Pappis C H, Argianas S A, Bousgas D, Athanasiades E
Department of Paediatric Surgery, Pendeli Children's Hospital, Athens, Greece.
Pediatr Radiol. 1988;18(1):51-3. doi: 10.1007/BF02395760.
In a period of 6 years 144 asymptomatic boys with cryptorchidism, of mean age 7 +/- SD 3.5 years, underwent orchiopexy. None of these boys referred to a history of a known urological anomaly, urinary tract infection, haematuria, palpable mass in the renal region, bladder extrophy, epispadias, hypospadias or anorectal malformation. On the third day after orchiopexy and intravenous pyelography was done in every boy following testicular protection against irradiation. Ultrasonic investigation was not available at that time. There were minor urological abnormalities in 36 (25%) boys and major ones in 8 (5.5%) boys. A major anomaly is defined as one resulting in significant loss of renal substance (one case of single kidney and three cases of unilateral renal hypoplasia), or requiring surgical correction for conservation of the renal substance (one case of ureterocele, two cases of pelviureteric stenosis and one case of vesicoureteric stenosis with ipsilateral hydronephrosis). The unsuspected major urological abnormalities are usually ipsilateral to the more undescended testis. They may be associated with a hernia and are more frequent in bilateral cryptorchidism. In conclusion we encourage the routine use of IVP, or ultrasonic investigation or dynamic renal scanning (99mTc-DTPA), if it is possible, in all patients undergoing orchiopexy for the detection of an unsuspected major renal anomaly.
在6年期间，144名平均年龄为7±标准差3.5岁的无症状隐睾男孩接受了睾丸固定术。这些男孩均无已知的泌尿系统异常、尿路感染、血尿、肾区可触及肿块、膀胱外翻、尿道上裂、尿道下裂或肛门直肠畸形病史。在睾丸固定术后第三天，对每个男孩在采取睾丸防辐射措施后进行了静脉肾盂造影。当时无法进行超声检查。36名（25%）男孩存在轻度泌尿系统异常，8名（5.5%）男孩存在重度异常。重度异常定义为导致肾实质显著丧失的情况（1例单肾和3例单侧肾发育不全），或为保护肾实质需要手术矫正的情况（1例输尿管囊肿、2例肾盂输尿管狭窄和1例伴有同侧肾积水的膀胱输尿管狭窄）。未被怀疑的重度泌尿系统异常通常与下降程度更差的睾丸同侧。它们可能与疝气有关，在双侧隐睾中更常见。总之，我们鼓励在所有接受睾丸固定术的患者中常规使用静脉肾盂造影，或者如果可能的话，使用超声检查或动态肾扫描（99m锝 - 二巯基丁二酸），以检测未被怀疑的重度肾脏异常。
