Diagnostic value of high resolution ultrasound in localisation of the undescended testis in children

Abstract

Background: The use of ultrasonography in the pre-operative localisation of undescended testes has become controversial due to fears about its  accuracy. This study was designed to ascertain the accuracy, sensitivity, specifi city, positive predictive value (PPV) and negative predictive value (NPV) of ultrasonography in the localisation of the undescended testes in children.

Patients and Methods: A prospective evaluation of all boys undergoing operation for undescended testes at the Lagos University Teaching  Hospital, Idi-Araba, Lagos, over a 12 month period was performed. The
pre-operative clinical and ultrasound fi ndings were compared with the fi ndings on surgical exploration.

Results: Forty boys with 52 undescended testes were studied. The mean age of the boys at the time of surgery was 4.0 ± 0 years (range 1-11  years). Fortysix (88.5%) testes were localised pre-operatively by ultrasound- 20 of 22 (90.9%) palpable testes and 26 of 30 (86.7%) non-palpable testes. Intra-operatively, 49 (94.2%) of the undescended testes were found while 3 (5.8%) were absent/vanishing testes. Ultrasound
evaluation had an accuracy of 86.5%, sensitivity of 89.8%, and specifi city of 33.3%, PPV of 95.7% and a NPV of 16.7%.

Conclusion: Ultrasound assessment is beneficial in pre-operative  evaluation of children with undescended testes.

Key words: Children, pre-operative assessment, ultrasonography,  undescended testes