The role of ultrasound in the management of undescended testes before and after orchidopexy – an update

Jędrzejewski, Grzegorz; Wieczorek, Paweł; Osemlak, Paweł; Nachulewicz, Paweł

doi:10.1097/md.0000000000005731

Cited by 15 publications

(17 citation statements)

References 15 publications

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“…Testicular location, morphology, volume, boundary, internal echo, blood distribution, and processus vaginalis in the MG and RG groups as detected with 2DUS and 3DUS were observed and compared. Classification of gray-scale US characteristics was based on previous studies [ 17 ]. Doppler US assessment of superficial tissue perfusion with a semi-quantitative method has been proven feasible by Adler et al [ 23 ].…”

Section: Methodsmentioning

confidence: 99%

“…There is a strong correlation between the position of an undescended testis and persistence of the processus vaginalis [ 15 ]. US has significant value for evaluating the inguinal canal and cryptorchidism [ 16 , 17 ], as well as motion in the spermatic cord [ 18 ]. Nevertheless, the relationship between sonographic mobility in cryptorchidism and persistence of the processus vaginalis and their associations with prognosis after orchiopexy remain unclear.…”

Section: Introductionmentioning

confidence: 99%

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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: Methodsmentioning

confidence: 99%

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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“…Some practitioners perform ultrasonography to evaluate undescended testis before and after orchiopexy. 38) Practically, ultrasonography is used because of uncertainty of the diagnosis. According to the nationwide questionnaire detailing the prac tice patterns of undescended testis in Korea (distributed to 167 Korean urologists), most urologists performed diagnostic imaging studies for unilateral impalpable undescended testis.…”

Section: Imaging Studiesmentioning

confidence: 99%

“…Imaging study is not recommended [30][31][32][33] Reasons 1. Imaging study cannot add diagnostic accuracy Practitioners perform imaging study 38,39) Reasons 1. Imaging study may add objective assessment of preoperative testicular position and size.…”

Section: Surgical Therapymentioning

confidence: 99%

Comparison of diagnostic and treatment guidelines for undescended testis

Shin

Jeon

2020

Clin Exp Pediatr

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Cryptorchidism or undescended testis is the single most com mon genitourinary disease in male neonates. In most cases, the testes will descend spontaneously by 3 months of age. If the testes do not descend by 6 months of age, the probability of spontaneous descent thereafter is low. About 1%-2% of boys older than 6 months have undescended testes after their early postnatal descent. In some cases, a testis vanishes in the abdomen or reascends after birth which was present in the scrotum at birth. An inguinal undescended testis is sometimes mistaken for an inguinal hernia. A surgical specialist referral is recommended if descent does not occur by 6 months, unde scended testis is newly diagnosed after 6 months of age, or testicular torsion is suspected. International guidelines do not recommend ultrasonography or other diagnostic imaging because they cannot add diagnostic accuracy or change treat ment. Routine hormonal therapy is not recommended for undescended testis due to a lack of evidence. Orchiopexy is recommended between 6 and 18 months at the latest to pro tect the fertility potential and decrease the risk of malignant changes. Patients with unilateral undescended testis have an infertility rate of up to 10%. This rate is even higher in patients with bilateral undescended testes, with intraabdominal un de scended testis, or who underwent delayed orchiopexy. Pa tients with undescended testis have a threefold increased risk of testicular cancer later in life compared to the general pop ulation. Selfexamination after puberty is recommended to facilitate early cancer detection. A timely referral to a surgical specialist and timely surgical correction are the most important factors for decreasing infertility and testicular cancer rates.

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“…An assessment of testicular volume in young children, particularly in cryptorchidism and migratory testis, is a sensitive parameter of growth or growth inhibition. In the case of testicular size or volume asymmetry, an accurate morphometry allows to determine testicular atrophy index (TAI), which describes the difference in the testicular size expressed as percentage, or testicular volume ratio (TVR), which describes the volume ratio of the inappropriately located testis to that of testis located in the scrotum ( 10 , 11 ) . The repeatability of the obtained dimensions is achieved by performing measurements in maximum sections, with the axial section always showing the mediastinum testis.…”

Section: Techniquementioning

confidence: 99%

Standardy badania ultrasonograficznego moszny

Tyloch

Wieczorek

2016

J Ultrason

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The paper presents a description of essential equipment requirements for scrotal ultrasonography, including current ultrasound techniques, as well as a review of the most common scrotal pathologies. Patient preparation for the examination as well as ultrasound methodology for the assessment of scrotal and inguinal canal structures are discussed. The standard for scrotal ultrasound examination includes a precise B-mode evaluation, including testicular volumetric assessment performed using automatic measurement options based on the formula of a rotating ellipsoid or three measurements perpendicular to one another. Also, criteria for morphological assessment of abnormalities within testicular or epididymal parenchyma, including a precise evaluation of lesion size, delineation, shape and vascular pattern obtained with Doppler US, have been proposed. Standard assessment further includes epididymal evaluation, including epididymal size in the case of enlargement. The paper additionally discusses the method of ultrasonographic examination and describes the most common pathologies occurring within scrotal structures, including a quantitative analysis of hydrocele and other abnormal fluid reservoirs. We have also presented criteria for the assessment of varicocele as well as color and spectral Doppler flows in scrotal pathologies. Furthermore, we have proposed key components of scrotal ultrasound documentation, so that the contained data could be used to establish appropriate diagnosis, allowing for both adequate clinical management and the reproducibility of subsequent US evaluations performed by either the same or a different examiner. The most common causes of diagnostic errors have also been discussed.

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The role of ultrasound in the management of undescended testes before and after orchidopexy – an update

Cited by 15 publications

References 15 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

Comparison of diagnostic and treatment guidelines for undescended testis

Standardy badania ultrasonograficznego moszny

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