Ectopic and Undescended Testes: 2 Variants of a Single Congenital Anomaly? (original) (raw)
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Undescended Testes: Incidence in 1,204 Consecutive Male Infants and Outcome at One Year of Age
2004
Background: Undescended testes (UDT) are a common congenital abnormality occurring in 2–5% of full-term boys at birth in the Western countries. By one year of age, the incidence rate spontaneously reduces to 1–2% in this group. Men with a history of UDT are at a higher risk of testicular cancer. Impaired fertility is another long-term risk associated with UDT. Although our knowledge on cryptorchidism has increased considerably over the last decades, many questions remain to be answered: Is the incidence rate increasing? What are the causes of undescent? Materials and methods: It was a hospital-based study. Totally, 1204 consecutively born boys were examined for cryptorchidism at birth and, if present, again at one year of age. The effect of birth weight, gestational age, the presence of other sexual abnormality in an individual, maternal history of gestation abnormalities, the mode of delivery and complications, parental constitutional and professional factors regarding cryptorchidi...
The Journal of Sexual Medicine, 2018
Objectives. To assess the incidence of testicular appendices (Tas), epididymal anomalies (EAs), and processus vaginalis (PV) patency in patients with undescended testis (UT) according to testicular position and to compare them with human fetuses. Methods. We studied 85 patients (108 testes) with cryptorchidism and compared the features with those of 15 fetuses (30 testes) with scrotal testes. We analyzed the relationships among the testis and epididymis, patency of PV, and the presence of TAs. We used the Chi-square test for statistical analysis (< 0.05). Results. In 108 UT, 72 (66.66%) had PV patent, 67 (62.03%) had TAs, and 39 (36.12%) had EAs. Of the 108 UT, 14 were abdominal (12.96%; 14 had PV patency, 9 TAs, and 7 EAs); 81 were inguinal (75%; 52 had PV patency, 45 TAs, and 31 EAs), and 13 were suprascrotal (12.03%; 6 had PV patency, 13 TAs, and 1 EAs). The patency of PV was more frequently associated with EAs (= 0.00364). The EAs had a higher prevalence in UT compared with fetuses (= 0.0005). Conclusions. Undescended testis has a higher risk of anatomical anomalies and the testes situated in abdomen and inguinal canal have a higher risk of presenting patency of PV and EAs.
Two Cases of Transverse Testicular Ectopia in Consanguineous Boys
European Journal of Pediatric Surgery Reports
Crossed testicular ectopia (CTE)/transverse testicular ectopia (TTE) is a rare condition occurring in only 1 in 4 million male patients, in which both testes migrate toward the same hemiscrotum.We report on two cases of TTE in first degree cousins (1 + 3 years of age).Both presented with right nonpalpable testis. On diffusion-weighted magnetic resonance imaging, the right testis was located above the left testis in both patients. Right orchiopexy was performed after passing the right testis through the median raphe of the scrotum followed by ipsilateral left scrotal orchiopexy.
Undescended Testes in Children: Clinicopathological Study of 32 Cases
TAJ: Journal of Teachers Association, 2018
Objective: To study the presentation, management, histopathological findings and outcome of undescended testes in children. Method: It was a prospective study done in Rajshahi Medical College Hospital and also private clinic in Rajshahi Metropolitan City during the period of 1 st December, 2007 to June, 2010. Thirty two children aged 4 months to 13 years with 40 undescended testes were selected in this study. Interventions like Orchidopexy, orchidectomy, herniotomy were done. Results: The age at surgery was four months to 13 years (mean 5.25 + 0.61 SE years). Nine (28.13%) had corrected before two years, twenty three (71.87%) after two years. Twenty four testes (60%) were palpable and sixteen (40%) were non-palpable, none of then cases was diagnosed at birth. Ultrasonography was performed in all cases. Evaluation was done by clinical, sonological, pre-operation and histopathological findings, Laparoscopy was done in one case. The condition was unilateral in 24(75%) and bilateral in Eight (25%). Forty percent of the testes were in the inguinal canal, 34% at the external ring and 10% at the internal ring and 16% in the abdomen. Fifteen (46.87%) testes were macroscopically smaller in size, four (10%) testes were atrophic (all were canalicular), one was tumour. Orchidopexy was performed in for 35 undescended testes and orchidectomy for five. Scrotal haematoma developed in 2 cases. Histopathological finding showed no spermatogonia in 25 (78.12%), among then 23 were above 2 years, 2 were below 2 years. Follow-up period were 6 months to 18 months, no atrophy/retraction was observed.
BioMed Research International
Objectives. To assess the incidence of testicular appendices (Tas), epididymal anomalies (EAs), and processus vaginalis (PV) patency in patients with undescended testis (UT) according to testicular position and to compare them with human fetuses. Methods. We studied 85 patients (108 testes) with cryptorchidism and compared the features with those of 15 fetuses (30 testes) with scrotal testes. We analyzed the relationships among the testis and epididymis, patency of PV, and the presence of TAs. We used the Chi-square test for statistical analysis (p<0.05). Results. In 108 UT, 72 (66.66%) had PV patent, 67 (62.03%) had TAs, and 39 (36.12%) had EAs. Of the 108 UT, 14 were abdominal (12.96%; 14 had PV patency, 9 TAs, and 7 EAs); 81 were inguinal (75%; 52 had PV patency, 45 TAs, and 31 EAs), and 13 were suprascrotal (12.03%; 6 had PV patency, 13 TAs, and 1 EAs). The patency of PV was more frequently associated with EAs (p=0.00364). The EAs had a higher prevalence in UT compared with f...
