Impalpable Testis: Evaluation of Diagnostic and Treatment Procedures and Our Treatment Protocol

Fratrić, Ivana; Šarac, Dragan; Antić, Jelena; Đermanov, Marina; Jokić, Radoica

doi:10.1155/2018/3143412

Cited by 14 publications

(12 citation statements)

References 22 publications

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“…Clinical decision-making and postoperative management of cryptorchidism is determined by its presence and location [ 4 ]. As the criterion standard for functional evaluation, histological biopsy is rarely acceptable because of ethical issues [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Three‑Dimensional Ultrasonography in Preoperative and Postoperative Volume Assessment of the Undescended Testicle

You

Zhuang

et al. 2020

Med Sci Monit

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Background Ultrasound (US) is the preferred imaging method for cryptorchidism, but most guidelines indicate that its value is questionable. The aim of this study was to evaluate the clinical value of ultrasonic mobility and testicular atrophy index (TAI) based on three-dimensional US (3DUS) in preoperative and postoperative assessment of the undescended testis. Material/Methods Data from 158 children with unilateral extraperitoneal cryptorchidism were collected and their diagnoses were surgically confirmed. They were divided into different age groups and into 2 ultrasonic mobility groups: the mobile group (MG) and the restricted group (RG). Differences in sonographic characteristics between different groups were compared. Three-dimensional ultrasound performed with virtual organ computer-aided analysis (VOCAL) was used to determined preoperative and postoperative TAI and the reliability of TAI was analyzed. Results Measurement of testicular volume with the VOCAL method was significantly more reliable than that done with the two-dimensional Lambert method. In all age groups, preoperative testicular volumes were smaller than that in the contralateral scrotal testis and postoperatively, they increased steadily. Both preoperative and postoperative TAI were higher in the RG than in the MG. In the MG, postoperative TAI decreased significantly in all age groups. In the RG, in contrast, effective volume growth was only achieved in patients who had undergone surgery before they reached age 1 year. Conclusions TAI values determined with 3DUS using the VOCAL technique objectively reflect recovery of testicular volume following surgery for undescended testicle. Ultrasonic mobility evaluation is beneficial for clinical management of the condition.

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Section: Introductionmentioning

confidence: 99%

Three‑Dimensional Ultrasonography in Preoperative and Postoperative Volume Assessment of the Undescended Testicle

You

Zhuang

et al. 2020

Med Sci Monit

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“…In the past 20 years, laparoscopy has been widely used in the diagnosis and treatment of NPT, especially IAT and NVT, and there are still controversies about the diagnosis of EAT by laparoscopy 8 , 9 . Laparoscopy can indicate whether the testicular vessels and vas enters the inguinal canal through the internal inguinal ring, but cannot provide information about the testis outside the abdominal cavity 10 , 11 .…”

Section: Discussionmentioning

confidence: 99%

Ultrasound manifestations and clinical features of nonpalpable testis in children

Zhou

Wang

et al. 2022

Sci Rep

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To explore the value of ultrasound in the preoperative diagnosis of nonpalpable testis (NPT) in children. A retrospective study of 254 cases with NPT from May 2017 to December 2021. The preoperative ultrasound examination results were compared with the surgical exploration and pathological results. There were 254 cases (312 testes) NPT has got surgery in our centre. The surgical age were from 6 month to 12 years old, the median age was 2.33 years. There were 103 cases (136 testes) diagnosed as intra-abdominal testis (IAT) by preoperative ultrasound, and 80 cases (103 testes) of extra-abdominal testis (EAT), 71 cases (73 testes) of non-viable testis (NVT). There were 102 cases (135 testes) consistented as IAT by the diagnostic laparoscopy, the preoperative ultrasound’s coincidence of IAT was 99.02%. There were 80 cases (103 testes) consistented as EAT by the diagnostic laparoscopy, the preoperative ultrasound’s coincidence rate was100%. There were 62 cases (62 testes) consistented as NVT by the diagnostic laparoscopy, there were 9 cases (11 testes) misdiagnosed, the preoperative ultrasound’s coincidence rate was 84.9%. Ultrasound can provide valuable information for the preoperative diagnosis of children with nonpalpable testicles, and especially good at identifying the EAT and IAT with normal testicular morphology.

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“…Cryptorchidism is a common congenital malformation in pediatric urology which is also known as undescended testis (UDT) or incomplete testicular descent (1)(2)(3). According to the location of the testis, cryptorchidism can be divided into palpable testis and non-palpable testis (NPT), and palpable testis accounts for more than 80% of cryptorchidism cases (4).…”

Section: Introductionmentioning

confidence: 99%

Open controversies on the treatment of undescended testis: An update

et al. 2022

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Cryptorchidism is a common congenital malformation in pediatric urology. Although there have been many studies on the etiology of the disease, it has not been fully clarified, and while its diagnostic and treatment models have gradually approached standardization and systematization, some controversies regarding treatment remain. Additionally, although ultrasound is a non-invasive examination without ionizing radiation, its role in the evaluation of cryptorchidism remains controversial. The main basis for treating cryptorchidism is orchidopexy, and the main view on treatment age is that treatment should be performed between 6 and 12 months after birth, but no more than 18 months after birth. The view on hormone therapy is still controversial because most scholars believe that early surgery is the key to treatment. There are many surgical treatment methods for cryptorchidism, including traditional open surgery and laparoscopic surgery, which provide satisfactory results. In conclusion, the treatment of undescended testis (UDT) had been largely standardized, apart from the treatment of high intra-abdominal testis (IAT), which remains a matter of debate.

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Impalpable Testis: Evaluation of Diagnostic and Treatment Procedures and Our Treatment Protocol

Cited by 14 publications

References 22 publications

Three‑Dimensional Ultrasonography in Preoperative and Postoperative Volume Assessment of the Undescended Testicle

Three‑Dimensional Ultrasonography in Preoperative and Postoperative Volume Assessment of the Undescended Testicle

Ultrasound manifestations and clinical features of nonpalpable testis in children

Open controversies on the treatment of undescended testis: An update

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