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Management of Undescended Testis in Children in Aba Nigeria

Received: 21 May 2019     Accepted: 3 July 2019     Published: 10 August 2019
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Abstract

Introduction: The anomalies of descent of the testes are common problem in newborn male infants. An absence of the testis in the scrotal sac is defined as cryptorchidism. Ectopic testis occurs when it migrates from its usual path of descent to lie in an unusual location. it affects 2–5% of the infants at birth and 1–2% of them at 3 months of age, the incidence is even higher in preterm infants, reported at 30%. Methodology: This was a prospective cross-sectional study of all male children above 3 months of age with undescended testes who were managed by the Paediatric Surgery Unit of the Abia State University Teaching Hospital Aba from January 2016 to December 2018. Results: Thirty children aged ≤ 15 years with 40 undescended testes managed in 3 years The age at surgery was fourteen months to 15 years (median six years); five (17%) had correction before two years, 10 (33%) before five years and 15 (50%) at age ≥ 5 years. Thirty (75%) testes were palpable and ten (25%) non-palpable. Evaluation was mainly clinical. Ultrasonography was performed for six non-palpable testes but was not helpful. Laparoscopy was not used in any patient. The condition was unilateral in twenty (67%) and bilateral in ten (33%). Forty per cent of the testes were in the inguinal canal, 25% at the external ring, and 15% each at the internal ring and abdomen respectively. Six (20%) testes were macroscopically atrophic (canalicular three, abdominal two, internal ring one). Orchidopexy was performed for 34 undescended testes and orchidectomy forsix testes. Groin and scrotal haematoma developed following one orchidopexy. Following orchidopexy, two (6%) testes retracted necessitating repeat surgery. Conclusion: There is a need to educate parents, traditional birth attendants, midwives and doctors in our sub-region to ensure earlier presentation and treatment.

Published in International Journal of Clinical Urology (Volume 3, Issue 1)
DOI 10.11648/j.ijcu.20190301.14
Page(s) 15-17
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Undescended Testis, Children, Management

References
[1] Alexander Cho, Johanna Thomas, Ranil Parera Abraham Cherian, Undescended testis. BMJ 2019; 364: l926.
[2] Kurz S, Tasian G Current management of undescended testes. Curr Treat option Peds. 2016, 2, 43–51.
[3] Niedzielski J Z, Oszukowska E, Słowikowska-Hilczer J. Undescended testis – current trends and guidelines: a review of the literature. Arch Med Sci 2016; 12, 3: 667–677.
[4] Radmayr C, Dogan NS, Hoebeke P. Management of undescended testis. Journal of paediatric urology 2016; 12, 335-343.
[5] Hirantha D. Peiris. Bhanumathi Lakshminarayanan, Osarumwense D. Management of undescended testes: a comparative study in England and Africa. Annals of Pediatric Surgery 2014, Vol 10 No 4.
[6] Heyns CF, Human HJ, Werely CJ, De Klerk DP. The glycosaminoglycans of the gubernaculum during testicular descent in the foetus. J Urol 1990; 143 (3): 612–61.
[7] Docimo SG, Silver RI, Cromie W. The undescended testicle: diagnosis and management. Am Fam Physician 2000; 62 (9): 2037–2044.
[8] Ayhan Abacı, Gönül Çatlı, Ahmet Anık, Ece Böber. Epidemiology, Classification and Management of Undescended Testes: Does Medication Have Value in its Treatment. J Clin Res Pediatr En docrinol 2013; 5 (2): 65-7.
[9] OKEKE AA, OSEGBE DN. Prevalence and characteristics of cryptorchidism in a Nigerian district. BJU International (2001), 88, 941 ±945.
[10] Ameh EA, Mbibu HN. Management of undescended testes in children in Zaria, Nigeria. East Afr Med J 2000; 77: 485–487.
[11] Osifo DO, Osaigbovo EO. The prevalence, postnatal descent, and complications of undescended testes among children who underwent neonatal circumcision in Benin City, Nigeria. Journal of Paediatric Surgery 2009: 44 (4): 791-796.
[12] Adesanya OA, Ademuyiwa AO, Elebute OA, Ojewola R. The Undescended Testes in Children: a Prospective Epidemiological Study. East Cent. Afr. J. s urg 2013 Volume 18.
[13] Osuigwe AN, Nwose PC, Ndukwu C, Dilibe UC. Undescended Testis at Nnamdi Azikiwe Teaching Hospital, Nnewi, Nigeria - A Ten Year Audit. African Journal of Urology 2005; 11 (2): 101-104.
[14] Pankaj Nepal, Devendra Kumar, Vijayanadh Ojili Abnormal descent of the testis and its complications: A multimodality imaging review | Nepal | South African Journal of Radiology. Sajr2018 22: 1.
[15] Cortes D., Thorup J. M., Lenz K., Beck B. L. and Nielsen O. H. Laparoscopy in 100 consecutive patients with 128 impalpable testes. Brit. J. Urol. 1995; 75: 281-287.
[16] Perovic S. and Janic N. Laparoscopy in the diagnosis of nonpalpable testes. Brit. J. Urol. 1994; 73: 310-313.
[17] Kiran Kumar, Vinay HG, Ramesh Reddy. Clinical Study and Role of Diagnostic Laparoscopy in the Management of Undescended Testis: Our Experience. J Surgery Volume 14 2-2.
[18] Nassar A. H. M. Laparoscopic - assisted orchidopexy. a new approach to the impalpable testis. J. Paediat. Surg. 1995; 30: 39-4.
[19] Kumar D., Bremner D. N. and Brown P. W. Fertility after orchidopexy for cryptorchidism: a new approach to assessment. Brit. J. Urol. 1993; 73: 516-520.
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    Samuel Chidi Ekpemo, Chukwuemeka Onyearugha. (2019). Management of Undescended Testis in Children in Aba Nigeria. International Journal of Clinical Urology, 3(1), 15-17. https://doi.org/10.11648/j.ijcu.20190301.14

