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New Indian Journal of Surgery

Volume  9, Issue 2, March - April 2018, Pages 184-190
 

Original Article

Current Trends and Guidelines in Surgical Management of Undescended Testis

S.V. Satyanarayana Raoa, R. Ganapathib, P. Bhanumurthyc D. Sai Spandanad, P. Ashok Tejae

aProfessor & H.O.D bAssistant Professor, d,ePG Resident, Department of General Surgery cAssistant Professor, Department of Urology, Great Eastern Medical School and Hospital, Ragolu, Srikakulam, Andhra Pradesh 532484, India.

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9218.13

Abstract

Background: Undescended testis is one of the most common congenital malformations encountered in male neonates and is related to a multifactorial process. The incidence varies and depends on gestational age affecting 1.0-4.6% of full term and 1.1-45% of preterm neonates. Despite spontaneous descent within first months of life, nearly 1% of all full term male infants still have undescended testes at 01 year of age. It may affect both sides up to 30%.In new born cases with non-palpable, undescended testes on both sides and any sign of disorders of sex development, such as con-comitant hypospadias, urgent endocrinologic and genetic evaluation is  required.

Materials and Methods: This study was carried out in the Department of surgery, Great Eastern Medical School & Hospital, Srikakulam, Andhra Pradesh, India. A total of 30 patients were selected for the study from among admitted cases. A thorough clinical assessment, laboratory investigations and radio-imaging studies like Ultrasonography, computerized-tomography and magnetic resonance imaging were performed. Diagnostic laparoscopy was useful to detect nonpalpable and abdominal testis. After confirming
diagnosis, open orchidopexy was performed in 24 cases. Laparoscopic orchidopexy was done in 04 cases and orchidectomy in 02 cases.

Results: Undescended testis was found most commonly among boys of 01-03 years of age group with an
incidence of 55.6% in the present study. Absence of testis in the scrotum was the common complaint in 25 cases (83.4%). 04 cases presented with complications such as inguinal hernia and 1 case with torsion of testis.

Conclusion: The present study concludes that early placement of undescended testis in the scrotal position (orchidopexy) is the gold standard treatment. It also prevents potential impairment of fertility and reduces the risk of testicular malignancy. No consensus exists on the role of hormonal treatment. 


Keywords : Cryptorchidism; Intracanalicular Testes; Magnetic Resonance Imaging; Orchidopexy; Testicular Volume; Testicular Atrophic Index; Ultrasonography; Undescended Testis.
Corresponding Author : S.V. Satyanarayana Rao, Professor & H.O.D, Department of General Surgery, Great Eastern Medical School and Hospital, Ragolu, Srikakulam, Andhra Pradesh 532484, India.