Advertisement

Diagnosis of Undescended Testis

  • John M. Hutson
  • Jørgen M. Thorup
  • Spencer W. Beasley
Chapter
  • 692 Downloads

Abstract

Clinical diagnosis of undescended testes (UDT) requires some skill, because of the small size and mobility of the prepubertal testis inside the processus vaginalis. In addition, distinguishing between congenital UDT with failed gubernacular migration and retractile testes is challenging. In many centres ultrasonography has become a common adjunct to clinical examination, but has limitations, particularly for intraabdominal testes. Laparoscopy is the standard test for an impalpable testis, along with inhibin-B and AMH levels if it is bilateral.

Keywords

Spermatic Cord Inguinal Canal Undescended Testis Testicular Torsion Spigelian Hernia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Hutson JM, Beasley SW. Surgical examination of children. 2nd ed. Berlin: Springer; 2013.CrossRefGoogle Scholar
  2. 2.
    Wyllie GG. The diagnosis of undescended testes. Med J Aust. 1978;1(12):639–41.PubMedGoogle Scholar
  3. 3.
    Scorer CG. The incidence of incomplete descent of the testicle at birth. Arch Dis Child. 1956;31(157):198–202.PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Scorer CG. The descent of the testis. Arch Dis Child. 1964;39:605–9.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    John Radcliffe Hospital Study Group. Clinical diagnosis of cryptorchidism. Arch Dis Child. 1988;63:587–91.CrossRefGoogle Scholar
  6. 6.
    Scorer CG, Farrington GG. Congenital deformities of the testis and epididymis. London: Butterworths; 1971.Google Scholar
  7. 7.
    Johansen TE. The anatomy of gubernaculum testis and processus vaginalis in cryptorchidism. Scand J Urol Nephrol. 1988;22(2):101–5.PubMedGoogle Scholar
  8. 8.
    Johansen TE, Larmo A. Ultrasonography in undescended testes. Acta Radiol. 1988;29(2):159–63.PubMedCrossRefGoogle Scholar
  9. 9.
    Hutson JM, Thorup J. Evaluation and management of the infant with cryptorchidism. Curr Opin Pediatr. 2015;26(4):520–4.CrossRefGoogle Scholar
  10. 10.
    Kolon TF, Herndon CD, Baker LA, et al. Evaluation and treatment of cryptorchidism: AUA guideline. J Urol. 2014;192(2):337–45.PubMedCrossRefGoogle Scholar
  11. 11.
    Toppari J. Paediatrics: new cryptorchidism guidelines reach a consensus. Nat Rev Urol. 2014;11(8):432–3.PubMedCrossRefGoogle Scholar
  12. 12.
    Steinbrecher H. The undescended testis: working towards a unified care pathway for 2014. Arch Dis Child. 2014;99(5):397–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Fenton EJM, Woodward AA, Hudson IL, et al. The ascending testis. Ped Surg Int. 1990;5:6–9.CrossRefGoogle Scholar
  14. 14.
    Atwell JD. Ascent of the testis: fact or fiction. Br J Urol. 1985;57(4):474–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Stirk DI. Strangulated inguinofemoral hernia with descent of the testis through the femoral canal; a report of one case and review of the literature. Br J Surg. 1955;43(179):331–2.PubMedCrossRefGoogle Scholar
  16. 16.
    Fauntleroy AM. Development of an inguinal hernia through the femoral ring following descent of the testicle by the same route. Ann Surg. 1920;72(6):674.2–5.CrossRefGoogle Scholar
  17. 17.
    Beasley SW, Auldist AW. Crossed testicular ectopia in association with double incomplete testicular descent. Aust N Z J Surg. 1985;55(3):301–3.PubMedCrossRefGoogle Scholar
  18. 18.
    Heyns CF. Exstrophy of the testis. J Urol. 1990;144(3):724–5.PubMedGoogle Scholar
  19. 19.
