Management of undescended testes in adolescents and young adults

Authors

  • Francis I. Gbobo Department of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
  • Victor Abhulimen Department of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

DOI:

https://doi.org/10.18203/2349-2902.isj20223153

Keywords:

Undescended testes, Retractile testes, Orchidopexy

Abstract

Background: The undescended testes (UDT) are at risk of torsion, trauma and pathologic changes leading to subfertility and malignant transformation. Surgery for UDT should be performed before the age of 2 years.

Methods: This was a 5-year retrospective study conducted on patients who presented with features of UDT in Port Harcourt. Ethical approval for the study was sought and gotten from the hospital ethical committee. Data was obtained from ward admission registers, theatre, and discharge records. The information gotten included history, examination findings and treatment received. Patients who had ectopic testes, retractile testes and incomplete records were excluded from the study. The information was collected and analysed. Categorical data was presented in the form of frequencies and percentages using tables. Continuous variables were presented in means and standard deviation. Results were presented in tables and charts.

Results: The 15-19-year age group had the highest frequency. The median age was 19 years. Most subjects had at least secondary school education (71.43%). The right testes alone were undescended in 11 cases while the left alone was undescended in 7 cases. Three patients presented with undescended testes. Most (15) patients had their testes located in the inguinal canal. Poverty was the most common reason for late presentation. Orchidopexy was most commonly carried out via an inguinal approach.

Conclusions: Late presentation of patients with UDT is common. Inguinal orchidopexy was the most common surgery performed. Health education on the need for scrotal examination after birth can aid earlier presentation.

Author Biography

Victor Abhulimen, Department of Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

GBOBO ISESOMA FRANCIS,1 ABHULIMEN VICTOR 2

1PAEDIATRIC SURGERY UNIT, DEPARTMENT OF SURGERY,

UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL,

PORT HARCOURT, NIGERIA.

2DIVISION OF UROLOGY, DEPARTMENT OF SURGERY,

UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL,

PORT HARCOURT, NIGERIA.

Correspondence to ABHULIMEN VICTOR victorabhulimen80@gmail.com

References

Sijstermans K, Hack WW, Meijer RW, van der Voort-Doedens LM. The frequency of undescended testis from birth to adulthood: a review. Int J Androl. 2008;31:1-11.

Holland AJ, Nassar N, Schneuer FJ. Undescended testes: an update. Curr Opin Pediatr. 2016;28:388-94.

Shin J, Jeon GW. Comparison of diagnostic and treatment guidelines for undescended testis. Clin Exp Pediatrics. 2020;63(11):415.

Adesanya OA, Ademuyiwa AO, Elebute OA, Ojewola R, Bode CO. The undescended testes in children: A prospective epidemiological study. East and Central Afr J Surg. 2013;18(2):45-9.

Kurz D, Tasian G. Current management of undescended testes. Current treatment options in pediatrics. 2016;2(1):43-51.

Gates RL, Shelton J, Diefenbach KA, Arnold M, Peter SD, Renaud EJ, et al. Management of the undescended testis in children: An American pediatric surgical association outcome and evidence-based practice committee systematic review. J Pediatric Surg. 2022;57(7):1293-308.

Niedzielski JK, Oszukowska E, Słowikowska-Hilczer J. Undescended testis–current trends and guidelines: a review of the literature. Arch Med Sci. 2016;12(3):667-77.

Ritzén EM, Bergh A, Bjerknes R, Christiansen P, Cortes D, Haugen SE, et al. Nordic consensus on treatment of undescended testes. Acta Paediatrica (Oslo, Norway: 1992). 2007;96(5):638-43.

Abacı A, Çatlı G, Anık A, Böber E. Epidemiology, classification and management of undescended testes: does medication have value in its treatment? J Clin Res Pediatric Endocrinol. 2013;5(2):65.

Ameh EA, Mbibu HN. Management of undescended testes in children in Zaria, Nigeria. East Afr Med J. 2000;77(9).

