Perioperative surgical findings in congenital and acquired undescended testis

Vries, Annebeth Meij-de; Hack, W. W. M.; Heij, Hugo A.; Meijer, R. W.

doi:10.1016/j.jpedsurg.2010.02.121

Cited by 29 publications

(22 citation statements)

References 28 publications

(31 reference statements)

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“…It is seen in 1.5% of prepubertal boys, and early as well as late forms have been described [1,24,25]. Its pathogenesis is unclear, but tethering of cord structures because of persistence or a fibrous remnant of the processus vaginalis is considered a main etiologic factor [3,[26][27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Long-term testicular position and growth of acquired undescended testis after prepubertal orchidopexy

Vries

Goede

Voort

et al. 2012

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Long-term testicular position and growth of acquired undescended testis after prepubertal orchidopexy

Vries

Goede

Voort

et al. 2012

Journal of Pediatric Surgery

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“…This was also reported by Meij‐de Vries et al . [15], whose study, however, distinguished slightly different intraoperative testis locations. Also, in other publications related to acquired UDT, the position of the ascending testes at surgery was more likely to be in the superficial inguinal pouch [10,16,18].…”

Section: Discussionmentioning

confidence: 93%

“…Unfortunately, a similar study by Meij‐de Vries et al . [15] does not document preoperative testes positions. The distribution of intraoperative testis positions significantly differed between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Different surgical findings in congenital and acquired undescended testes

Brakel¹,

Dohle²,

Keizer‐Schrama³

et al. 2012

BJU International

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E 3 8 7What ' s known on the subject? and What does the study add? Much is known on the aetiology, natural course and treatment of congenital undescended testes (UDT), but these matters are less clear for acquired UDT and still debated. Several studies have examined anatomical fi ndings in patients with UDT. However, most of these studies do not distinguish between congenital and acquired UDT.This study describes clinical and surgical differences between congenital and acquired UDT, in which full history was known for all patients. Major differences were found in preoperative testis position as well as intraoperative testis position, patency of processus vaginalis and epididymal anomalies between congenital and acquired UDT. OBJECTIVE• To compare surgical fi ndings in congenital and acquired undescended testes (UDT). PATIENTS AND METHODS• A review of 139 boys with 158 congenital UDT and 69 boys with 84 acquired UDT was performed. The most caudal testicular position preoperatively, testis position at surgery, patency of the processus vaginalis and epididymal anomalies were prospectively recorded. RESULTS• In the congenital group, orchiopexy had been performed at median age (range) 4.9 (1.5 -14.6) years, while the median age (range) in the acquired group was 11.9 (3.8 -23.3) years. Preoperatively, only congenital UDT were found not palpable or emergent inguinal, while only acquired UDT could be manipulated in an unstable scrotal position. In comparison with congenital UDT, acquired UDT were signifi cantly more often located at the scrotal entrance, 27/158 vs 32/84 respectively ( P < 0.001). At surgery anorchia, vanished testis or testes lying intra-abdominally were only registered in the congenital UDT group. Also 37/158 congenital UDT were located in the superfi cial inguinal pouch vs 52/84 of the acquired UDT ( P = 0.04). In congenital UDT the processus vaginalis was wide open in 74/158, while in acquired UDT the processus vaginalis was closed in 46/84 ( P < 0.001) and small open in 26/84 ( P = 0.04). Epididymal anomalies were more often seen in the congenital UDT group (37%) than in the acquired group (11%). CONCLUSION• The most caudal position of congenital UDT after manipulation before surgery was at the scrotal entrance. These testes were frequently associated with epididymal anomalies and wide open processus vaginalis. This was in contrast to acquired UDT, which can often be pushed down well below the scrotal entrance and are more likely to be situated in the superfi cial inguinal pouch, with a normal epididymis and closed processus vaginalis.

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“…Some 7-20% of cryptorchidism cases cannot be detected at birth, and are said to be acquired [26,27]. Our study therefore implicitly assumes that potential differences in the incidence of acquired cryptorchidism have a negligible influence on the calculated rate ratios (including both congenital and acquired cryptorchidism).…”

Section: Discussionmentioning

confidence: 99%

Socio-occupational class, region of birth and maternal age: influence on time to detection of cryptorchidism (undescended testes): a Danish nationwide register study

et al. 2014

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BackgroundCryptorchidism (undescended testes) is associated with poor male fertility, but can be alleviated and fertility preserved to some degree by early detection and treatment. Here we assess the influence of socio-occupational class, geographical region, maternal age and birth cohort on time to detection and correction of cryptorchidism.MethodsAll boys born in Denmark, 1981 to 1987 or 1988 to 1994, with a diagnosis of cryptorchidism were identified in nationwide registers. The boys were followed for a diagnosis until their 16th birthday. The age at first diagnosis was noted and used as proxy for time to detection of cryptorchidism. Parental employment in the calendar year preceding birth was grouped into one of five socio-occupational classes. Geographical region was defined by place of birth in one of 15 Danish counties. Detection rate ratios of cryptorchidism were analyzed as a function of parental socio-occupational group, county, maternal age and birth cohort by use of Poisson regression.ResultsSome 6,059 boys in the early and 5,947 boys in the late cohort received a diagnosis of cryptorchidism. Time to detection was independent of parental socio-occupational group and maternal age but differed slightly between geographical regions. A similar pattern was obtained for surgical correction after a diagnosis. Age at diagnosis decreased by 2.7 years from the early to the late cohort.ConclusionsThese results indicate that childhood socio-occupational inequality in detection and correction of cryptorchidism would play a negligible role in male infertility in a life course perspective. Geographical region may have exerted some influence, especially for the oldest cohort.

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Perioperative surgical findings in congenital and acquired undescended testis

Cited by 29 publications

References 28 publications

Long-term testicular position and growth of acquired undescended testis after prepubertal orchidopexy

Long-term testicular position and growth of acquired undescended testis after prepubertal orchidopexy

Different surgical findings in congenital and acquired undescended testes

Socio-occupational class, region of birth and maternal age: influence on time to detection of cryptorchidism (undescended testes): a Danish nationwide register study

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