Undescended Testis In Older Boys: Further Evidence That Ascending Testes Are Common

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 - Orchiopexy is usually performed between the ages of six months and one year. Despite the fact it is generally diagnosed early in life, there is a subset of patients that come for orchiopexy at a later age. This retrospective review evaluated the groups' experience with patients undergoing late orchiopexy, defined as orchiopexy performed after four years of age.

This study evaluated 191 late orchiopexy procedures in 177 patients. The median age of surgery was 7.2 years. The ages ranged from 4 years to16.2 years. The testes were palpable in 72% of the cases and impalpable in 28%. It appeared that the apparent reasons for the late orchiopexies were an ascending testis in 45% of the cases, parental delay in 22% of the cases, late referral in 20% of the cases and iatrogenic cryptorchidism after other inguinal surgery in 9% of the cases. It appeared that ascending testes were more likely to have a history of being retractile in 85% of the cases. Over three-quarters of them had a patent processus vaginalis at the time of surgery. The ascending testes appeared to be localized to the superficial inguinal area in 87% of the cases.

The group concluded that an informed primary care provider as well as parental education on the benefits of early orchiopexy are paramount. It also stated that as urologists, we have to be aware of the ascending testis phenomenon that it is probably much more common than previously recognized. It also emphasized that patients with retractile testes should be followed regularly as a good number of these patients end up with an ascending testis syndrome.

Guven A, Kogan BA
J Pediatr Surg. 2008 Sep;43(9):1700-4
doi:10.1016/j.jpedsurg.2008.03.029

Written by UroToday.com Medical Editor Pasquale Casale, MD

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