Diagnostic Evaluation of Herniography in Cryptorchism

Chung, Sung Kwang; Chang, Sae Kook

Abstract

Herniography is proved to be a valuable roentgenographic technique for delineating the configuration of almost all the peritoneal sacs and the position of most of the undescended testes, as well as most of the associated urologic anomalies. The authors applies this technique to thirty three boys with cryptorchism (39.4% bilateral) in this department during last 3 years and 6 months period from Jan. 1978 to June 1981. The results were as follows. 1) There were 40 open peritoneal sacs at operation, including 3 open sacs contralateral to unilateral cryptorchid testes. With the most accurate preoperative examination only 19 of these open sacs were noted (47.5%), while with herniography, 38 of the 40 were correctly identified (95.0%). 2) The position of the cryptorchid testes were accurately diagnosed by preoperative examination in 28 of the 45 instances (62.2%) With herniography we correctly located 33 testes (73.3%), despite the lack of an accompanying peritoneal sac with 8 cryptorchid testes (17.8%). 3) Associated anomalies and diseases were found in 24 instances of 33 boys, 2 of these 24 instances were discovered by the incidental pyelogram film of the herniogram to have upper urinary tract abnormalities, including one with ureteral stone and one with kidney malrotation. 4) Only 6 minor complications arose in 33 children as a result of this procedure, including 3 with abdominal injection, one with inadvertently needling of the colon, one with pain & sweating, one with transient fever. However, all of these were not troublesome for affected patients.