Outcome Of Different Treatment Modalities In Newborns With Undescended Testes Secondary To Large Abdominal Wall Or Diaphragmatic Defects

Main Category: Pediatrics / Children's Health
Also Included In: Urology / Nephrology
Article Date: 03 Oct 2006 - 0:00 PDT

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This study from Innsbruck, Austria assessed retrospectively the outcome of different treatment modalities in newborns with undescended testes secondary to large abdominal wall or diaphragmatic defects. Large abdominal and diaphragmatic defects are known to be associated with cryptorchidism, however there is no consensus on the incidence as it varies widely.

The group had a total of 112 neonates with large abdominal wall or diaphragmatic defects that were treated between the years of 1981 to 2005. Of the 55 male patients in their series, 9 (16.4%) presented with abdominal testes and 4 had an extra-abdominal testis (7.3%). Two patients underwent primary orchiopexy and had testes of normal size and in the normal position at last follow-up. In one of these patients in whom the testis was brought down to the internal inguinal ring, surprisingly spontaneous descent occurred and the testis on the affected side was normal. The other patient required additional surgery and had an atrophic testis at last follow-up. In 1 patient with severe concomitant malformations, primary orchiectomy was performed. The 4 patients who did not receive initial treatment all lost their testes secondary to proposed atrophy.

The group concluded that primary orchiopexy should be attempted in all cases of abdominal wall defects associated with abdominal cryptorchid testes. They base this on their observation that it yields better testicular salvage rates. In cases in which the spermatic cord is not long enough to place the testis into the scrotum, mobilization and fixation at the lowest site possible resulted in better outcomes than of course leaving the testis in the abdomen.

Reference: Andreas P. Berger and Josef Hager.
Management of neonates with large abdominal wall defects and undescended testis.

Urology 68(1): 175-178, July 2006.
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