    Stephens FD, Smith ED, Hutson JM. Congenital anomalies of the kidney, urinary ad genital tracts. 2nd ed. London: Martin Dunitz; 2002.Google Scholar
  20. 20.
    Jones BC, Hutson JM. The syndrome of Spigelian hernia and cryptorchidism: a review of paediatric literature. J Pediatr Surg. 2015;50(2):325–30.PubMedCrossRefGoogle Scholar
  21. 21.
    Balsara ZR, Martin AE, Wiener JS, et al. Congenital Spigelian hernia and ipsilateral cryptorchidism: raising awareness among urologists. Urology. 2014;83(2):457–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Andrade K, Smith S, Goodarzian F. An infant with an ectopic torsed testis in the abdominal wall. Emerg Radiol. 2014;21(2):223–5.PubMedCrossRefGoogle Scholar
  23. 23.
    Williams DW. Anomaly of scrotum and testes: simple plastic repair. J Urol. 1963;89:860–3.PubMedGoogle Scholar
  24. 24.
    Adair EL, Lewis EL. Ectopic scrotum and diphallia: report of a case. J Urol. 1960;84:115–7.PubMedGoogle Scholar
  25. 25.
    Thorup J, Petersen BL, Kvist K, Cortes D. Bilateral vanished testes diagnosed with a single blood sample showing very high gonadotrophins (follicle-stimulating hormone and luteinizing hormone) and very low inhibin B. Scand J Urol Nephrol. 2011; 45:425–31.Google Scholar
  26. 26.
    Vos A, Vries AM, Smets A, et al. The value of ultrasonography in boys with a non-palpable testis. J Pediatr Surg. 2014;49(7):1153–5.PubMedCrossRefGoogle Scholar
  27. 27.
    Fritzsche PJ, Hricak H, Kogan BA, et al. Undescended testis: value of MR imaging. Radiology. 1987;164(1):169–73.PubMedCrossRefGoogle Scholar
  28. 28.
    Kollin C, Hesser U, Ritzen EM, et al. Testicular growth from birth to two years of age, and the effect of orchidopexy at age nine months: a randomized, controlled study. Acta Paediatr. 2006;95(3):318–24.PubMedCrossRefGoogle Scholar
  29. 29.
    Troughton AH, Waring J, Longstaff A, et al. The role of magnetic resonance imaging in the investigation of undescended testes. Clin Radiol. 1990;41(3):178–81.PubMedCrossRefGoogle Scholar
  30. 30.
    Bretan Jr PN, Vigneron DB, Hricak H, et al. Assessment of testicular metabolic integrity with P-31 MR spectroscopy. Radiology. 1987;162(3):867–71.PubMedCrossRefGoogle Scholar
  31. 31.
    Naslund MJ, Gearhart JP, Jeffs RD. Laparoscopy: its selected use in patients with unilateral nonpalpable testis after human chorionic gonadotropin stimulation. J Urol. 1989;142(1):108–10.PubMedGoogle Scholar
  32. 32.
    Elder JS. Laparoscopy and Fowler-Stephens orchiopexy in the management of the impalpable testis. Urol Clin North Am. 1989;16(2):399–411.PubMedGoogle Scholar
  33. 33.
    Boddy SA, Corkery JJ, Gornall P. The place of laparoscopy in the management of the impalpable testis. Br J Surg. 1985;72(11):918–9.PubMedCrossRefGoogle Scholar
  34. 34.
    Guiney EJ, Corbally M, Malone PS. Laparoscopy and the management of the impalpable testis. Br J Urol. 1989;63(3):313–6.PubMedCrossRefGoogle Scholar
  35. 35.
    Abeyaratne MR, Aherne WA, Scott JE. The vanishing testis. Lancet. 1969;2(7625):822–4.PubMedCrossRefGoogle Scholar
  36. 36.
    Barker A, Ahmed S, Freeman JK. Unnecessary investigations for impalpable testes. Med J Aust. 1987;147(4):211.PubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • John M. Hutson
    • 1
  • Jørgen M. Thorup
    • 2
  • Spencer W. Beasley
    • 3
  1. 1.Royal Children’s Hospital University of MelbourneParkvilleAustralia
  2. 2.Univ. Hospital of Copenhagen RigshospitaletKøbenhavnDenmark
  3. 3.University of OtagoChristchurchNew Zealand

Personalised recommendations