Undescended testis in older boys: further evidence that ascending testes are common
Undescended testis in older boys: further evidence that ascending testes are common
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DOI：
10.1016/j.jpedsurg.2008.03.029
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发表时间：
2008-09-01
影响因子：
2.4
通讯作者：
Kogan, Barry A.
中科院分区：
文献类型：
--
作者：
Guven, Ahmet;Kogan, Barry A.
简介：出于手术、睾丸和心理原因，我们建议在 9 至 10 个月大时进行睾丸固定术。然而，在实践中，我们观察到许多患者接受睾丸固定术的年龄较晚。为了更好地理解这种差异，我们回顾了接受晚期睾丸固定术的患者的经验。方法：我们回顾性回顾了 1997 年 7 月至 2006 年 4 月期间接受过睾丸固定术的所有男孩的办公室医疗记录。我们将“晚期”睾丸固定术定义为在 4 岁或之后进行的手术。每个男孩都由儿科泌尿科医生仔细检查，并对术前、术中和术后检查结果进行了审查。结果：177 名患者中有 191 例晚期睾丸固定术（552 名患者总共 587 例睾丸固定术）。手术时的中位年龄为 7.2 岁（范围：4.0-16.2）。术前，140 例（72%）的睾丸可触及，51 例（28%）的睾丸无法触及。延迟睾丸固定术的明显原因是 85 例 (45%) 的睾丸上升（之前下降），41 例 (22%) 的父母延迟，39 例 (20%) 的延迟转诊，以及 18 例 (9%) 的医源性隐睾。上升的睾丸更有可能有回缩史（85% vs 30%），有阴道突未闭（78% vs 54%），并且局限于腹股沟浅层区域（87% vs 50%）。结论：初级保健提供者和家长对早期睾丸固定术益处的教育很重要。但除此之外，升睾症比之前想象的更为常见。睾丸回缩的患者应定期随访 (C) 2008 Elsevier Inc. 保留所有权利。
Introduction: We recommend orchiopexy between 9 and IS months of age for surgical, testicular, and psychological reasons. However, in practice, we observed many patients coming to orchiopexy at a later age. To understand this difference better, we reviewed our experience with patients undergoing late orchiopexy.Methods: We reviewed retrospectively the office medical records of all boys who had undergone an orchiopexy between July 1997 and April 2006. We defined a "late" orchiopexy as that performed at 4 years of age or later. Each boy was examined carefully by a pediatric urologist, and preoperative, intraoperative, and postoperative findings were reviewed.Results: There were 191 late orchiopexies in 177 patients (from a total of 587 orchiopexies in 552 patients). Median age at the operation was 7.2 years (range, 4.0-16.2). Preoperatively, the testes were palpable in 140 (72%) and nonpalpable in 51 (28%). The apparent reason for the late orchiopexy was an ascending testis (previously descended) in 85 (45%), parental delay in 41 (22%), late referral in 39 (20%), and iatrogenic cryptorchidism in 18 (9%). Ascended testes were more likely to have a history of being retractile (85% vs 30%), to have a patent processus vaginalis (78% vs 54%), and to be localized to the superficial inguinal area (87% vs 50%).Conclusions: Primary care provider and parent education on the benefits of early orchiopexy is important. but in addition, ascending testes are much more common than previously thought. Patients with retractile testes should be followed regularly (C) 2008 Elsevier Inc. All rights reserved.