Testicular ectopia in adults
Bandhauer, K.; Toggenburg, H.
Helvetica Chirurgica Acta 48(3-4): 349-354
1981
ISSN/ISBN: 0018-0181 PMID: 7287469 Document Number: 180974
Testicular ectopia in adults: Postpuberal ectopic testes are seen in about 0.8% of the male population thus being identical in frequency as after the first year of life. Based on our own experience with 32 cases between 1970 and 1979 the significant features of the diagnosis, potential development of malignancy, coincident subfertility and treatment are outlined: 1. In contrast to the situation of early childhood, missing puberal development during early adulthood is always indicative of absent endocrinologically active testis parenchyma. 2. Routine diagnostic work-up includes selective gonadal venography, sonography and CT-scanning may also be of diagnostic help. 3. The risk of tumor development is higher in undescendent as compared to normotopic testes preferably in abdominal ectopia; orchiopexy after the 6th year of life is not preventive in this regard. 4. Unilateral cryptorchism is associated with infertility, the exact cause is obscure, pathological changes are also seen in the contralateral normotopic testis and orchiopexy after the 2nd year of life does not improve spermatogenesis. 5. The therapeutical concept should be oriented on the patient's individual cosmetic and psychological needs and requirements in cases of testicular ablation or orchiopexy and should take, at the same time, the potential risk of malignancy into consideration. Testes prosthesis is an accept able means; in cases in which orchiopexy is easily achieved testis biopsy should be performed to rule out carcinoma in situ. Endocrine work-up is essential to characterize hormone insufficiency and to enable proper substitution.