SOVREMENNAYA PEDIATRIYA.2016.1(73):143-145; doi10.15574/SP.2016.73.143

Treatment of testicular pathology localization in combination with a modified scrotum in childhood

Spahiu O. V., Paholchuk A. P. 
Zaporozhye State Medical University, Ukraine

The combination of localization testicular pathology (cryptorchidism) with underdeveloped or enlarged scrotum as a manifestation of inguinal-scrotal hernias in children is premature infants up to 30%.

Objective. To improve the results of treatment of comorbidity changes localization testicle (cryptorchidism) with underdeveloped or enlarged scrotum in children.

Materials and methods. We observed 316 children with cryptorchidism, who were treated in the Department of Pediatric Surgery of Zaporozhye in the period from 2010–2015. Age of children from 9 months to 15 years. The age distribution of patients was in the group of 9 to 18 months — 246 children (77.8%), from 18 months to 6 years — 42 (13.3%), from 6 to 10 years — 18 (5.7%) from 10 to 15 years — 10 children (3.2%). Bilateral cryptorchidism was diagnosed in 58 children, which made up 18.3%, right-hand — in 82 (25.9%), left-handed — in 77 (24.3%) children. Among all studied the egg is not palpable in 68 (21.5%) children. Inguinal form was observed in 217 (68.8%) children. Among these patients, palpate the testicle at the external inguinal ring in 164 (52.1%) boys and at the entrance to the scrotum — in 53 (16.79%). Abdominaya form — in 59 (18.7), ectopia — in 14 (4.4%), testicular agenesis — in 26 (8.2%) children. We observed a combination of cryptorchidism with hernias in 31 (9.8%), testicular hypoplasia in 36 (11.3%) and hypospadias in 27 (8.5%) children. The study excluded patients with repeated orhiopeksiey.

Results and discussion. In a study of inguinal-scrotal children found that increased scrotum was observed in 31 (9.8%) patient, underdeveloped (decrease) scrotum in 99 (31.3%), and the size of age in 186 (41.1%) children. The conducted work analysis showed that the highest number of children with cryptorchidism were in the age of up to 18 months (246 children — 77.8%). But, unfortunately, there are also later referral to specialists. During the study period 281 orhiopeksy done, of whom 231 (73.1%) access inguinal and laparoscopic — in 59 (18.7%) patients. Testicular atrophy were observed. In 15 (4.7%) children revealed agenesis of testis. In 59 children with abdominal form of laparoscopic access, out of which 9 (2.8%) children revealed agenesis of testis. In 20 (6.3%) boys egg determined in the abdominal cavity and was held orhiopeksiya. In 4 cases of violation of the formation of gender was determined rudimentary gonad, egg is not found. In 26 (8.2%) patients had the elements of the spermatic cord went into the inguinal canal. All Ball performed audit of the inguinal canal, 18 revealed hypoplasia of the testis.

Conclusions. Newborn babies with underdeveloped scrotum or increase subject to inspection for the study of space lokalizitsii eggs. Surgical correction of testicular pathology localization — cryptorchidism most effectively and is preferably carried out in children under the age of 12 months. The laparoscopic technique is less traumatic and the most informative as a way of diagnosing abdominal form of cryptorchidism.

Key words: cryptorchism, treatment, children.

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