Incidence Of Undescended Testes Research Articles

Clinical factors related to undescended testis in infants with gastroschisis.

Recent studies have reported the high incidence of undescended testis (UDT) in patients with gastroschisis. Although various mechanical, hormonal, and genetic theories have been postulated to describe testicular descent, the mechanism contributing to this condition remains controversial. We aimed to investigate the incidence and risk factors of UDT in infants with gastroschisis. Male neonates who underwent surgery for gastroschisis between January 1982 and December 2019 were enrolled. Data were analyzed regarding the prevalence of UDT, including spontaneous testicular descent and the necessity of orchidopexy. Patients were grouped into those with or without UDT to identify the risk factors for UDT. Among 38 patients with gastroschisis, six (15.8%) developed UDT. There were no significant differences in gestational age or birthweight between patients with and without UDT. The patients with UDT had a significantly larger defect size than those without UDT (P = 0.037). In addition, the timing of abdominal closure was significantly later in patients with UDT than in those without UDT (P = 0.004). None of the patients with UDT exhibited spontaneous testicular descent requiring subsequent orchidopexy. Patients with gastroschisis had a high prevalence of UDT. In gastroschisis, the incidence of UDT was related to the defect size and the timing of abdominal wall closure, indicating that an insufficient increase in intra-abdominal pressure during the fetal period may affect the development of UDT.

A Rare Cause of Acute Abdomen: Testicular Torsion in an Inguinal Undescended Testis

Testicular torsion is well-known urologic emergency. It warrants urgent diagnosis and surgical intervention for successful outcomes. The incidence of undescended testis in new born is 2%-8% and reduces to <1% by 1 year of age. In majority of cases, it is located in inguinal canal. Though undescended testis is a known risk factor for testicular torsion, there are limited cases reports in the literature. Testicular torsion in undescended testis is difficult to diagnose due to vague symptoms and absence of testicular signs. We report a unique case of testicular torsion in an inguinal undescended testis in a 14-year young male.

Secular trends in the incidence and timing of surgical intervention for congenital undescended testis and surgically treated hypospadias in Ontario, Canada between 1997 and 2007

Recent studies have suggested contradictory trends in the incidence of undescended testis (UDT) and hypospadias (HYP), partly because of methodological issues and ascertainment bias. The recently described association of "testicular dysgenesis syndrome" links concomitant UDT and HYP, with decreasing sperm counts and testicular cancer. Current guidelines suggest that orchidopexy for UDT should be performed by 18 months of age. We conducted a retrospective population-based cohort study to estimate the incidence of UDT, HYP, and concomitant UDT and HYP in Ontario, based on a surgical procedure performed in the 5 years after birth. We hypothesized that the incidence of UDT and HYP are stable in the province of Ontario, Canada, over an 11-year time period. Linked administrative databases held at the Institute of Clinical Evaluative Sciences (ICES) in the province of Ontario, were used to identify all live male newborns between 1997 and 2007. Incidence rates of UDT, HYP and concomitant UDT and HYP were calculated by identifying a surgical procedure for these anomalies, within 5 years of birth. Incidence trends were analyzed using the Cochrane Armitage test for trend. Age at surgery for surgical intervention for an orchidopexy or HYP repair was determined. The incidence of UDT, defined by an orchidopexy within 5 years of birth, has remained stable in Ontario, Canada (8.2/1000 male live births, p-value for trend 0.9, 95% CI 8.0-8.4). The incidence of hypospadias has similarly remained stable (3.8/1000 male live births, p-value for trend 0.8, 95% CI 3.7-3.9). The incidence of concomitant UDT and HYP repair showed a significant increase over the 11-year period (0.2/1000 male live births, p-value for trend 0.03, 95% CI 0.2-0.3). The median age at orchidopexy (23 months, IQR 16-34 months) was beyond guideline recommendations, with earlier orchidopexy in recent years. The median age at hypospadias repair was 17 months (IQR 12-26 months). The variable rates of incidence for UDT and HYP can be explained by variations in study methodology and differing data sources utilized. The current study uses a surgical procedure to minimize information bias to correctly identify index cases of UDT and HYP. The incidence of undescended testis and hypospadias, over 5 years after birth, has remained stable in the province of Ontario between 1997 and 2007 (Summary Table). Concomitant UDT and HYP incidence showed a significant increase over this time period. Most boys in Ontario, Canada, undergo orchidopexy beyond 18 months of age.

