Testicular Growth and Operative Results after Orchiopexy in Unilateral Cryptorchidism

Kim, Jong sung; Park, Kyun chul

Abstract

To know testicular growth and operative results after orchiopexy in unilateral cryptorchidism a retrospective study was performed on 56 patients at least 8 months after orchiopexy due to unilateral cryptorchidism by palpation of testis, inspection of operation scar, evaluating testis volume using Prader orchidometer, and interviewing with the patients and their parents about previous undescended testis. Their medical records were also reviewed. Patients' mean age at orchiopexy was 6 years and 8 months. Mean duration after orchiopexy was 3 years and 7 months at the time of followup. Inguinal orchiopexy was performed in all patients except one. Operative success was defined as scrotal position of previous undescended testis without atrophy Testis volume ratio was defined as T2/T1 (T1=volume of previous undescended testis, T2= volume of contralateral descended testis). Mean testicular volume was 3.66+/-3.12ml in previous undescended testis and 5.11+/-5.42ml in contralateral descended testis, respectively(p>0.05.) In patients with public hair mean testicular volume was 8.76+/-2.30ml in previous undescended testis and 13.5+/-4.80ml in contralateral descended testis, respectively(p<0.01). Testis volume ratio had moderate correlation with age at orchiopexy and age at followup(r=0.44, 0.46, respectively). Operative success rate was 88%. Of 47 parents who accompanied by patients 32 were satisfied, 7 were intermediate, 8 were unsatisfied with previous undescended testis associated with size, position, and/or consistency. Inguinal operation scar was cosmetically better in transverse skin incision than in oblique skin incision(p<0.01). Moderate correlation of testis volume ratio with age at orchiopexy might suggest that early orchiopexy enhances catch-up growth of previous undescended testis. Moderate correlation of testis volume ratio with age at followup and significant difference of mean testicular volume between previous undescended testis and contralateral undescended testis in patients with public airs, might imply that growth of previous undescended testis become retarded comparing to that of contralateral descended testis at puberty which is critical period for testicular growth. These should be confirmed via prospective long-term studies which include early orchiopexy and more accurate measurement of testis volume using ultrasonography. Appropriate surgical treatment of cryptorchidism needs various orchiopexy techniques and proper selection of surgical options including orchiectomy.