Proximal Hypospadias and Acquired Cryptorchidism: Incidence, Morphology and Potential Clinical Implications

No AccessJournal of UrologyPediatric Article1 Nov 2021Proximal Hypospadias and Acquired Cryptorchidism: Incidence, Morphology and Potential Clinical ImplicationsThis article is commented on by the following:Editorial CommentEditorial Comment Anthony D'Oro, Ilina Rosoklija, Elizabeth B. Yerkes, Bruce W. Lindgren, Karen Rychlik, and Earl Y. Cheng Anthony D'OroAnthony D'Oro *Correspondence: Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave., Chicago, Illinois 60611 telephone: 626-993-7364; E-mail Address: [email protected] Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author , Ilina RosoklijaIlina Rosoklija Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author , Elizabeth B. YerkesElizabeth B. Yerkes Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author , Bruce W. LindgrenBruce W. Lindgren Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author , Karen RychlikKaren Rychlik Biostatistics Research Core, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author , and Earl Y. ChengEarl Y. Cheng Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001944AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We identified the incidence of acquired cryptorchidism among patients with proximal and mid shaft hypospadias, predictors of acquired cryptorchidism, and the prevalence of testis-epididymis nonfusion with ascended testes. We hypothesized that proximal hypospadias would be associated with higher incidence of acquired cryptorchidism than mid shaft hypospadias, and that ascended testes would exhibit increased prevalence of testis-epididymis nonfusion similar to anatomical findings in an undescended testis. Materials and Methods: A retrospective cohort study of patients who underwent primary proximal and mid shaft hypospadias repair from 2010 to 2016 was conducted. Clinical and operative notes were reviewed. Patients with congenitally undescended testes or differences of sex development were excluded. Results: A total of 175 patients were identified. Those with proximal hypospadias (14/104, 13%) were more likely than those with mid shaft hypospadias (1/71, 1%) to develop acquired cryptorchidism (p=0.04). Among proximal hypospadias patients, increased risk of acquired cryptorchidism was associated with pre-term birth (p <0.01) and penoscrotal transposition (p=0.01) but not with testis position on initial examination (p >0.99). In the 14 proximal hypospadias patients with acquired cryptorchidism, 21 ascended testes underwent orchiopexy. Operative notes adequately described testis-epididymis anatomy for 8/21 ascended testes. Testis-epididymis nonfusion was described in 6/8 ascended testes. Conclusions: Risk of acquired cryptorchidism is increased among patients with proximal hypospadias. Operative notes revealed a high rate of epididymal nonfusion with ascended testes, suggesting these testes morphologically resemble undescended testes. Close followup of testis position is needed in these patients, and the threshold to perform orchiopexy may need to be lower in select patients. References 1. : The descriptive epidemiology of congenital and acquired cryptorchidism in a UK infant cohort. Arch Dis Child 2009; 94: 868. Google Scholar 2. : Prevalence of acquired undescended testis in 6-year, 9-year and 13-year-old Dutch schoolboys. Arch Dis Child 2007; 92: 17. Google Scholar 3. : Proximal hypospadias and risk of acquired cryptorchidism. J Urol 2010; 184: 715. Link, Google Scholar 4. : The epidemiology of congenital cryptorchidism, testicular ascent and orchidopexy. J Urol 2003; 170: 2396. Link, Google Scholar 5. : Spontaneous alterations in position of the testes. 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Google Scholar © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByWan J (2021) This Month in Pediatric UrologyJournal of Urology, VOL. 206, NO. 5, (1085-1086), Online publication date: 1-Nov-2021.Related articlesJournal of UrologyAug 18, 2021, 12:00:00 AMEditorial CommentJournal of UrologyAug 18, 2021, 12:00:00 AMEditorial Comment Volume 206Issue 5November 2021Page: 1291-1299 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.KeywordsepididymiscryptorchidismtestishypospadiasMetricsAuthor Information Anthony D'Oro Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois *Correspondence: Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave., Chicago, Illinois 60611 telephone: 626-993-7364; E-mail Address: [email protected] More articles by this author Ilina Rosoklija Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author Elizabeth B. Yerkes Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author Bruce W. Lindgren Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author Karen Rychlik Biostatistics Research Core, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author Earl Y. Cheng Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author Expand All Advertisement PDF DownloadLoading ...