A clinical study of undescended testes

Background: The aim of the present study was to study the clinical presentation of undescended testis (UDT) as regards to age, position, side and study the management on UDT.Methods: Total 41 patients, 50 UDT cases were studied prospectively. Patients below the age of 15 years with history of absent testes in the scrotum were included in the study and patients with retractile testes were excluded. Patients were subjected for ultrasonography (USG) scrotum. Palpable UDT and those were located on USG were subjected for open or laparoscopic assisted orchiopexy or 2 stage Stephen-Flower orchidopexy or orchidectomy.Results: 41.4% patients were between age group of 1 to 5 yrs. 43.9% patients were having right sided UDT. 76% testes were palpable only. 21.9% were having bilateral UDT. 48% testes were present in inguinal canal. In 80% patient’s orchiopexy was done. One patient (2.4%) had postoperative wound infection.Conclusions: In our study the maximum number of cases were recorded between 1 to 5 years of age. Right sided UDT were common presentation. Maximum UDT were palpable. We also concluded that USG remains the specific non-invasive modality of diagnosis and localization. Almost half of them were present in the inguinal canal. Orchidopexy is the most common technique for placement of UDT in the scrotum. There were low complications and high success rate in treating UDT. We concluded that there is need of coordinated campaign between surgeons, pediatricians, general practitioners and community workers for timely intervention of UDT and advice for early approach for treatment.

Scrotal Ultrasound Is Not Routinely Indicated in the Management of Cryptorchidism, Retractile Testes, and Hydrocele in Children

Cryptorchidism, or undescended testes, is the most common congenital genitourinary anomaly. A failure or delay of treatment may result in reduced fertility or an increased risk of testicular cancer. The American Urological Association (AUA) recommends that a scrotal ultrasound (SUS) not be performed in the preoperative management of cryptorchidism. This study investigated how likely pediatricians were to perform SUS despite the AUA guidelines. We retrospectively studied 243 patients referred to a single pediatric urology practice for clinically diagnosed testis pathology including undescended testis, hydrocele, and retractile testis over a 4-year period (January 1, 2015, to December 30, 2018). A total of 72 patients (29.6%) underwent a SUS ordered by their pediatrician prior to the pediatric urology visit. Pediatricians should be aware that SUS performed prior to pediatric urological evaluation does not alter management and is associated with a significant financial cost in patients with cryptorchidism or hydrocele.