| Abstrakt: |
Objective: Most cases of undescended testis are diagnosed and treated in childhood with excellent post-operative results and minimal morbidity. However its presentation in adults provides an opportunity to study its spontaneous course and the challenges associated with its diagnosis, management and outcome. Patients and method: We conducted a prospective study of 62 consecutive patients who were managed for undescended testes above the age of 18 years from February 2008 to October 2012 at Sharda Hospital, Greater Noida. Results: A total of 62 patients, mean age 29 years, range 18-55 years were managed. Only 6.4 %(4 cases) presented with primary complaint of undescended testis. Twenty two, 28, 12 were right, left sided and bilateral respectively. Inguinal hernia (45.2%) was the most common associated anomaly, 14 cases (22.25%) had infertility, and ignorance (41.9%) was the commonest reason for delay in presentation. Thirty four cases were intra-canalicular, 8 were intra-abdominal, 3 cases required laparoscopy for detection, and 2 cases were of vanishing testis. Orchiopexy was completed in 28 unilateral and 4 bilateral cases, 10 cases underwent bilateral orchiectomy. Semen parameters did not improve in any case of infertility following orchiopexy. Conclusions: Management of adult cryptorchidism is more challenging due to the absolute and irreversible nature of the changes and significantly poor outcomes, both surgical and psychological in a large proportion of patients. Increasing awareness and education of primary health care workers can help reduce the presentation of cryptorchidism in adults and its attendant complications. [ABSTRACT FROM AUTHOR] |
