Abstract

Objective: Undescended testis has been reported with a frequency of 0.8-2% in the first year of life in male newborns, with approximately 20-35% of cases being nonpalpable testes. In approximately 40-60% of nonpalpable testes, residual tissue or nubbin structure is noted on exploration. In patients whose testicular tissue is not palpable, there may be nubbin tissue with testis or testicular remnants in the abdomen, inguinal canal, or in an ectopic position. Testicular agenesis or atrophy is found in approximately 8-10% of inguinal examinations for undescended testis. With this survey study, we aimed to evaluate different approaches for cases of nonpalpable testis for which there is no common consensus in management. In this way, the preferences of both pediatric surgeons and pediatric urologists can be better identified and outcomes better predicted.

Materials and Methods: Questionnaires prepared via Google Forms were sent by e-mail to 459 pediatric surgeons and pediatric urology specialists via e-mail.

Results: 90 surgeons participated in the study. In 74% of cases, a preoperative USG examination was preferred, and in 44% of cases, surgery was started with laparoscopy. For high undescended testes, descent as far as possible without extra surgery was preferred by 29%, whereas the two-stage Stephan-Fowler procedure (SF) was preferred by 37%. Removal of the nubbin structure was preferred by 87%. In patients with a single testis located in the scrotum, no further surgery was preferred in 72% of cases.

Conclusions: Standardized protocols for nonpalpable testes have not been finalized, and it is believed that consensus will require large-scale, randomized, controlled national trials with long-term follow-up comparing different methods and techniques and examining atrophy percentages.

Cite as: Nilsun Kuas, Ergun Ergün, Gülnur Göllü, Murat Çakmak, Ufuk Ateş. Türkiye’de ele gelmeyen testis hastalarına güncel yaklaşım farklılıkları. Coc Cer Derg/Turkish J Ped Surg 2022;36(2): 26-33. doi: 10.29228/JTAPS.58049