Trends in treatment outcomes for retractile testis in Japanese boys: A single-center study.
orchiopexy
pediatrics
retractile testis
spontaneous resolution
undescended testis
Journal
International journal of urology : official journal of the Japanese Urological Association
ISSN: 1442-2042
Titre abrégé: Int J Urol
Pays: Australia
ID NLM: 9440237
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
13
07
2020
accepted:
11
11
2020
pubmed:
11
12
2020
medline:
28
4
2021
entrez:
10
12
2020
Statut:
ppublish
Résumé
To investigate the natural course of retractile testis by analyzing its prevalence and outcomes. This retrospective study included 215 boys in whom retractile testis was diagnosed after reviewing the medical history and physical examinations of the patients. Orchiopexy was performed once the testis became undescended. We investigated the trends in the prevalence and outcomes of retractile testis and compared clinical factors between cases that resolved spontaneously and those that required orchiopexy. Of 215 boys, 145 were finally evaluated. The mean age at diagnosis was 2 years, and 100 boys were aged ≤2 years when they were hospitalized. Seventy-three boys were referred to our institution through health examinations as babies. The condition improved spontaneously in 89 boys, while 43 boys underwent orchiopexy, and 13 boys remained under follow-up. The follow-up period between diagnosis and resolution was significantly longer in the spontaneous resolution group than in the surgical intervention group (P = 0.011). Bilateral retractile testis improved spontaneously in significantly more boys compared to unilateral retractile testis (P = 0.0010). Spontaneous resolution was observed in boys of all ages, but those diagnosed at ≤3 years of age had a significantly higher rate of spontaneous resolution compared to those who were diagnosed at >3 years of age (P = 0.0019). Our findings suggest that retractile testis cannot be affirmed as a variant of normal testis. Performing examinations at a young age is critical for preventing misdiagnosis, screening failures, and unnecessary surgery.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
327-332Informations de copyright
© 2020 The Japanese Urological Association.
Références
Caesar RE, Kaplan GW. The incidence of the cremasteric reflex in normal boys. J. Urol. 1994; 152(2 Pt 2): 779-80.
Barthold JS, González R. The epidemiology of congenital cryptorchidism, testicular ascent and orchiopexy. J. Urol. 2003; 170(6 Pt 1): 2396-401.
Inan M, Aydiner CY, Tokuc B et al. Prevalence of cryptorchidism, retractile testis and orchiopexy in school children. Urol. Int. 2008; 80: 166-71.
Engeler DS, Hösli PO, John H et al. Early orchiopexy: prepubertal intratubular germ cell neoplasia and fertility outcome. Urology 2000; 56: 144-8.
Park KH, Lee JH, Han JJ, Lee SD, Song SY. Histological evidences suggest recommending orchiopexy within the first year of life for children with unilateral inguinal cryptorchid testis. Int. J. Urol. 2007; 14: 616-21.
Agarwal PK, Diaz M, Elder JS. Retractile testis-is it really a normal variant? J. Urol. 2006; 175: 1496-9.
Bae JJ, Kim BS, Chung SK. Long-term outcomes of retractile testis. Korean J. Urol. 2012; 53: 649-53.
Jiang DD, Acevedo AM, Bayne A, Austin JC, Seideman CA. Factors associated with delay in undescended testis referral. J. Pediatr Urol. 2019; 15: 380.e1-380.e6.
Sharma D, Sohn JK, Zillioux JM, Herndon CDA, Corbett ST, Kern NG. Identifying and addressing training deficiencies in the examination of cryptorchidism-a quality improvement study. J. Pediatr. Urol. 2020; 16: 61.e1-61.e8.
Bingöl-Koloğlu M, Tanyel FC, Anlar B, Büyükpamukçu N. Cremasteric reflex and retraction of a testis. J. Pediatr. Surg. 2001; 36: 863-7.
Kubota M, Nakaya K, Arai Y, Ohyama T, Yokota N, Nagai Y. The area and attachment abnormalities of the gubernaculum in patients with undescended testes in comparison with those with retractile testes. Pediatr. Surg. Int. 2014; 30: 1149-54.