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    Samuel Chidi Ekpemo; Chukwuemeka Onyearugha. Management of Undescended Testis in Children in Aba Nigeria. Int. J. Clin. Urol. 2019, 3(1), 15-17. doi: 10.11648/j.ijcu.20190301.14

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    AMA Style

    Samuel Chidi Ekpemo, Chukwuemeka Onyearugha. Management of Undescended Testis in Children in Aba Nigeria. Int J Clin Urol. 2019;3(1):15-17. doi: 10.11648/j.ijcu.20190301.14

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  • @article{10.11648/j.ijcu.20190301.14,
      author = {Samuel Chidi Ekpemo and Chukwuemeka Onyearugha},
      title = {Management of Undescended Testis in Children in Aba Nigeria},
      journal = {International Journal of Clinical Urology},
      volume = {3},
      number = {1},
      pages = {15-17},
      doi = {10.11648/j.ijcu.20190301.14},
      url = {https://doi.org/10.11648/j.ijcu.20190301.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20190301.14},
      abstract = {Introduction: The anomalies of descent of the testes are common problem in newborn male infants. An absence of the testis in the scrotal sac is defined as cryptorchidism. Ectopic testis occurs when it migrates from its usual path of descent to lie in an unusual location. it affects 2–5% of the infants at birth and 1–2% of them at 3 months of age, the incidence is even higher in preterm infants, reported at 30%. Methodology: This was a prospective cross-sectional study of all male children above 3 months of age with undescended testes who were managed by the Paediatric Surgery Unit of the Abia State University Teaching Hospital Aba from January 2016 to December 2018. Results: Thirty children aged ≤ 15 years with 40 undescended testes managed in 3 years The age at surgery was fourteen months to 15 years (median six years); five (17%) had correction before two years, 10 (33%) before five years and 15 (50%) at age ≥ 5 years. Thirty (75%) testes were palpable and ten (25%) non-palpable. Evaluation was mainly clinical. Ultrasonography was performed for six non-palpable testes but was not helpful. Laparoscopy was not used in any patient. The condition was unilateral in twenty (67%) and bilateral in ten (33%). Forty per cent of the testes were in the inguinal canal, 25% at the external ring, and 15% each at the internal ring and abdomen respectively. Six (20%) testes were macroscopically atrophic (canalicular three, abdominal two, internal ring one). Orchidopexy was performed for 34 undescended testes and orchidectomy forsix testes. Groin and scrotal haematoma developed following one orchidopexy. Following orchidopexy, two (6%) testes retracted necessitating repeat surgery. Conclusion: There is a need to educate parents, traditional birth attendants, midwives and doctors in our sub-region to ensure earlier presentation and treatment.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Management of Undescended Testis in Children in Aba Nigeria
    AU  - Samuel Chidi Ekpemo
    AU  - Chukwuemeka Onyearugha
    Y1  - 2019/08/10
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ijcu.20190301.14
    DO  - 10.11648/j.ijcu.20190301.14
    T2  - International Journal of Clinical Urology
    JF  - International Journal of Clinical Urology
    JO  - International Journal of Clinical Urology
    SP  - 15
    EP  - 17
    PB  - Science Publishing Group
    SN  - 2640-1355
    UR  - https://doi.org/10.11648/j.ijcu.20190301.14
    AB  - Introduction: The anomalies of descent of the testes are common problem in newborn male infants. An absence of the testis in the scrotal sac is defined as cryptorchidism. Ectopic testis occurs when it migrates from its usual path of descent to lie in an unusual location. it affects 2–5% of the infants at birth and 1–2% of them at 3 months of age, the incidence is even higher in preterm infants, reported at 30%. Methodology: This was a prospective cross-sectional study of all male children above 3 months of age with undescended testes who were managed by the Paediatric Surgery Unit of the Abia State University Teaching Hospital Aba from January 2016 to December 2018. Results: Thirty children aged ≤ 15 years with 40 undescended testes managed in 3 years The age at surgery was fourteen months to 15 years (median six years); five (17%) had correction before two years, 10 (33%) before five years and 15 (50%) at age ≥ 5 years. Thirty (75%) testes were palpable and ten (25%) non-palpable. Evaluation was mainly clinical. Ultrasonography was performed for six non-palpable testes but was not helpful. Laparoscopy was not used in any patient. The condition was unilateral in twenty (67%) and bilateral in ten (33%). Forty per cent of the testes were in the inguinal canal, 25% at the external ring, and 15% each at the internal ring and abdomen respectively. Six (20%) testes were macroscopically atrophic (canalicular three, abdominal two, internal ring one). Orchidopexy was performed for 34 undescended testes and orchidectomy forsix testes. Groin and scrotal haematoma developed following one orchidopexy. Following orchidopexy, two (6%) testes retracted necessitating repeat surgery. Conclusion: There is a need to educate parents, traditional birth attendants, midwives and doctors in our sub-region to ensure earlier presentation and treatment.
    VL  - 3
    IS  - 1
    ER  - 

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Author Information
  • Department of Surgery, Abia State University, Aba, Nigeria

  • Department of Paediatrics, Abia State University, Aba, Nigeria

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