of surgery to determine the anatomical patency of the "third inguinal ring". They were also evaluated for its association in relation to the patient's age at surgery, the affected side, the position of the testis, epididymal anomalies and the patent processus vaginalis. The group found that the mean age at surgery was 5.2 years. The "third inguinal ring" was closed in 118 boys and open in 82 of them. The closed "third inguinal ring" was found more frequently in patients with an intraabdominal testis. There were no statistical significant factors observed between patency of the "third inguinal ring" and other factors that were evaluated.

The group concluded that the "third inguinal ring" may represent the passage point of the testis into the scrotum which really did not seem patent in over 60% of the patients with unilateral cryptorchidism. They felt that this anatomic finding is not an important factor in the pathogenesis of cryptorchidism.

Braga LH, Lorenzo AJ, Pippi Salle JL, Miranda ME, Tatsuo ES, Lanna JC.
Eur J Pediatr Surg. 2008 Aug;18(4):237-40
10.1055/s-2008-1038672

Written by UroToday.com Medical Editor Pasquale Casale, MD

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