Undescended testes: perspective from a developing country

Abstract

Objective: This report details the findings at operation and challenges of managing undescended testes (UDT) in southeastern Nigeria.

Methods: Prospective evaluation of children managed for undescended testis from January 2013 to November 2015 in Enugu, southeastern Nigeria.

Results: There were 54 patients with total of 69 undescended testes (39 unilateral, 15 bilateral) involving the left side in 39 and the right side in 30 cases. The median age at operation was 5 years (Range 1 – 15 years). Three (4.35%) testes were localized at suprascrotal position, 12 (17.4%) were emergent, 33 (47.8%) canalicular, 18 (26.1%) abdominal, and 3 (4.35%) were vanishing. The volume of the localized testes ranged from 0.7mls to 8.5mls (mean 2.0mls). Epididymal anomaly was noticed in 31 (47%) with the commonest anomaly being head non-fusion. Age at operation was an independent predictor of testicular volume (OR 4.91). Single stage scrotal repositioning was achieved in 28/37 (75.7%) of cases and was not dependent on age (p=0.58). Testes localized distal to the internal ring are more likely to be mobilized to the scrotum at initial orchidopexy than those located in intraabdominal position (44/48 vs 4/18; p<0.05).

Conclusion: Most of the patients with UDT in our setting had surgery at a later age than recommended. The age at operation correlated with the size of the testis but did not affect the location of the testis, and the success with one-stage scrotal repositioning. Long-term follow up and evaluation is imperative.

Keywords: Undescended testes; anomalies; morphology; Challenges; Developing Country