Sijstermans K, Hack W W M, van der Voort-Doedens L M, Meijer R W
Department of Paediatrics, Medical Center Alkmaar, Alkmaar, The Netherlands.
Urol Int. 2009;83(4):438-45. doi: 10.1159/000251185. Epub 2009 Dec 8.
We aimed to investigate long-term testicular growth and the position of congenital undescended testes (UDT) after orchidopexy (ORP), taking into account that nowadays UDT has to be divided into congenital and acquired forms.
This study included 181 patients with 199 congenital UDT (91 right-sided, 72 left-sided, 18 bilateral), in whom ORP had been carried out (1986-2006). Long-term testicular position and growth were assessed by clinical examination and ultrasound (US).
In 44.5% (65/146), testicular volume of the unilaterally operated congenital UDT was >50th percentile for age. In 55.5% (81/146), the volume was < or =50th percentile, and 13.0% (19/146) of these were < or =10th percentile. In 7 of 34 (20.6%) bilaterally operated congenital UDT, testicular volume was < or =10th percentile. The difference in size between the operated congenital UDT and the contralateral non-operated testes measured by both Prader orchidometer (p = 0.00) and US (p = 0.00) was statistically significant. There was a strong correlation between the orchidometer and US. On examination, 87.9% (175/199) of the operated testes were located in the lower scrotum.
The findings of this study suggest that ORP for congenital UDT is safe, and even when performed later than current recommendations did not result in severe growth retardation.
考虑到如今先天性隐睾必须分为先天性和后天性两种形式,我们旨在研究睾丸固定术后先天性隐睾(UDT)的长期生长情况及位置。
本研究纳入了1986年至2006年间接受睾丸固定术的181例患者,共199个先天性UDT(右侧91个,左侧72个,双侧18个)。通过临床检查和超声(US)评估睾丸的长期位置和生长情况。
在单侧手术的先天性UDT中,44.5%(65/146)的睾丸体积高于同年龄组第50百分位数。55.5%(81/146)的睾丸体积小于或等于第50百分位数,其中13.0%(19/146)小于或等于第10百分位数。在34例双侧手术的先天性UDT中,7例(20.6%)的睾丸体积小于或等于第10百分位数。通过普拉德睾丸测量器(p = 0.00)和超声(p = 0.00)测量,手术侧先天性UDT与对侧未手术睾丸的大小差异具有统计学意义。睾丸测量器与超声之间存在很强的相关性。检查发现,87.9%(175/199)的手术睾丸位于阴囊下部。
本研究结果表明,先天性UDT的睾丸固定术是安全的,即使手术时间晚于当前建议,也不会导致严重的生长发育迟缓。