Abstract
This prospective study aimed to evaluate whether Contralateral compensatory testicular hypertrophy (CTH) is valid as a predictive tool for a non-viable testis in children aged between 6 and 18 months, and whether CTH is affected by mini-puberty. Seventy-two testes from 60 boys aged between 6 and 18 months were categorized into three groups: 24 testes contralateral to surgically removed non-viable testes (NVTs), 24 testes contralateral to surgically corrected undescended testes (UDTs), and 24 testes from a normal controls. Contralateral testicular length and volume were measured with ultrasonography and compared among the groups. Group 1 (NVT) had a significantly longer length and larger volume than group 2 (UDT). The length and volume of each group among three developmental periods (6–10, 10–14, and 14–18 months) were also analyzed. In the controls, the length was significantly larger at 6–10 months than at 10–14 months in accordance with previously reported changes in testicular size due to the effect of “mini-puberty.” The volume of controls showed a similar pattern, though without statistical significance. However, this pattern was not observed in the NVT and UDT groups. A receiver operating curve revealed that a testicular length of 16.1 mm or a volume of 0.59 ml had the highest sensitivity and specificity for predicting NVTs. The CTH was also found to be valid as a predictive tool for a NVT in children of ages 6 to 18 months, as the effect of mini-puberty appeared to be absent in the NVT and UDT groups. However, the cut-off values were less than those of previous reports. The proper cut-off level according to the age and measurement method should be applied in this developmental period.
Highlights
Contralateral compensatory testicular hypertrophy (CTH) in patients with a non-viable testis (NVT) is a well-known phenomenon.[1]
Hurwitz and Kaptein reported a testicular length of 18 mm in the contralateral testis as a cut-off value for an ipsilateral NVT in children under the age of 11 years,[2] and Shibata et al reported a cut-off of 2.2 ml of contralateral testicular volume in children under the age of 5 years.[5]
Among the 31 patients with a non-palpable testis, viable undescended testes (UDTs) were confirmed during laparoscopy and inguinal exploration in 7 patients. These 7 patients were categorized into group 2, along with 17 patients with palpable UDTs located in the inguinal canal
Summary
Contralateral compensatory testicular hypertrophy (CTH) in patients with a non-viable testis (NVT) is a well-known phenomenon.[1]. For the preservation of fertility, recent guidelines recommend surgical correction of undescended testes as early as possible, starting after 6 months of age and before 18 months of age.[7, 8] testicular volume changes due to the unstable level of gonadotropic hormones, known as mini-puberty,[9, 10] could confuse clinicians using the previous cut-off value during infancy. We hypothesized that CTH is valid as a predictive tool for an NVT even in children aged 6–18 months, though with a different cut-off level. To validate this hypothesis, we performed a prospective study in this age group. We analyzed whether CTH is affected by mini-puberty
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