Beruflich Dokumente
Kultur Dokumente
Mean
Mean volume
No of volume of
Age Range of contralateral TAI (%)
Patients affected
testis (ml)
testis (ml)
0-2 5 0.44 0.63 27.10
2-4 10 0.56 1.09 35.40
4-6 8 0.57 1.20 44.20
6-10 6 0.66 1.17 52.80
>10 6 0.76 1.25 28.90
Mean
Mean volume
No of volume of
Age Range of contralateral TAI (%)
Patients affected
testis (ml)
testis (ml)
0-2 5 0.88 1.10 20.00
2-4 10 0.86 1.00 17.24
4-6 8 0.96 1.28 21.04
6-10 6 0.96 1.15 16.37
>10 6 0.81 0.85 22.40
Table 3. Comparison of testicular atrophy index (TAI) before
and after orchiopexy (N = 35 ))
TAI TAI
Age
No of before after Student t-
Range Difference
Patients surgery surgery test
(yrs)
(%) (%)
0-2 5 27.10 20.00 7.10 NS
2-4 10 35.40 17.24 18.16 p<0.001
4-6 8 44.20 21.04 23.16 p<0.001
6-10 6 52.80 16.37 36.43 p<0.001
>10 6 28.90 22.40 6.50 NS
DISCUSSION
• Important : accurate assessment of position and the volume
affected testis compare with normal contralateral
• Scrotal US : greatest accuracy to determine testicular
volume
• At this age fertility is undefined, so only impaired affected
testis growth compare to normal contralateral can be assess
as indication for surgery
• Still controversy indication for surgery in retactile/wandering
testicle
• Recommendation : watchful waiting, repeated US scrotal
every 12 months, if significant volume decrease → surgery
•
• According to Niedzielski, TAI ≥ 20% → surgery
• Sayfan et al → 20% - 25%
• This study TAI ranged from 27.1% - 52.8% at initial
diagnosis
• Testicular atrophy approx. 5 - 10% of testis in long-term
outcome after orchiopexy, but impossible to determine
it’s caused by blood vessel injury during op. or
preexistent primary damage (testicular dyplasia)
• In this study : repair undescent testis : growth (+)
• Postoperative TAI decreased from 18.16% to 36.43%
depending on patient’s age
• The smallest difference TAI (no growth of affected testis)
found in youngest and oldest
• This indicates that the best result of surgical treatment
should be expected in boys aged 2 - 10 years
CONCLUSIONS