607 - Incidence of undescended testes in preterm labor and factors associated with spontaneous descent

607 - Incidence of undescended testes in preterm labor and factors associated with spontaneous descent

Undescended Testes in Children

Objectives: Undescendent testes is most common urological problem in children. The incidence of undescended testes among term newborn is 2-9%. Testes may be spontaneous descended into scrotum in first 3-6 months. Undescended testes classified according to location of testes. Physical examination is sufficient for diagnosis. The patients should be operated between 6 months and 18 months for protec- ting the patient's fertility. Hormon therapy used for treatment in past years. But the current surgical treatment is orchiopexy. For this purpose, conventional surgery and laparoscopy are the preferred methods. Laparoscopy is used by both diagnostic and therapeutic

Analgesics During Pregnancy and Undescended Testis

To the Editor: Two recent papers suggested associations between the use of analgesics (paracetamol, aspirin, and ibuprofen) by women during pregnancy and the occurrence of congenital cryptorchidism in their offspring.1,2 This hypothesis deserves consideration given the widespread use of analgesics by pregnant women and the suspected secular increase in incidence of undescended testes in some areas.3 We therefore explored this association within a cohort of pregnant women in which specific information on the position of the testis has been collected at birth. Women from Eden mother–child cohort were recruited before 24 gestational weeks in the maternity wards of Nancy and Poitiers (France) University hospitals, between 2003 and 2006.4,5 Exposure to analgesics during the first 2 trimesters of pregnancy was assessed from a questionnaire asked by the study midwives between 24 and 28 gestational weeks. Women were asked “Since the beginning of the pregnancy, did you take one of the following drugs? Aspirin, paracetamol (listing 3 common preparations containing paracetamol) or ibuprofen (Advil).” Answers were recorded as yes/no/does not know, without distinguishing among the types of analgesic. A similar question was asked by the study midwife shortly after birth regarding analgesic use during the whole pregnancy. During a clinical examination conducted within 3 days after birth, pediatricians and study midwives assessed testis location (in scrotum, inguinal superficial, or not palpable). All singleton newborns with at least one testis not located in the scrotum were categorized as cases of undescended testes. We studied the association between analgesics use and occurrence of undescended testes, using logistic regression adjusted for gestational duration (defined from the date of the last menstrual period5,6), center, maternal age, parity, smoking, and educational level. Propensity-based methods provide an alternative to traditional adjustment to correct for confounding.7 Such methods may be particularly relevant when the number of cases (and hence the maximum number of covariates one can efficiently control for by adjustment8) is limited. We built a propensity score corresponding to the probability of use of analgesics as a function of maternal characteristics, and used this in additional weighted logistic models quantifying the impact of analgesics on occurrence of undescended testes using the inverse-probability-of-treatment weighted estimator.7 The frequency of undescended testis was 3.4% in Poitiers (16 cases, 465 births) and 5.1% in Nancy (22 cases, 430 births), giving an overall rate of 4.3% (4.1% after exclusion of preterm births). Analgesic use (overall frequency, 81%) was associated with parity (P = 0.04), toothache (P = 0.02), and antibiotic use (P = 0.08) during pregnancy. Frequency of undescended testis was 4.6% among offspring exposed to analgesics, compared with 2.9% among unexposed offspring (unadjusted odds ratio [OR] = 1.6 [95% confidence interval (CI) = 0.6–5.3]). After adjustment, the OR of undescended testis associated with use of analgesics during the 2 first trimesters of pregnancy was 1.2 (CI = 0.5–3.2; Table) in the whole population, and 1.5 among term births (CI = 0.5–4.4). ORs associated with analgesic use during the whole pregnancy were in the same range. The propensity-based weighting approach yielded ORs close to 1.0 (Table).TABLE: Association of In Utero Exposure to Analgesics With Undescended Testis Among Male Singleton Live Births From Eden Cohort, 2003–2006The main strength of our study is its longitudinal design. Limitations include small sample size, an inability to distinguish among specific compounds, and lack of information on dose, mixture, and exact timing of use. Our estimate of the association between maternal use of analgesic during the whole pregnancy and undescended testis risk (OR = 1.5 [95% CI = 0.5–7.5]; Table) was similar to that reported in the Danish population described by Kristensen et al1 before adjustment (OR = 1.5 [95% CI = 0.8–2.8]), but weaker after adjustment (OR = 1.2 in our study vs. 1.4 in the Danish study). We adjusted for parity, as was done by Jensen et al2 but not Kristensen et al. Our point estimates seemed sensitive to the choice of adjustment factors, to the exclusion of preterm births and propensity score weighting. Confidence intervals were broad, not allowing for conclusions regarding a possible impact of analgesics on the risk of undescended testes. We suggest that other cohorts with relevant exposure and outcome data report similar analyses, so that a meta-analysis can be performed. Claire Philippat Lise Giorgis-Allemand Inserm, U823, IAB Grenoble, France Institut Albert Bonniot Grenoble University Grenoble, France Cécile Chevrier Sylvaine Cordier Bernard Jégou Inserm, U625, GERHM Rennes, France GERHM, IFR140 University of Rennes I Rennes, France Marie-Aline Charles Inserm, U1018, CESP Villejuif, France Rémy Slama Inserm, U823, IAB Grenoble, France Institut Albert Bonniot Grenoble University Grenoble, France [email protected]

