Anatomical location of undescended testes and comparison between their size at different anatomical locations: A cross sectional study

Abstract

Introduction: Undescended testis (UDT) or cryptorchidism is a common childhood condition in which a boy is born without having one or both testes in their scrotum. It is a very frequent clinical finding in boys, with a prevalence of about 2-4%. The inguinoscrotal phase of testicular descent normally takes place in the last trimester of pregnancy. The regulation of prenatal testicular descent in humans is not fully understood, but numerous genetic and endocrinal factors are thought to have been involved. Preterm boys have been described to have a higher rate of UDT. The classification of UDT is performed according to palpable or nonpalpable testis. If the testis is located inside the normal path of descent, the testis is called ’intra-abdominal’, for those located in the abdomen is called ’intracanalicular’, for those located between the internal and external rings or ’suprascrotal’, for those located between the entrance of the scrotum and the external ring. This study was conducted to determine the frequency of anatomical location of undescended testis in pediatric patients undergoing orchidopexy as well as to compare the mean size of undescended testis at different anatomical location in pediatric patients undergoing orchidopexy as a secondary objective. Methods: It’s a cross sectional study of 94 patients with total 110 testes as per inclusion criteria. Study was performed at pediatric surgery department of Liaquat National university hospital Karachi, Pakistan for a duration of eight months. Orchidopexy was performed under general anesthesia as a surgical day care procedure. At orchiopexy, the outcome variables i.e. location and size of the testis was noted. The size of the testis was measured in anteroposterior and mediolateral dimensions vernier caliper, graduated in mm. The size of testis was calculated by modified Lambert’s formula (0.71xlengthxwidth2). All the collected data were entered into the proforma attached at the end. Results: Mean±SD of age was 4.29±2.19 with C.I (3.38…….4.74) years. Mean±SD of size of testis was 425.68±244.43 with C.I. (375.89……..475.47) mm. In location of testis 4 (4.2%) was located at intra-abdominal, 15 (16%) at intracanalicular and 75 (79.8%) was located at distal to superficial ring. Mean size of testis in intra-abdominal location was 276.29±145.47, intra-canalicular 367.89±196.15, distal to superficial ring was 442.27±54.08 and non-significant P-value was found i.e. (p=0.264). Conclusion: No significant difference was found between mean size of testis and location of undescended testis. The most common location was distal to superficial ring. Keyword: Testes; Undescended; Anatomical Location; Orchidopexy; Anatomical Location