Associated factors investigationsand management of Undescended Testis (UDT) at KNH: a prospective study

Abstract

A descriptive prospective study was done to review the associated factors, investigations and management of undescended testes at the Paediatric Surgical Unit of Kenyatta National Hospital from June 2003 to November 2003. There were a total of 57 patients with undescended testes seen within the period of study and out of these 40 patients had had orchidopexy and the other 17 were still pending. Twenty patients had their serum gonadotropins evaluated and was compared to 20 other children of similar age with normal (descended testes) who had been admitted to paediatric surgical ward for other reasons e.g. incision and drainage of an abscess. The ages ranged form 1 month to 13 years with mean age of 5 years. Most of the children with undescended testes were delivered during the month of September 18%, June 12% and October 10%. None was delivered during the month of January and 2% were delivered in the month of February. First born males were 62%, second born 36%, none was sixth born or above. The median mothers' age at delivery of children with undescended testes was between 21-25 years (54%). None was 41 years of age and above who delivered a child with undescended testes. None of the mothers gave a history of smoking· at anyone time before or during pregnancy. The abnormality detected at a health institution were 58%. The family members detected 42%. Among the family members, the mothers detected 54%, the fathers 21%, the grandmother 21% and the aunties 4%. The patients who had other associated anomalies were 28.1% of which hypospadia accounted for 8.7%, umbilical hernia 5.2% and prune belly syndrome 5.2%. Ultrasound was performed on 42.1% of the patients to locate the testis. None had Computerized Tomography Scan or Magnetic Resonance Imaging. There was no significant statistical difference in the gonadotropin levels of children with undescended testes and those with normal (descended) testes at all age groups. P values of LH and FSH were 0.790 and 0.070 respectively. Among the 40 patients who had orchidopexy performed, 33 were first operations and 7 were redo operations. Among the 7 redo orchidopexy, 5 (71.4%) had bilateral undescended testes and 2 (28.6%) had unilateral undescended testes. Two patients had complication at surgery; one had avulsed vas deferens and the other had testicular artery injured.