Stec Andrew A, Thomas John C, DeMarco Romano T, Pope John C, Brock John W, Adams Mark C
Division of Pediatric Urology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-9820, USA.
J Urol. 2007 Oct;178(4 Pt 2):1722-4; discussion 1724-5. doi: 10.1016/j.juro.2007.05.091. Epub 2007 Aug 17.
The incidence of testicular ascent of a previously descended but retractile testis is reported to be between 2% and 45%. It has been our bias that only a small percent of retractile testes ascend and ultimately require orchiopexy.
We performed a retrospective review of all retractile testes diagnosed by any of 4 pediatric urologists at our institution from 1996 to 2005. A retractile testis was defined as one that could be brought to at least the mid scrotum without tension despite a history of maldescent or a retractile nature. Patients were excluded if followup was less than 6 months or they had a history of ipsilateral inguinal surgery. A followup telephone survey was done in patients not reexamined at resolution.
A total of 172 patients met our inclusion criteria and were followed to resolution. A total of 274 retractile testes were initially identified, including 26% unilateral and 74% bilateral testes. A total of 19 testes ascended and ultimately required orchiopexy within a followup of 6 to 101 months. A patent processus vaginalis was identified in 13 cases (68%). Another 235 patients initially seen with a diagnosis of retractile testis who had no followup examination at our institution were contacted via telephone. This set of boys initially had a total of 392 involved testes, of which 2 underwent orchiopexy elsewhere before resolution. The incidence of secondary ascent was 3.2% in the combined set of patients.
Retractile testes can ascend and, therefore, they require followup until resolution. In our experience most retractile testes do not require surgery.
据报道，既往已下降但可回缩睾丸的睾丸上升发生率在2%至45%之间。我们一直认为，只有一小部分可回缩睾丸会上升并最终需要进行睾丸固定术。
我们对1996年至2005年期间在本机构由4名小儿泌尿科医生中的任何一位诊断出的所有可回缩睾丸进行了回顾性研究。可回缩睾丸定义为尽管有下降异常或可回缩的病史，但在无张力情况下至少可降至阴囊中部的睾丸。如果随访时间少于6个月或有同侧腹股沟手术史，则将患者排除。对未在复查时重新检查的患者进行了随访电话调查。
共有172例患者符合我们的纳入标准并随访至病情缓解。最初共识别出274个可回缩睾丸，其中26%为单侧睾丸，74%为双侧睾丸。在6至101个月的随访期内，共有19个睾丸上升并最终需要进行睾丸固定术。13例（68%）发现有鞘状突未闭。另外，通过电话联系了另外235例最初诊断为可回缩睾丸但未在本机构进行随访检查的患者。这组男孩最初共有392个受累睾丸，其中2个在病情缓解前在其他地方接受了睾丸固定术。在合并的患者组中，继发性上升的发生率为3.2%。
可回缩睾丸会上升，因此，它们需要随访直至病情缓解。根据我们的经验，大多数可回缩睾丸不需要手术。
