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Why do undescended testes and posterior urethral valve occur together?

Pediatric Surgery International volume 32, pages 509–514 (2016)Cite this article

Abstract

Background/Aim

Undescended testis (UDT) occurs in ~2 % of newborn males, and occasionally these infants also have posterior urethral valve (PUV). The cause of this relationship is uncertain. We aimed to review the literature to identify publications documenting co-occurrence of UDT and PUV, and to summarise the theories of co-occurrence.

Methods

A search of the literature (Embase, Medline, Pubmed; 1947–2015) was undertaken to identify publications describing the link between UDT in PUV patients, as well as PUV in UDT patients. Ten publications in English were found with both UDT and PUV: 9 articles describing the frequency of UDT in patients with PUV, and 1 article examining the frequency of PUV in infants with UDT.

Results

UDT occurred in 12–17 % of PUV compared with 1–2 % in the control population, consistent with a 10-fold increase. PUV occurred in 1.2 % of UDT patients compared with 0.01 % in the control population, consistent with a 100-fold increase.

Discussion

PUV leads to a 10-fold increase in occurrence of UDT, while the presence of UDT causes a 100-fold increase in occurrence of PUV. Four main theories of causation have been proposed, each of which have some merit but little supporting evidence, leaving the cause of simultaneous occurrence of PUV and UDT uncertain.

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Author notes

    Affiliations

    1. Faculty of Medicine, University of Melbourne, Melbourne, Australia

      Jeremy Wong, Vishal Punwani, Christopher Lai & Jessalynn Chia

    2. Department of Paediatrics, University of Melbourne, Melbourne, Australia

      John M. Hutson

    3. Urology Department, The Royal Children’s Hospital, 50 Flemington Road, Parkville, Melbourne, 3052, VIC, Australia

      John M. Hutson

    4. Douglas Stephens Surgical Research Group, Murdoch Childrens Research Institute, Melbourne, Australia

      John M. Hutson

    Authors
    1. Jeremy Wong
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    2. Vishal Punwani
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    3. Christopher Lai
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    4. Jessalynn Chia
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    5. John M. Hutson
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    Corresponding author

    Correspondence to John M. Hutson.

    Additional information

    J. Wong, V. Punwani, C. Lai and J. Chia contributed equally.

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    Wong, J., Punwani, V., Lai, C. et al. Why do undescended testes and posterior urethral valve occur together?. Pediatr Surg Int 32, 509–514 (2016). https://doi.org/10.1007/s00383-016-3883-4

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    • DOI: https://doi.org/10.1007/s00383-016-3883-4

    Keywords

    • Posterior urethral valve
    • Undescended testis
    • Cryptorchidism