Retractile testis - Is it really a normal variant?
Retractile testis - Is it really a normal variant?
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DOI：
10.1016/s0022-5347(05)00674-9
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发表时间：
2006-04-01
影响因子：
6.6
通讯作者：
Elder, JS
中科院分区：
文献类型：
--
作者：
Agarwal, PK;Diaz, M;Elder, JS
目的：睾丸回缩被认为是青春期前男孩睾丸下降的一种正常变异。我们研究了可伸缩睾丸，以确定其自然history.Materials和方法：我们回顾性地审查了122名男孩（平均年龄5.4岁）谁被称为一个可疑的隐睾，并发现有一个可伸缩的睾丸图表。回缩性睾丸定义为阴囊上睾丸，可以很容易地操纵到阴囊内，并保持在那里，直到引发提睾反射。男孩随后每年检查，这表明存在的伸缩性，下降（nonretractile）或undescendant睾丸，和存在或不存在的紧张或无弹性的精索与retractile testes.Results：在204伸缩性睾丸61（30%）下降（成为nonretractile），66（32%）成为UDT和77（38%）仍然retractile。在62个精索绷紧或无弹性的可伸缩睾丸中，35个（56%）成为UDT。在61例睾丸固定术中，8例（13%）显示迷走突开放。UDT与下降睾丸发育的男孩平均年龄为4.9岁与6.6岁（p = 0.001）。7岁或以上的男孩自发下降的几率为58%，而7岁以下的男孩自发下降的几率为21%（p < 0.0001）。回缩性睾丸有32%的风险成为一个上升或获得性隐睾。在7岁以下的男孩中，或者当精索看起来紧张或缺乏弹性时，风险更高。睾丸回缩的男孩应每年监测一次，直到睾丸明显下降。
Purpose: Retractile testes are thought to represent a normal variant of descended testes in prepubertal boys. We studied retractile testes to determine their natural history.Materials and Methods: We retrospectively reviewed the charts of 122 boys (mean age 5.4 years) who were referred for a suspected undescended testis and were found to have a retractile testis. A retractile testis was defined as a suprascrotal testis that could be manipulated easily into the scrotum and remained there without traction until the cremasteric reflex was induced. The boys were followed by annual examinations, which demonstrated the presence of retractile, descended (nonretractile) or undescended testes, and the presence or absence of a taut or inelastic spermatic cord in association with a retractile testis.Results: Of 204 retractile testes 61 (30%) descended (became nonretractile), 66 (32%) became UDTs and 77 (38%) remained retractile. Of the 62 retractile testes with a taut or inelastic spermatic cord 35 (56%) became UDTs. Of the 61 orchiopexies performed 8 (13%) showed a patent processus vaginalis. Boys in whom UDTs vs descended testes developed were a mean of 4.9 vs 6.6 years old (p = 0.001). The chance of spontaneous descent was 58% in boys 7 years or older, compared to 21% in boys younger than 7 (p < 0.0001).Conclusions: A retractile testis is not a normal variant. Retractile testes have a 32% risk of becoming an ascending or acquired undescended testis. The risk is higher in boys younger than 7 years old, or when the spermatic cord seems tight or inelastic. Boys with retractile testes should be monitored annually until the testes have clearly descended.