Previous testicular position in boys referred for an undescended testis: further explanation of the late orchidopexy enigma?

• Published in: BJU international Vol. 92; no. 3; pp. 293 - 296
• Main Authors: Hack, W.W.M., Meijer, R.W., Van Der Voort‐Doedens, L.M., Bos, S.D., De Kok, M.E.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-08-2003; Blackwell
• Subjects: acquired undescended testis; Adolescent; Ambulatory Care; Biological and medical sciences; Child; Child, Preschool; cryptorchidism; Cryptorchidism - pathology; Cryptorchidism - surgery; Gynecology. Andrology. Obstetrics; Humans; Infant; Infant, Newborn; late orchidopexy; Male; Male genital diseases; Medical sciences; Non tumoral diseases; Orchiectomy - methods; previous testicular position; Referral and Consultation; Time Factors; Human; Cryptorchidism; previous testicular position; Congenital disease; late orchidopexy; Differential diagnostic; acquired undescended testis; Treatment; Malformation; Surgery; Orchiopexy; Acquired character; Male genital diseases; Child; Testicular diseases
• DOI: 10.1046/j.1464-410X.2003.04317.x
• EISSN: 1464-410X
• ISSN: 1464-4096

OBJECTIVE
To investigate the significance of the acquired undescended testis (UDT), which is differentiated into congenital and acquired forms, by assessing the previous testicular position in affected boys.
PATIENTS AND METHODS
The study comprised 261 boys who had been referred for a non‐scrotal testis to the outpatient clinic during an 8‐year period (1993–2000). There was a bimodal distribution of age, with peaks at 2.0 and 10.0 years. In each boy with UDT the previous testicular position was ascertained.
RESULTS
On referral, 340 testes were not in the scrotum (182 uni‐ and 79 bilateral). Of the 340 testes, 82 (24%) in 61 boys were diagnosed as retractile, whereas the remaining 258 in 221 boys were undescended. The previous testicular position was known in 208 of 221 boys (94%), with 244 UDTs. In 65 of these 244 (26.6%) the testis had never been scrotal (congenital UDT); in 179 (73.4%) a previous intrascrotal position was recorded in early childhood (acquired UDT) at least once, in 149 (61%) at least twice and in 117 (48%) at least three times. The mean age at referral for congenital UDT was 2.1 years and for acquired UDT was 8.4 years.
CONCLUSIONS
These results show that acquired UDT is frequent, and occurs at about three times the rate of congenital UDT. Because these boys are referred for treatment later in childhood, the acquired UDT probably accounts for the high rate of (late) orchidopexy.