Comparison of various diagnostic and therapeutic modalities of undescended testis
DOI:
https://doi.org/10.18203/2349-2902.isj20211826Keywords:
Undescended testis, USG, LaparoscopyAbstract
Background: Undescended testes (UDT), which are defined as the failure of testes to descend in scrotum. It is the most common developmental defect in male infants. It is recorded in 30% of preterm infants compared with 3% of term infants.
Methods: Convenient sampling method for data collection, clinical palpation, ultrasound, magnetic resonance imaging (MRI), endoscopic ultrasound, laparoscopic methods for detection and therapeutic management.
Results: Laparoscopy has proven to be the only diagnostic modality where the findings provide a clear dependable direction for the definitive management of impalpable testes, so it allows an accurate diagnosis and definitive treatment in the same sitting.
Conclusions: Diagnostic imaging has no role in the routine evaluation of boys with undescended testes. Laparoscopy in impalpable testes is the procedure of choice and allows definitive management, even when conversion to open procedure is necessary.
References
Cryptorchidism: a prospective study of 7500 consecutive male births, 1984-8. John Radcliffe Hospital Cryptorchidism Study Group. Arch Dis Child. 1992;67(7):892-9.
Christensen JD, Dogra VS. The undescended testis. Semin Ultrasound CT MR. 2007;28(4):307-16.
Tasian GE, Copp HL. Diagnostic performance of ultrasound in nonpalpable cryptorchidism: a systematic review and meta-analysis. Pediatrics. 2011;127(1):119-28.
Tasian GE, Copp HL, Baskin LS. Diagnostic imaging in cryptorchidism: utility, indications, and effectiveness. J Pediatr Surg. 2011;46(12):2406-13.
Hutson JM, Hasthorpe S. Abnormalities of testicular descent. Cell Tissue Res. 2005;322(1):155-8.
Gill B, Kogan S. Cryptorchidism. Current concepts. Pediatr Clin North Am. 1997;44(5):1211-27.
Mayr R, May M, Martini T, Lodde M, Comploj E, Pycha A, et al. Comorbidity and performance indices as predictors of cancer-independent mortality but not of cancer-specific mortality after radical cystectomy for urothelial carcinoma of the bladder. Eur Urol. 2012;62(4):662-70.
Hadziselimovic F. Cryptorchidism, its impact on male fertility. Eur Urol. 2002;41(2):121-3.
Esposito C, Escolino M, Savanelli A, Alicchio F, Roberti A, Settimi A. Ultrasonography is unnecessary and misleading in evaluating boys with a nonpalpable testis and can be a cause of a legal process. Med Sci Law. 2013;53(4):247-8.
Barthold JS, González R. The epidemiology of congenital cryptorchidism, testicular ascent and orchiopexy. J Urol. 2003;170(6):2396-401.
Rusnack SL, Wu HY, Huff DS, Snyder HM, Zderic SA, Carr MC, et al. The ascending testis and the testis undescended since birth share the same histopathology. J Urol. 2002;168(6):2590-1.
Turek PJ, Ewalt DH, Snyder HM, Stampfers D, Blyth B, Huff DS, et al. The absent cryptorchid testis: surgical findings and their implications for diagnosis and etiology. J Urol. 1994;151(3):718-20.
Çildağ MB. Evaluation of Pediatric Undescended Testes with Elastosonography. J Med Ultrasound. 2017;25(3):157-60.
Bae KH, Park JS, Jung HJ, Shin HS. Inguinal approach for the management of unilateral non-palpable testis: is diagnostic laparoscopy necessary? J Pediatr Urol. 2014;10(2):233-6.
Ismail KA, Ashour MHM, Afifi MA, Hashish AA, Dosouky NE, Negm M, et al. Laparoscopy in the management of impalpable testis (Series of 64 Cases). Afr J Paediatr Surg. 2017;14(4):65-9.
Tasian GE, Copp HL, Baskin LS. Diagnostic imaging in cryptorchidism: utility, indications, and effectiveness. J Pediatr Surg. 2011;46(12):2406-13.