Incidence of testicular ascent in boys with retractile testes
Incidence of testicular ascent in boys with retractile testes
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DOI：
10.1016/j.juro.2007.05.091
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发表时间：
2007-10-01
影响因子：
6.6
通讯作者：
Adams, Mark C.
中科院分区：
文献类型：
--
作者：
Stec, Andrew A.;Thomas, John C.;Adams, Mark C.
目的：据报道，先前下降但回缩的睾丸出现睾丸上升的发生率在 2% 至 45% 之间。我们的偏见是，只有一小部分回缩睾丸上升并最终需要睾丸固定术。材料和方法：我们对 1996 年至 2005 年间我们机构的 4 名儿科泌尿科医生中的任何一位诊断出的所有回缩睾丸进行了回顾性审查。回缩睾丸的定义是，尽管有恶变或回缩性质的病史，但仍可以在没有张力的情况下至少到达阴囊中部。如果随访时间少于 6 个月或有同侧腹股沟手术史，则排除患者。对解决后未重新检查的患者进行了电话随访调查。结果：共有 172 名患者符合我们的纳入标准，并进行随访直至解决。初步鉴定出274个回缩睾丸，其中单侧睾丸占26%，双侧睾丸占74%。总共 19 个睾丸上升，最终需要在 6 至 101 个月的随访中进行睾丸固定术。 13 例（68%）发现阴道突起未闭。通过电话联系了另外 235 名最初被诊断为睾丸回缩但未在我们机构接受后续检查的患者。这组男孩最初共有 392 个受累睾丸，其中 2 个在解决之前在其他地方接受了睾丸固定术。在合并的患者组中，二次上升的发生率为 3.2%。结论：回缩的睾丸可以上升，因此需要随访直至解决。根据我们的经验，大多数回缩睾丸不需要手术。
Purpose: The incidence of testicular ascent of a previously descended but retractile testis is reported to be between 2% and 45%. It has been our bias that only a small percent of retractile testes ascend and ultimately require orchiopexy.Materials and Methods: We performed a retrospective review of all retractile testes diagnosed by any of 4 pediatric urologists at our institution from 1996 to 2005. A retractile testis was defined as one that could be brought to at least the mid scrotum without tension despite a history of maldescent or a retractile nature. Patients were excluded if followup was less than 6 months or they had a history of ipsilateral inguinal surgery. A followup telephone survey was done in patients not reexamined at resolution.Results: A total of 172 patients met our inclusion criteria and were followed to resolution. A total of 274 retractile testes were initially identified, including 26% unilateral and 74% bilateral testes. A total of 19 testes ascended and ultimately required orchiopexy within a followup, of 6 to 101 months. A patent processus vaginalis was identified in 13 cases (68%). Another 235 patients initially seen with a diagnosis of retractile testis who had no followup examination at our institution were contacted via telephone. This set of boys initially had a total of 392 involved testes, of which 2 underwent orchiopexy elsewhere before resolution. The incidence of secondary ascent was 3.2% in the combined set of patients.Conclusions: Retractile testes can ascend and, therefore, they require followup until resolution. In our experience most retractile testes do not require surgery.