Relationship between undescended testis position and prevalence of testicular appendices, epididymal anomalies and patency of processus vaginalis
Favorito, L1; Gallo, C1; Costa, W1; Sampaio, F1
1: State University of Rio de Janeiro, Brazil
Objective: Assess the incidence of testicular appendices (TAs), epididymal anomalies (EAs) and processus vaginalis (PV) patency in patients with undescended testes (UT) according to testicular position, and compare these findings with those of human fetuses with testis situated in scrotum.
Methods: We studied 85 patients (108 testes) with cryptorchidism and we compared with 15 fetuses (30 testes) that had scrotal testes. Testicular position was classified as: a) Abdominal (proximal to the internal ring); b) Inguinal (between the internal and external rings); and c) Supra-scrotal (below the external ring). We analyzed the relationships between testis and epididymis (epididymal atresia and disjunction were considered EAs), patency of PV and the presence of TAs. We used qui-square test for statistical analysis (p<0.05).
Results: The mean age of fetuses were 31.66 weeks postconception and the patients mean age was 5.16 years. In the fetuses we observed patency of the PV in 7 cases (23.34%), presence of TAs in 27 (90%) and EAs in only 1 testis (3.44%). In 108 UT, 72 (66.66%) had PV patent, 67 (62.3%) had TAs and 39 (36.12%) had EAs. Of the 108 UT, 14 testes were abdominal (12.96%; 14 had PV patency, 9 TAs and 7 EAs); 81 testes were inguinal (75%; 52 had PV patency, 45 TAs and 31 EAs) and 13 testes were supra-scrotal (12.03%; 6 had PV patency, 13 TAs and 1 EAs). Patency of PV had a higher prevalence in UT than in normal fetuses (p<0.0001) and in abdominal UT when compared to inguinal (p=0.0072) and supra-scrotal UT (p=0.0014). The patency of PV was more frequent associated to EAs (p=0.00364). The EAs had a higher prevalence in UT when compared with fetuses (p=0.0005). We do not observe differences in EAs between abdominal and inguinal UT (p=0.4082) and between the inguinal and supra-scrotal UT (p=0.0308); nevertheless, we observed a higher prevalence of anomalies in abdominal (0.0002) and inguinal UT (p=0.0003) when compared with fetal testis and abdominal and supra-scrotal UT (p=0.0161). We do not observe differences in the incidence of TAs between UT and fetuses (p=0.1367).
Conclusions: Undescended testis has a higher risk of anatomical paratesticular anomalies and the testes situated in abdomen and inguinal canal has a higher risk to present patency of PV and EAs.
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