Long-Term Outcomes of Retractile Testis

Abstract

PurposeRetractile testis is considered to be a variant of normal testis in prepubertal boys. There is no agreed-upon management of retractile testis. The aim of this study was to provide data on the long-term outcomes of patients with retractile testis.Materials and MethodsThis study retrospectively reviewed the medical record of 43 boys who were referred for suspected undescended or retractile testis and were finally diagnosed with retractile testis between January 2001 and December 2008. All boys were biannually examined by a pediatric urologist to evaluate the presence of retractile, descended, or undescended testis and testicular volume.ResultsOf 43 boys, there were 22 boys with unilateral retractile testis (51.1%) and 21 boys with bilateral retractile testis (48.9%). Their mean age was 3.0±2.7 years and the follow-up duration was 4.4±1.7 years. Of 64 retractile testes, 29 (45.3%) succeeded in descending, 26 (40.6%) remained retractile, and 9 (14.1%) became undescended testis or of a decreased size requiring orchiopexy. The mean initial diagnostic age of the patients who underwent orchiopexy was 1.3±0.9 years; meanwhile, the mean initial diagnostic age of those who went on to have normal testis was 4.3±3.3 years (p=0.009). The mean follow-up duration was 3.6±1.5 years in the orchiopexy group, 4.0±1.4 years in the descended testis group, and 5.1±1.8 years in group with remaining retractile testis.ConclusionsRetractile testis has a risk of requiring orchiopexy. The risk is higher in the population diagnosed at a younger age. Boys with retractile testis should be observed periodically until the testis is descended in the normal position.

Do retractile testes have anatomical anomalies?

“…Studies applying ultrasound confirm that retractile testes show reduced volume in relation to normal testes ( 21 ). One recent retrospective study of 43 boys who had been diagnosed as having retractile testis noted that surgical intervention had been found necessary in 16.3% of the cases and the probability of surgery was higher in cases that had been diagnosed at younger ages ( 22 ).…”

Determining the Normal Size and Values of the Testicles in Adult Population in the Western Region, Saudi Arabia.

“…[2,13] Since the US was used in measuring the testicular volume, several equations were used to calculate the volume, one of the most common equation was formulated by Lambert 1951 (0.71 * length * width * height). [2,6,14] Regarding the fact the cut-off point didn't determine ,previous studies showed various results in measuring testicular volume relying on the using method. [2,15] The results of the current studies showed that the mean scores of testicles volume were 12.0±5.0 for right testicular and 11.2±4.7 for left testicular, which consistent with other studies, in India studies the mean scores for right and left testicles were 11.83±3.2 and 11.08±2.8 respectively, [11] and in Albania study the mean scores were 12.8 and 12.4 for right and left testicles respectively .…”

“…[5 ] Retractile testis and undescended testes are the most common and unusual scrotal abnormalities, where retractile testis was defined as " testis that was located in the upper scrotum or lower inguinal canal but that could be made to descend completely into the scrotum by manual reduction and then returned to the original position by the cremasteric reflex " and undescended testes was defined as " the absence of the testicle in the scrotal position since birth ". [6,7] Several studies conducted to compare between several ways of testicular volume measurement to determine the most accurate methods [1] and from these studies , numerous of them confirmed the accuracy of US in measuring testicular dimensions directly and demonstrate it as the standard method, where doctors are able to differentiate the testis from the adjacent soft tissues and epididymis which help in the cases of small testes and give the exact volume even its consuming times more than methods , [1,3,8] also it was found to be a valuable method in following up testicular growth and puberty development where it can expose any small biological changes in testicles . [9] The mean age of participant (healthy men) in this study was 41.2±16.5 , this is similar to the result from West Africa where the mean age was 36.8 ±7.2, [10] in India study was 34.6±5.7, [11] and in Albania study was31.5 ±3.8 , [12] However the results from Nigeria were different and the mean age was 72.74 ±9.38 years and the participants were prostate cancer patients, where several studies reported that testicles volume influenced by age ( testicles volume after 60 decreases by aging), [7,13] body mass index, illness, serum FSH and LH concentrations, race and environment such as big and small cities and different countries .…”

Trends in treatment outcomes for retractile testis in Japanese boys: A single‐center study

“…2 However, Agarwal et al 6 suggested that RT was not a normal variant because of the development of UDTs in 32% of cases; furthermore, boys aged <7 years had a higher risk of developing testicular complications compared to those aged ≥7 years. 6 Bae et al 7 investigated 43 boys with RT in Korea and found that the condition was associated with a high risk of surgical intervention during a long-term follow-up period. Therefore, classifying RT as a variant of normal testis is controversial, and careful follow-up (at least once a year) is critical for its treatment.…”

“…Therefore, classifying RT as a variant of normal testis is controversial, and careful follow-up (at least once a year) is critical for its treatment. 7 The aim of the present study was to investigate the natural course of RT, including trends in its prevalence and outcomes, at a single institution. Understanding its prevalence and outcomes, including spontaneous resolution and surgical intervention, could lead to the development of better initial management and follow-up strategies for boys diagnosed with RT.…”