Congenital abdominal wall defects and cryptorchidism: a population-based study

Arimatias Raitio,Anna Hyvärinen,Johanna Syvänen,Ilkka Helenius,Mika Gissler,Ulla Sankilampi,Asta Tauriainen

doi:10.1007/s00383-021-04863-9

Abstract

PurposeSeveral studies have reported high prevalence of undescended testis (UDT) among boys with congenital abdominal wall defects (AWD). Due to rarity of AWDs, however, true prevalence of testicular maldescent among these boys is not known. We conducted a national register study to determine the prevalence of UDT among Finnish males with an AWD.MethodsAll male infants with either gastroschisis or omphalocele born between Jan 1, 1998 and Dec 31, 2015 were identified in the Register of Congenital Malformations. The data on all performed operations were acquired from the Care Register for Health Care. The register data were examined for relevant UDT diagnosis and operation codes.ResultsWe identified 99 males with gastroschisis and 89 with omphalocele. UDT was diagnosed in 10 (10.1%) infants with gastroschisis and 22 (24.7%) with omphalocele. Majority of these required an operation; 8/99 (8.1%) gastroschisis and 19/89 (21.3%) omphalocele patients. UDT is more common among AWD patients than general population with the highest prevalence in omphalocele.ConclusionsCryptorchidism is more common among boys with an AWD than general population. Furthermore, omphalocele carries significantly higher risk of UDT and need for orchidopexy than gastroschisis. Due to high prevalence testicular maldescent, careful follow-up for UDT is recommended.

Highlights

Abdominal wall defects (AWDs), notably gastroschisis and omphalocele, are relatively rare congenital anomalies with a prevalence of 1.85 and 1.96 per 10,000 births in Finland, respectively [1, 2]
The data on AWDs were collected from the Finnish Register of Congenital Malformations (FRM) [21] and the Care Register for Health Care (CRHC) [22], both maintained by the Finnish Institute for Health and Welfare (THL)
Ten of 99 (10.1%) boys with gastroschisis were diagnosed with undescended testis (UDT) while 22/89 (24.7%) infants with omphalocele had evidence of testicular maldescent

Summary

Introduction

Abdominal wall defects (AWDs), notably gastroschisis and omphalocele, are relatively rare congenital anomalies with a prevalence of 1.85 and 1.96 per 10,000 births in Finland, respectively [1, 2] Total prevalence of these anomalies has increased in Finland since previous rates published in 1980s [3]. Gastroschisis in an isolated anomaly [1, 4, 5], whereas omphalocele is often associated with other severe anomalies including chromosomal abnormalities and cardiac defects [2, 6, 7] As both of these congenital malformations are life-threatening conditions at birth, it has been speculated that the prevalence of UDT among boys with AWD may be under-reported because of the greater emphasis on lethal comorbidities [8].

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