A. de Vries
- Testing the undescended testis
H.A. Delemarre-van de Waal
- Award date
- 14 February 2014
- Number of pages
- Document type
- PhD thesis
- Faculty of Medicine (AMC-UvA)
A testis should reside in the scrotum because of its lower temperature which is good for spermatogenesis. Therefore, in case of an undescended testis an orchidopexy seems indicated. The introduction of this thesis is about the evidence of an improvement of fertility in adulthood by an orchidopexy of the undescended testis in childhood.
The first part of this thesis, before surgery, is about indications. Chapter one shows why a pre-operative ultrasound is indicated in case of a non-palpable testis. Chapter two, three and four describe the results of a conservative approach of the acquired undescended testis and demonstrate a high rate of spontaneous descent and a nonoccurrence of torsion.
The second part, during surgery, is about the prospectively studied surgical differences between the congenital and acquired undescended testis. The two forms of undescended testes appear to differ in several surgical findings. However, there are congenital aspects in the acquired undescended testis.
Part three, after surgery, describes the results of orchidopexy. Chapter six, seven and eight illustrate respectively a small volume, a high rate of intratesticular varicocele and a high percentage of testicular microlithiasis after orchidopexy at diagnosis for acquired undescended testes. Chapter nine and ten launch the PET/CT scan as a new method to evaluate the result of orchidopexy. The PET/CT scan shows some function of the orchidopexied congenital undescended testis, although less than its counterpart.
To reach consensus on the treatment of the acquired undescended testis, a randomized controlled trial is indicated.
- Research conducted at: Universiteit van Amsterdam