Use of the processes vaginalis: A new technique for reinforcing the neourethra in hypospadias associated with undescended testis

Context:The incidence of undescended testis (UDT) along with hypospadias varies from 6 to 31%. The simultaneous repair of UDT and hypospadias is rarely done. Herein, we present a novel technique to use processes vaginalis as a vascular cover for neourethra in a hypospadias patient with UDT. We have done urethroplasty and orchiopexy simultaneously. This is the first report concerning the use of processes vaginalis to reinforce the urethra.Aims:Simultaneous repair of hypospadias and undescended testis.Results:Both the patients withstood the procedure well. Postoperative period was uneventful. Patients passed urine in single stream without any fistula.Conclusions:In patients of undescended testis with hypospadias, simultaneous repair with the processes vaginalis flap is an ideal technique with good results. Processes vaginalis is good vascular cover for neourethra.

The True Incidence of Cryptorchidism in Denmark

Considerable controversy exists regarding the recently published high prevalence of cryptorchidism and the actual orchiopexy rate in Denmark. Therefore, we carried out another prevalence study. The study population included 1,094 consecutive males delivered alive at Glostrup University Hospital during 2002, with a 4-year review of patient data and telephone contact with primary physicians. At birth the overall frequency of cryptorchidism was 2.4% (26 of 1,088 cases, 23% bilateral). The frequency of cryptorchidism in singletons was 2.4% (24 of 1,012 patients). The frequency of cryptorchidism in patients with a birth weight of 2,500 gm or more was 2.1%, compared to 8.2% in those with a birth weight of less than 2,500 gm (chi-square p <0.05). The frequency of cryptorchidism in twins was 2.6% (2 of 76). The frequency of birth weight below 2,500 gm was 51% (39 of 76) in twins and 4.9% (50 of 1,012) in singletons (chi-square p <0.00005). The weight of the placenta was higher in twins (median 1,000 gm) than in singletons (650 gm). At age 4 years 1.6% of the boys had undergone or were waiting to undergo surgery for cryptorchidism, and 0.6% had a diagnosis of retractile testes. In a small cohort of newborns the incidence of cryptorchidism in Denmark has not changed, and is similar to previous reports from the 1950s. The risk is higher in low birth weight singleton neonates but does not appear to be higher in twins, despite lower birth weight and prematurity.

Incidence of Cryptorchidism and Ascending Testes in Trisomy 21: A 10 Year Retrospective Review

Children with Down syndrome have an increased risk of cryptorchidism, but the reported incidence is unclear. In a proportion of these children, the testes are within the scrotum at birth but later appear to have ascended to an ectopic position. Records of patients diagnosed with trisomy 21 who had surgery for undescended testes in two tertiary paediatric centres over a 10-year period were examined. Information on liveborn males with Down syndrome was obtained from the Victorian Genetic Registry, and then the incidence of congenital and acquired undescended testes was determined. The incidence of undescended testes in Down syndrome was found to be 6.52% (24/368), with 4.35% (16/368) being acquired undescended or ascending testes. In conclusion, there is an increased incidence of cryptorchidism in Down syndrome; in particular, there is a significant proportion of acquired undescended testes.

Incidence of cryptorchidism and ascending testes in Trisomy 21: a 10�year retrospective review

Children with Down syndrome have an increased risk of cryptorchidism, but the reported incidence is unclear. In a proportion of these children, the testes are within the scrotum at birth but later appear to have ascended to an ectopic position. Records of patients diagnosed with trisomy 21 who had surgery for undescended testes in two tertiary paediatric centres over a 10-year period were examined. Information on liveborn males with Down syndrome was obtained from the Victorian Genetic Registry, and then the incidence of congenital and acquired undescended testes was determined. The incidence of undescended testes in Down syndrome was found to be 6.52% (24/368), with 4.35% (16/368) being acquired undescended or ascending testes. In conclusion, there is an increased incidence of cryptorchidism in Down syndrome; in particular, there is a significant proportion of acquired undescended testes.

Dose-dependent effect of phthalate ester on testicular descent in pre-and post natal rats.

