European Journal of Pediatrics

, Volume 152, Supplement 2, pp S45–S46 | Cite as

Bilateral undescended testes

  • Howard M. SnyderIII
Cryptorchidism and Male Pseudo-Hermaphroditism

Abstract

The management of boys with undescended testes appears to be an increasingly common problem. While Scorer (1964) [11] reported an incidence of 0.8% of undescended testes in boys of one year of age, a recent survey (Radcliffe Hospital, Oxford, 1986) [18] suggests the incidence has risen to as high as 1.6%. While the etiology may be varied, it is quite clear that many cases represent disturbances of the hypothalamic-pituitary-gonadal axis and may represent a forme fruste of hypogonadotropic hypogonadism [3]. Bilateral undescended testes might logically appear to represent the worst end of such an endocrinopathy. Indeed, a review of the experience at The Children's Hospital of Philadelphia [12] of boys with bilateral undescended testes indicated a greater number of CNS abnormalities (P=0.0000) than in boys with unilateral undescended testes (Table 1). Also consistent with bilateral cryptorchid testes representing the most severe end of the spectrum was the reported findings from that study that bilateral undescended testes also exhibit a significantly greater number of associated G-U anomalies (P=0.0004).

Key words

Cryptorchidism Bilateral surgery Management 

References

  1. 1.
    Abeyaratne MR, Aherne WA, Scott JES (1969) The vanishing testis. Lancet 2:822PubMedGoogle Scholar
  2. 2.
    Bartone FF (1984) Pitfalls in using human chorionic gonadotrophin stimulation tests to diagnose anorchia. J Urol 132:563PubMedGoogle Scholar
  3. 3.
    Bloom DA, Ayers JTW, McGuire EJ (1988) The role of laparotomy in management of non-palpable testes. J Urol 94:465Google Scholar
  4. 4.
    Bloom DA (1991) Two-step orchiopexy with pelviscopic clip ligation of the spermatic vessels. J Urol 145:1030–1033PubMedGoogle Scholar
  5. 5.
    Gross RE, Jewett TC Jr (1956) Surgical experiences from 1222 operations for undescended testes. JAMA 160:634Google Scholar
  6. 6.
    Hadziselimovic F (1983) Cryptorchidism, Management and Implications. Berlin, Springer-VerlagGoogle Scholar
  7. 7.
    Hutson JM, Beasley SW (1992) Descent of the Testis. London, Edward Arnold Co.Google Scholar
  8. 8.
    John Radcliffe Hospital Cryptorchidism Study Group (1986) Cryptorchidism: An apparent substantial increase since 1960. Br Med J 293:1401–1404Google Scholar
  9. 9.
    Kogan SJ (1987) Fertility in cryptorchidism: An overview in 1987. Eur J Pedr 146 [Suppl. 2]:21–24Google Scholar
  10. 10.
    Ransley PC, Vordermark JS, Caldamone AA (1984) Preliminary ligation of the gonadal vessels prior to orchiopexy for the intra-abdominal testicle: A staged Fowler-Stephens procedure. World J Urol 2:266–268Google Scholar
  11. 11.
    Scorer CG (1964) The descent of the testis. Arch Dis Child 39:605–609PubMedGoogle Scholar
  12. 12.
    Snyder HM, Wu H-Y, Huff D, Hadziselimovic F, Duckett JW, Blyth B (1991) Bilateral undescended testis: More evidence for an underlying endocrinopathy. Abstract #262, presented at the American Urological Association meeting, Toronto, CanadaGoogle Scholar

Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • Howard M. SnyderIII
    • 1
  1. 1.Division of UrologySurgical “Associates of the Children's Hospital of Philadelphia, One Children's CenterPhiladelphiaUSA

Personalised recommendations