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Niet-scrotale testes; beleid voor de eerste lijn [First-line management of non-scrotal testes]

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Author: Aendekerk, R.P.P. · Leerdam, F.J.M. van · Hirasing, R.A.
Type:article
Date:2002
Source:Nederlands Tijdschrift voor Geneeskunde, 12, 146, 557-561
Identifier: 236497
Keywords: Health · Cremaster muscle · Ectopic testis · General practitioner · Orchidopexy · Patient referral · Review · Scrotum · Surgical technique · Treatment indication · Cryptorchidism · Humans · Infant · Infant, Newborn · Male · Orchiectomy · Puberty · Sexual Maturation · Treatment Outcome

Abstract

For non-scrotal testes a distinction can be made between retractile testes (completely descended and normally developed but sometimes situated subcutaneously in the groin area), retained testes (testes cannot be brought into the scrotum or this can only be achieved using light manual pressure) and ectopic testes (lying outside of the descent trajectory). - It is estimated that 0.7-0.8% of all boys have as yet undescended testes. - The first few days after the birth are the most suitable for testing and registration, as then the cremaster reflex is absent. Registration should take place in both the youth healthcare file and in the 'growth book' for the parents. - Retractile testes do not require treatment. There is no consensus concerning the treatment of (possible) acquired nonscrotal testes. For undescended testes the management depends on previous testes localisations. For ectopic testes and testes that have never been scrotal, a referral for surgical treatment should be made prior to the second birthday. - Orchidopexy (a better description is orchidofuniculolysis followed by orchidopexy) is only justified in the case of testes which have never descended. - In the case of a clear indication, the general practitioner should make a prompt referral (before the second birthday) and in other cases assurance should be provided and an expectant policy adopted until puberty.