Mono-n-butyl phthalate (MBP) was administered to pregnant rats from the 15th to the 17th gestational day to investigate the dose-dependent effect of phthalate ester on testicular descent in both pre- and postnatal rats. Thirty pregnant rats (280-330 g) were separated into five groups and administered 1.0 g/kg/day MBP in group I, 0.5 g/kg/day in group II, 0.25 g/kg/day in group III, 0.125 g/kg/day in group IV from the day 15 to 17 of gestation. The rats in group V were only administered solvent and acted as controls. The position of the testis was evaluated in both pre- and postnatal rats. This was significantly higher in 20-day old fetuses in groups I and II than in groups III, IV or V. After birth, the incidence of undescended testis was also higher in groups I and II compared with those of groups III, IV or V. The undescended testes were located in the abdominal cavity in groups I and II, whereas they were located at the inguinal region in group III. The lowest dose that induced an adverse effect on testicular descent was 0.25 g/kg/day. In conclusion, maternal MBP inhibited testicular descent in prenatal rats and thus dose-dependently induced undescended testes postnatally. High-doses of MBP are thus considered to inhibit the transabdominal descent of the testis, probably due to its estrogenic activity, whereas low-doses of MBP may act as an anti-androgen and thereby inhibit inguinoscrotal testicular descent in postnatal rats.

Alterations in maternal epidermal growth factor (EGF) effect testicular descent and epididymal development

Objective. (1) To determine the ability of epidermal growth factor (EGF) to reverse antiandrogen-induced cryptorchidism and epididymal abnormalities; (2) to evaluate whether alterations in maternal EGF would result in abnormal testicular descent or mal development of the epididymis. Methods. Experiment 1: Timed pregnant ICR mice were treated with either flutamide, flutamide plus EGF, or vehicle alone on gestational days 1 1 through birth. Experiment 2: Maternal EGF was abolished by removing the submandibular glands. Following timed mating, dams were treated with either flutamide, anti-EGF, DHT or vehicle alone on gestational days 11 through birth. Results. Experiment 1 : Treatment with flutamide resulted in a 36 percent (26/72) incidence of undescended testes (UDT), and a 43 percent (31/72) incidence of abnormal epididymides. Rats treated simultaneously with flutamide plus EGF had a reduced incidence of UDT (14%, 6/42) and epididymal anomalies (19%, 8/42); p < 0.01. Experiment 2: The absence of maternal EGF resulted in a significant incidence of cryptorchidism in 11/50 (22%) testes, and epididymal anomalies in 19/50 (38%); p < 0.01. Conclusions. Our findings suggest that EGF stabilizes the wolffian duct system and partially mediates testicular descent.

Omphalocele, Cryptorchidism, and Brain Malformations

Nineteen male infants died with a large omphalocele and 52% had associated cryptorchidism. However, two different groups with both omphalocele and cryptorchidism were recognized: (1) Eleven patients with omphalocele without brain malformation and an incidence of undescended testes not significantly different from the normal population; (2) Eight patients with omphalocele and brain malformation all having cryptorchidism. A comparison of the groups indicated that intact intraabdominal pressure during intrauterine life is not a main driving force of testicular descent, whereas normal testicular descent may occur only when the brain is normally developed. Whenever a child with omphalocele and cryptorchidism is examined, careful evaluation of the central nervous system is indicated. This triad of malformations may have prognostic and therapeutic implications.

Omphalocele, cryptorchidism, and brain malformations

Nineteen male infants died with a large omphalocele and 52% had associated cryptorchidism. However, two different groups with both omphalocele and cryptorchidism were recognized: (1) Eleven patients with omphalocele without brain malformation and an incidence of undescended testes not significantly different from the normal population; (2) Eight patients with omphalocele and brain malformation all having cryptorchidism. A comparison of the groups indicated that intact intraabdominal pressure during intrauterine life is not a main driving force of testicular descent, whereas normal testicular descent may occur only when the brain is normally developed. Whenever a child with omphalocele and cryptorchidism is examined, careful evaluation of the central nervous system is indicated. This triad of malformations may have prognostic and therapeutic implications.

Cryptorchidism in the Newborn

The incidence of cryptorchidism in newborn infants is stated to be 3% to 4% by Curran and Curran in a recent article.1 The reference cited is a report by Scorer published in 1957.2 However, a review of the literature shows that the incidence of cryptorchidism in the full-term new born infant is slightly lower and in the low birth weight infant (birth weight 2,500 gm or less), it is considerably higher. Up until 1955 there was much confusion regarding the incidence of undescended testes in the newborn.

The Incidence of Undescended Testis in Boys attending Elementary Schools in Greece

The Incidence of Undescended Testis in Boys attending Elementary Schools in Greece