Abstract
BackgroundComplications in the urinary tract related to congenital Zika syndrome have recently been reported. One complication, cryptorchidism, has been reported by the Microcephaly Epidemic Research Group/MERG, in Pernambuco/Brazil. The present article describes for the first time the surgical findings in a case series of boys with Zika-related microcephaly and cryptorchidism, who underwent surgical testicular exploration as a contribution to better understand the possible mechanisms involved in gonads formation and descent.MethodsA total of 7 children (11 testicular units), aged 3 to 4 years, were submitted to inguinal or scrotal orchidopexy for the treatment of palpable cryptorchidism between August 2019 and January 2020. Characteristics of the gonads and its annexes related to appendixes, testis-epididymis dissociation, gubernacular insertion, and associated hydroceles and/or hernias were described. Measures in centimetres were taken for volume calculate.ResultsWe found a low prevalence of testicular and epididymal appendix (66.7%), a high prevalence of testis-epididymis dissociation (55.6%), low mean testicular volume for their ages (lower for older boys) and ectopic gubernacular insertion in all cases. There was no evidence of associated hydroceles and/or hernias in any case. No surgical complication was registered or reported, and all explored gonads were properly placed in the scrotal sac.ConclusionsWe herein describe the surgical findings of these children's orchidopexies and discuss the possible mechanisms of viral action in embryogenesis and postnatal growth and development of the testes and annexes. These children need to be followed over time due to the higher risk of testicular atrophy and malignancy. Surgical timing seems to be relevant to avoid loss of testicular volume.
Highlights
Complications in the urinary tract related to congenital Zika syndrome have recently been reported
We provide the first report on the findings of testicular surgical exploration in a case series of 7 male children, aged 3 to 4 years, with Zika-related microcephaly (ZRM) and cryptorchidism participating in the Microcephaly Epidemic Research Group (MERG) Paediatric Cohort, in Pernambuco, Brazil (Study Protocol: de Vasconcelos et al BMC Urol (2020) 20:186 http:/www.cpqam.fiocruz.br/merg/) [4]
The records regarding the aspect of the testes and annexes, gonadal volume, gubernacular insertion, and associated findings were obtained by in-surgery measurement and photographs taken by the research group during the surgical procedures
Summary
Complications in the urinary tract related to congenital Zika syndrome have recently been reported. Cryptorchidism, has been reported by the Microcephaly Epidemic Research Group/MERG, in Per‐ nambuco/Brazil. The present article describes for the first time the surgical findings in a case series of boys with Zikarelated microcephaly and cryptorchidism, who underwent surgical testicular exploration as a contribution to better understand the possible mechanisms involved in gonads formation and descent. Neurodevelopmental impairments and structural brain defects are amongst the most common features in children with Zika-related microcephaly (ZRM), the condition has been increasingly associated with de Vasconcelos et al BMC Urol (2020) 20:186 http:/www.cpqam.fiocruz.br/merg/) [4]. As main objective to better understand the possible mechanisms involved in this syndrome and its influences over gonads formation and descent
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