Ectopic testis: an experience of a tertiary-level urology center at Upper Egypt
Annals of Pediatric Surgery
Background: Testicular ectopia is defined as a testis which is located away from the normal pathway of testicular descent and outside its ipsilateral hemiscrotum. Controversies have been raised about considering the abdominal and inguinal ectopic testes as undescended ones. Our purpose was to review our center's experience with the diagnosis and management of testicular ectopia focusing on the inguinal ectopic testis. Retrospectively, we studied the clinical and surgical characteristics of a case series of testicular ectopia which was managed in our center during July 2001-June 2016. Results: Out of 1132 patients with undescended testes, 44 cases (3.9%) had testicular ectopia. Twenty-three cases (mean age = 5.15 ± 5.79 years) fulfilled the criteria of inguinal ectopic testis. Clinically, testes were relatively mobile and superficial. Surgically, they were located in the superficial inguinal pouch, had relatively long spermatic cords, and commonly had average rather than small sizes. The other ectopic 21 cases (mean age = 10.56 ± 6.92 years) were perineal, anterior abdominal wall, femoral, prepubic, and transverse testes in 7 (33.3%), 4 (19%), 4 (19%), 3 (14.3%), and 3 (14.3%) cases, respectively. Congenital inguinal hernia was the commonest associated anomaly (22.7%). All cases were treated surgically with only 1 case of testicular atrophy (2.3%). Conclusions: Testicular ectopia is rare with relatively delayed presentations. Different anatomical sites have been reported including the superficial inguinal pouch and anterior abdominal wall with variable complexities and controversies. The inguinal ectopic testis is the most controversial, but it might be characterized from other entities based on certain clinical and surgical criteria.
Urology, 1994
We have long been interested in epididymal and ductal anom. alies associated with cryptorchidism in the literature. We decided to study their prevalence in our cases due to the significance of these anomalies in patients' future fertility. Methods. We studied six hundred fifty-two testes treated for failed descent in our department and evaluated the epididymal and ductal anomalies we observed intraoperatively. Results. Epididymal and vasal anomalies occurred with an overall frequency of 36 percent (235 of 652 cases). Flimsy attachment of the head of epididymis to the testis constituted the most common anomaly. Conclusions. The prognosis of future fertility should consider the epididymal anomalies detected at orchiopexy. Such anomalies may coexist with excellent testis histology so that fertility impairment may occur based on sperm transport, despite the preservation of germ cells by early orchiopexy
Epidemiological Study on Undescended Testis
Although half a century ago doctors believed undescended testis could descend in the scrotum anytime during the childhood up to the beginning of puberty, today it is accepted that both testes should be in the bursae at the time of birth (in 3 – 4% of cases this is not the situation). Otherwise, according to the most authors, one can wait at most one year (incidence drops to 1%), and then, during the second year of life, the testicular descent must be performed, as pathological changes in the undescended testis are visible as early as from the age of two thanks to the improvement of optical microscopy. However, an important number of cases are still diagnosed as late as around puberty, the purpose of this study being to evidence some of the possible causes that lead to this delayed diagnosis, which results in the modification of condition prognosis. Introduction Half a century ago doctors believed undescended testis could descend in the scrotum anytime during the childhood up to the ...
Fertility potential in a cohort of 65 men with previously acquired undescended testes
Journal of Pediatric Surgery, 2014
Purpose: To evaluate testicular function in men with previously acquired undescended testes (AUDT) in whom spontaneous descent was awaited until puberty followed by orchiopexy in case of nondescent. Methods: Andrological evaluation including paternity, scrotal ultrasound, reproductive hormones, and semen analysis was performed in three groups: men with AUDT, healthy controls, and men with previously congenital undescended testes (CUDT). Results: In comparison with controls, men with AUDT more often had significantly abnormal testicular consistency, smaller testes, lower sperm concentration, and less motile sperm. Except for more often a normal testicular consistency in men with AUDT, no differences were found between men with AUDT and men with CUDT. Also, no differences were found between men with AUDT which had spontaneously descended and men who underwent orchiopexy. Conclusions: Fertility potential in men with AUDT is compromised in comparison with healthy controls, but comparable with men with CUDT. This suggests that congenital and acquired UDT share the same etiology. No significant difference was found between men who had spontaneous descent and men needing orchiopexy. However, fertility potential is unknown for men after immediate surgery at diagnosis, and this should be a subject for future studies.
Malformation of the epididymis in undescended testis
Pediatric Surgery International, 1998
During a 6-year period, 312 boys (mean age 4.7 years) underwent orchidopexy for cryptorchidism. A total of 388 epididymides were examined and the con-®gurations were recorded as a prospective trial. This study consists of 166 ectopic testes and 222 undescended testes. The observed con®gurations of epididymides in the ectopic testes were: type 1a in 99 cases (59.6%), type 1b in 35 (21.1%), type 2 in 24 (14.5%), type 3 in 7 (4.2%), and type 4 in 1 (0.6%). There were no patients in the study with type 5 and 6 anomalies. The con®gurations of epididymides in the undescended testes were: type 1a in 105 (47.3%), type 1b in 63 (28.4%), type 2 in 26 (11.7%), type 3 in 13 (5.9%), type 4 in 5 (2.3%), type 5 in 7 (3.2%), and type 6 in 3 (1.4%).The data revealed that the incidence of epididymal abnormalities in undescended testes (41%) was higher than that in the ectopic testes (25.9%) (P < 0.05).