Davey RB
Women's & Children's Hospital, 72 King William Road, North Adelaide SA 5006, Australia
Pediatr Surg Int. 1997 Mar 21;12(2/3):165-7.
A review of 468 orchidopexies was undertaken to ascertain the importance of a complete hernial sac extending to or beyond the testis. A hernial sac was present in 84% (171/202) of testes in patients under 5 years of age, in contrast to 23% (61/266) in patients over 5 years. It seems reasonable to presume that the failure of the hernial sac to close is secondary to failure of normal descent, which in turn is due to antenatal factors and may be classified as "early maldescent". In the older age group maldescent is due to failure of the last stage of descent, which should occur in the 5- to 10-year prepubertal age period ("late maldescent", or the "ascending" testis). The cause of late maldescent is not due to a short processus, as this increases in length with age (approximately 0.5 cm/year), unless the persistence of the processus itself is the cause. A classification of early or late maldescent is suggested.
对468例睾丸固定术进行了回顾，以确定完整疝囊延伸至睾丸或超过睾丸的重要性。5岁以下患者中，84%（171/202）的睾丸存在疝囊，而5岁以上患者中这一比例为23%（61/266）。似乎有理由推测，疝囊未能闭合继发于正常下降失败，而正常下降失败又归因于产前因素，可归类为“早期下降异常”。在年龄较大的组中，下降异常是由于下降最后阶段的失败，该阶段应发生在青春期前5至10岁期间（“晚期下降异常”，或“上升”睾丸）。晚期下降异常的原因并非是鞘突短，因为鞘突长度会随年龄增长（约每年0.5厘米），除非鞘突本身持续存在是原因。建议对早期或晚期下降异常进行分类。
