Cryptorchidism : A study or 200 cases at kenyatta national

Abstract

A cryptorchid testis 1S a relatively common problem of the male sex.

In the years 1975 to 1984 a total of two hundred (200) cases of cryptorchid testes were seen and treated in Kenyatta National Hospital (K.~.H.). The two hundred patients had a total of two hundred and sixty three (263) improperly descended testes.

The ma1n symptom was absence of the testicle from the scrotum. This was present in all the t~o hundred ratients. This symptom was followed by the presence of a swelling 1n 123 (61.5%) cases and then pair). in ("\1 (:::;.::;~) cases.

The condition was unilateral in one hundred and thirty six

(136) (68%), bilateral in sixty four (64) (32%), right sided

in sixty three (63) (46.32%) left sided in seventy three (73) (53.68 % ), twen ty ei ght (28) (lO.64%) test es w el' e intra-abdomin aI, eight (8) 3.04%) were at the internal inguinal ring, a hundred and f ort y (140) (53.3%) Here in the mid inguinal canal, thirty-

seven (37) 14.06%) at the external inguinal ring, forty-four (44) 16.7%) at the sup erf i.ci al inguinal pouch, five (5) (1.0%) at the pubic region, one (1) (0.33%) at the penile base. No testis was in the femoral or perineal reg1on.

Two (2) nonun i on 0 f tes tis and epi di dyni s .'•'ree f ounr' at surgery.

Clinically eighty-nine (89) (33.84%) patients were associated with an open processus vaginalis, two (0.76%) patients were associated with torsion, seven (7) (2.66%) patients were associated with hydrocele, Four (4) (1.52%) patients had hypospadias, one (1) patient had Noonan's syndrome, one (1) patient had prune belly syndrome. In one hundred and two (102) C38~78%) cases the testicle was palpable.

One (1) patient (0.5%) had intravenous urogram which was normal. Two patients (1%) had buccal smear done. No burr bodies were seen. Two patients (1%) had chromosomal studies which showed a normal male karyotype 46xy. Fourteen (14) patients (7%) had biopsy and histology done.

Two hundred and fourteen (214) C81.~3%) had a single stage orchidopexy, thirty-five (35) (13.3%) patients had a two stage orchidopexy. Fourteen (14) (5.2%) patients had orchidectomy.

In two hundre~ and twenty-six (226) (~5.92%) cases the length of the vas deferens was adequate. In thirty-seven (37) (14.08\) cases the 1engt~ of the vas deferens was inadequate.

In thirty-two (32) (12.16%) patients the testicle was atrophic. In eighty-six (86) (32.69%) ~atients the testicle , was smaller than the opposite side. In one hundred and forty-fiv

(145) (55.15%) patients the testicle was normal.

In one hundred and sixty-three (163) (16.98%) the proces~us vagina1is was patent. In one hundred (100) (38.)2%) cases no hernial sac was found.

In two hundred and seventeen (217) (82.52%) the entrance to the scrotum was completely obliterated by fibrous tissue. In forty-six (46) (17.48%) it was normal.

One hundred and sixty-five (165) (82.5%) patients had dartous pouch technique type 0 f 0 rchidopexy . fight (8) (4%) patients had Keetley-Torek operation, two patients (1%) had Ombredanne Operation and in twenty-five (25) (12.5%) it was not specified what type of the orchidopexy wa~ done.

Finally in the follow-up cases the testicle was In the scrotum in one hundred and sixty (160) (80%) and at the upper part of the scrotum in t went y+s i x (26) (13%).