Rabinowitz R, Hulbert W C
Department of Urology, University of Rochester School of Medicine, New York, USA.
J Urol. 1997 May;157(5):1892-4. doi: 10.1016/s0022-5347(01)64895-x.
We reviewed the records of 21 boys who had 23 previously documented descended testes that reascended and who underwent orchiopexy during a 2-year period.
We retrospectively reviewed a 2-year experience in 103 boys (115 undescended testes) who underwent orchiopexy in 1988 and 1989.
In our 2-year experience 21 of the 103 boys with undescended testes had multiple recorded confirmations of testicular descent in the past. Of the boys 40% had previously been examined in the office or with general anesthesia by a pediatric urologist or pediatric surgeon for another reason, and 40% had a nurse or physician parent. Surgery was performed at ages 5 to 14 years, an average of 2 years after the initial presentation with reascent. Human chorionic gonadotropin was unsuccessful in causing testicular descent. There was no correlation with a patent processus vaginalis and no association with adhesions. The testis was located in the superficial inguinal pouch in the majority of patients, and the gubernacular attachment was in an abnormal location in all and ectopic in half of the cases.
Our observations confirm that the etiology of this condition is a missed diagnosis at a younger age. The testis is undescended but almost completely descended. With somatic growth the distance between the terminal portion of the gubernaculum of the apparently descended testis and the scrotum increases, making the diagnosis more obvious. The potential for this condition makes it mandatory that intrascrotal testicular location be confirmed by periodic physical examination through puberty.
我们回顾了21名男孩的记录，这些男孩曾有23个先前记录为已降入阴囊的睾丸再次上升，并在两年内接受了睾丸固定术。
我们回顾性分析了1988年和1989年103名接受睾丸固定术的男孩（115个隐睾）的两年经验。
在我们的两年经验中，103名隐睾男孩中有21名过去有多次记录证实睾丸已降入阴囊。在这些男孩中，40%之前因其他原因在办公室或全身麻醉下接受过小儿泌尿科医生或小儿外科医生的检查，40%有护士或医生家长。手术在5至14岁进行，平均在最初出现睾丸再次上升后2年。人绒毛膜促性腺激素未能使睾丸降入阴囊。与鞘状突未闭无相关性，与粘连也无关联。大多数患者的睾丸位于腹股沟浅袋内，所有患者的睾丸引带附着位置均异常，半数病例为异位。
我们的观察结果证实，这种情况的病因是年轻时漏诊。睾丸本是未降入阴囊但几乎已完全降入。随着身体生长，看似已降入阴囊的睾丸引带末端与阴囊之间的距离增加，使诊断更加明显。鉴于这种情况的可能性，必须在青春期通过定期体格检查确认睾丸是否位于阴囊内。
