The chronological changes of testicular microlithiasis in patients with hypospadias

Abstract

The prevalence and chronological changes of testicular microlithiasis (TM) in children with hypospadias (HS) was retrospectively reviewed. Children with HS who were born during January 2010 and March 2013 and who underwent testicular ultrasonography both preoperatively and at school age (5-7 years of age) were enrolled. The prevalence or degree of TM was compared between the two evaluations. TM was classified as limited (LTM, 1-4 echogenic foci per field) or classic (CTM, more than 5 echogenic foci). Statistical analysis was performed using Fisher’s exact test. Thirty children (mild HS: 16, severe HS: 14) were included. Five cases (9 testes) had undescended testes. Median age at each evaluation was 0.84 and 6.24 years respectively. On preoperative evaluation, while LTM was observed in 4 children (13%, 3 with unilateral and 1 with bilateral), none had CTM. Of 3 with unilateral LTM preoperatively, bilateral LTM or bilateral CTM developed in 2 or 1, respectively. In 1 with bilateral LTM preoperatively, bilateral CTM was identified thereafter. Among 26 without TM preoperatively, TM was newly detected in 6 (unilateral LTM in 3, bilateral LTM in 1, and bilateral CTM in 2). TM was not diminished or resolved in any cases. Gestational age, birth weight, presence of undescended testis, severity of HS, or preoperative testosterone administration were not related to TM or CTM. TM and CTM was identified in 33% and 13% of patients with HS at school age. The prevalence and degree of TM increased with age, and TM was never improved or diminished with time.