The Risk of Retractile Testes Becoming Ascending Testes

摘要

The estimated incidence of orchiopexies by 14 to 17 years of age is 2% to 3%. This is inconsistent with the reported incidence of undescended testes (only 0.8%) by the end of the first year of life. A bimodal distribution for age at orchiopexy has been reported by Fenton and colleagues1 and Hack and colleagues,2 showing peaks at 2 years and 10 to 11 years, with an overall mean age of 6.6 years. Therefore, the acquired undescended testis or ascending testis in boys with a previously documented scrotal testis might explain why older boys undergo orchiopexy. This phenomenon might be due to a hyperactive cremasteric reflex, incomplete absorption of the patent processus vaginalis in boys with retractile testis, fibrous adhesions to the spermatic cord after inguinal surgery, and misdiagnosis due to an inaccurate physical examination. Prior inguinal surgery and a hyperactive cremasteric reflex are not frequently observed; thus misdiagnosis has previously been the explanation for the ascending testis.