Osifo DO, Osaigbovo EO. The prevalence, postnatal descent, and complications of undescended testes among children who underwent neonatal circumcision in Benin City, Nigeria. J Pediatric Surg. 2009;44(4):791-6.

David OO, Iyekoretin E. Undescended testes in a developing country: A study of the management of 71 patients. Afr J Paediatric Surg. 2008;5(1):11.

Ekpemo SC, Onyearugha C. Management of undescended testis in children in Aba Nigeria. Int J Clin Urol. 2019;3(1):15-7.

Yarhere IE, Jaja T, Wekere GC. Genital abnormalities and management outcomes as seen in the university of port harcourt teaching hospital, Nigeria. Niger J Med. 2022;31(3):268-73.

Onwuchekwa RC, Sapira MK, Onwuchekwa AC. Unilateral renal agenesis coexisting with bilateral cryptorchidism in an adult Nigerian: Case report. Niger Med J. 2009;50(3):71.

Gadelkareem RA, Shahat AA, Reda A, Moeen AM, Abdelhafez MF, Abughanima MF, et al. Ectopic testis: an experience of a tertiary-level urology center at Upper Egypt. Ann Pediatric Surg. 2020;16(1):1-9.

Daniel M. Top 10 most educated states in Nigeria. 2022. Available at: http://www.nigerianinfo pedia.com.ng/mosteducated-states-innigeria/. Accessed on 03 October 2022.

Désiré AM, Buhendwa C, Césaire TM, Prisca KI, Levi LN, David NB, et al. Epidemiology, diagnosis and therapeutic approaches of cryptorchidism at the Panzi General Hospital, DR Congo: A 5-year retrospective study. Ethiopian J Health Sci. 2020;30(1).

Ndour O, Fall M, Faye Fall AL, Diouf C, Ndoye NA, Ngom G, Ndoye M. Aspects épidémiologiques, cliniques et thérapeutiques de la cryptorchidie chez l’enfant: analyse de 123 observations. Afr J Urol. 2015;21:10-4.

Elomien E, Ajayi O, Idowu O. The 2018 World Poverty Clock Report and Nigeria as “The Poverty Capital of the World”: Changing the Narrative through Innovation, Leadership and Sustainable Development. African Renaissance. 2022;2022(si1):375.

Ayinde IA, Otekunrin OA, Akinbode SO, Otekunrin OA. Food security in Nigeria: impetus for growth and development. J Agric Econ. 2020;6:808-20.

Abhulimen V, Raphael EJ. Testicular cancer at the University of Port Harcourt Teaching Hospital: A 10-year retrospective review. J West Afr Coll Surgeons. 2019;9(3):21.

Neheman A, Levitt M, Steiner Z. A tailored surgical approach to the palpable undescended testis. J Pediatric Urol. 2019;15(1):59-e1.

Ramzan M, Sheikh AH, Qureshi MA, Zubair M, Majid F. Single incision trans scrotal versus standard inguino-scrotal orchidopexy in children with palpable undescended testis: our experience from April 2007 to April 2010. Pak J Med Sci Quarterly. 2012;28(4):827.

Yang Z, Li S, Zeng H, Yin J, Xu W, Li J, et al. Laparoscopic orchiopexy versus open orchiopexy for palpable undescended testis in children: a prospective comparison study. J Laparoendoscopic Adv Surg Techniques. 2020;30(4):453-7.

Hong H, Cai W, Wu J, Wu X, Lin L, Li T, et al. Scrotoscopy and traditional open surgery shows a high degree of consistency in the diagnosis of testicular torsion: An initial report. Medicine. 2020;99(31).

Saka R, Tazuke Y, Ueno T, Watanabe M, Nomura M, Masahata K, et al. Laparoscopy-assisted transscrotal orchidopexy for palpable undescended testis: Initial results. J Laparoendoscopic Adv Surg Techniques. 2020;30(10):1131-6.

Downloads

Published

2022-11-28

Issue

Section

Original Research Articles