The undescended testis: Clinical management and scientific advances

Vikraman, Jaya; Hutson, John M.; Li, Ruili; Thorup, Jørgen

doi:10.1053/j.sempedsurg.2016.05.007

Cited by 38 publications

(31 citation statements)

References 72 publications

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“…Temperature in the scrotum is 33 • C, which is about 4 • C lower than the core body temperature. Ambient scrotal temperature of around 33 • C is seminal for the function of the testis after birth (203,204). Higher temperature is considered to impinge especially on germ cells and it has been suggested that gonocytes require a lower ambient temperature for maturation (205).…”

Section: Potential Mechanisms Of Cryptorchidism-induced Hypogonadismmentioning

confidence: 99%

Hypogonadism and Cryptorchidism

et al. 2020

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Congenital cryptorchidism (undescended testis) is one of the most common congenital urogenital malformations in boys. Prevalence of cryptorchidism at birth among boys born with normal birth weight ranges from 1.8 to 8.4%. Cryptorchidism is associated with a risk of low semen quality and an increased risk of testicular germ cell tumors. Testicular hormones, androgens and insulin-like peptide 3 (INSL3), have an essential role in the process of testicular descent from intra-abdominal position into the scrotum in fetal life. This explains the increased prevalence of cryptorchidism among boys with diseases or syndromes associated with congenitally decreased secretion or action of androgens, such as patients with congenital hypogonadism and partial androgen insensitivity syndrome. There is evidence to support that cryptorchidism is associated with decreased testicular hormone production later in life. It has been shown that cryptorchidism impairs long-term Sertoli cell function, but may also affect Leydig cells. Germ cell loss taking place in the cryptorchid testis is proportional to the duration of the condition, and therefore early orchiopexy to bring the testis into the scrotum is the standard treatment. However, the evidence for benefits of early orchiopexy for testicular endocrine function is controversial. The hormonal treatments using human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone (GnRH) to induce testicular descent have low success rates, and therefore they are not recommended by the current guidelines for management of cryptorchidism. However, more research is needed to assess the effects of hormonal treatments during infancy on future male reproductive health.

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Section: Potential Mechanisms Of Cryptorchidism-induced Hypogonadismmentioning

confidence: 99%

Hypogonadism and Cryptorchidism

et al. 2020

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“…Consequently, approximately one-third of UDT cases continue to exist. This condition requires surgical intervention with orchidopexy to fix the testes within scrotum [3]. The preferred age for orchiopexy is before the completion of the first year of life.…”

Section: Introductionmentioning

confidence: 99%

Age at Surgery and Outcomes of Undescended Testes at King Salman Armed Forces Hospital, Tabuk, Saudi Arabia

Alnoaiji

Alrashidi

Ghmaird

et al. 2019

Cureus

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ObjectiveThe aim of this study was to investigate the age at diagnosis and surgery of undescended testes and patients’ outcomes.MethodsThis is a retrospective study that reviewed the files of patients who underwent orchidopexy at the King Salman Armed Forces Hospital (KSAFH), Tabuk, Saudi Arabia (SA), between January 1, 2015, and March 30, 2019. All children from birth until 13 years old who were admitted within the specified time frame and underwent orchidopexy were included in this study. The gathered data were analyzed through the Statistical Package for Social Sciences software (SPSS, version 23; SPSS Inc., Chicago, IL, USA).Results A total of 175 patients were included in this study. The rate of orchidopexy at our institution was 12.2%. The median ages at diagnosis and surgery were 12 and 24 months, respectively. The median duration between diagnosis and surgery was eight months. The most common site of undescended testis was inguinal (80.6%). Bilateral undescended testes were recorded in 24.6% of cases, and 25.7% of cases were impalpable. The size of the undescended testis was average in half the cases, small in 44.6% and atrophic in 6.4% of cases. Postoperative complications were reported in 4.0% of cases. Cox regression analysis revealed that the age at diagnosis was a significant risk factor affecting the time of surgery.ConclusionThe findings of this study revealed that most cases of undescended testes in Tabuk were operated beyond the age recommended by international guidelines. The age at diagnosis seems to significantly affect the time of surgery.

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“…NPT'de tanısal laporoskopiyi ilk olarak 1976 yılında Cortesi ve arkadaşları kullanmış olup (11), laparoskopik orşiopeksi ise ilk kez 1992 yılında Jordon ve arkadaşları tarafından uygulanmıştır. Yaklaşık 30 yıl önce uygulanan bu yöntem günümüzde NPT tanı ve tedavisinde altın standart tedavi yöntemi olarak kabul edilmektedir (12,13). NPT testis tespit edilen hastalarda amaç; testis olup olmadığını doğrulamak, uygun testislerde orşiopeksi yapmak , orşiopeksi yapılamayacak olanlarda testis ve eklerini çıkarmaktır.…”

Section: Introductionunclassified

Diagnostic Laparoscopy in Nonpalpable Testes; Single Center Clinical Results

Demir

Yağmur

Kati

et al. 2020

Harran Üniversitesi Tıp Fakültesi Dergisi

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Öz. Amaç: Nonpalpabl testis tanı ve tedavisinde laparoskopi altın standart yöntemdir. Bu çalışmamızda nonpalpabl testis olgularında laparoskopinin tanı ve tedavideki yerini, etkinliğini ve sonuçlarını tartışmayı amaçladık. Materyal ve Metod: Nonpalpabl testis tanısı ile laparoskopi planlanan 56 hasta çalışmaya dahil edildi. Hastaların yaşı, özgeçmişi, fizik muayene bulguları, laboratuar bulguları, ultrasonografi ve manyetik rezorans görüntüleme bulguları incelendi. Tüm hastalara genel anestezi altında tekrar muayene yapıldı. Nonpalpabl testis tanısı teyit edilen hastalara tanısal laparoskopi uygulandı. Laparoskopi bulguları, cerrahi prosedür ve komplikasyonlar değerlendirildi. Bulgular: Çalışmaya dahil edilen 56 hastanın yaş ortalaması 15,3±2,1 yıl idi. Hastaların 28'inde sağ, 22'sinde sol, 6'sında ise her iki testis palpe edilemedi. Sekiz hastada genel anestezi sonrası yapılan muayenede testislerin palpe edilmesi üzerine laparoskopi uygulanmadan orşiopeksi yapıldı. Testisleri palpe edilemeyen 48 hastaya ise tanısal laparoskopi uygulandı. 24 hastada spermatik kordun inguinal kanala girdiği, 15 hastada testislerin intra-abdominal yerleşimli olduğu, 7 hastada kör sonlanan spermatik kord ve 2 hastada ise testis bulunmamakla birlikte müllerien yapılar görüldü. İntra-abdominal testis bulunan hastalardan 9'una laparoskopik orşiopeksi, 6'sına ise laparoskopik orşiektomi uygulandı. Spermatik kordun inguinal kanala girdiği görülen 24 hastaya inguinal eksplorasyon yapıldı. Komplikasyon oranı %4,2 olarak bulundu. Sonuç: Nonpalpabl testis olgularında hem tanı hem de tedavi amacıyla kullanılabilen laparoskopi, düşük komplikasyon oranları ile standart olarak önerilen ve yaygın kabul gören bir yöntemdir.

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The undescended testis: Clinical management and scientific advances

Cited by 38 publications

References 72 publications

Hypogonadism and Cryptorchidism

Hypogonadism and Cryptorchidism

Age at Surgery and Outcomes of Undescended Testes at King Salman Armed Forces Hospital, Tabuk, Saudi Arabia

Diagnostic Laparoscopy in Nonpalpable Testes; Single Center Clinical Results

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