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Infertility, affecting one in six couples, is often related to the male partner’s congenital and/or environmental conditions or complications postsurgery. This retrospective study examines the link between orchiopexy for undescended testicles (UDT) and testicular torsion (TT) in childhood and adult fertility as assessed through sperm analysis. The study involved the analysis of semen samples from 7743 patients collected at Soroka University Medical Center (Beer Sheva, Israel) between January 2009 and December 2017. Patients were classified into two groups based on sperm concentration: those with concentrations below 5 × 106 sperm per ml (AS group) and those above (MN group). Medical records and surgical histories were reviewed, categorizing orchiopexies by surgical approach. Among 140 individuals who had undergone pediatric surgery, 83 (59.3%) were placed in the MN group and 57 (40.7%) in the AS group. A higher likelihood of being in the MN group was observed in Jewish compared to Arab patients (75.9% vs 24.1%, P = 0.006). In cases of childhood UDT, 45 (78.9%) patients exhibited sperm concentrations below 5 × 106 sperm per ml (P < 0.001), and 66 (76.7%) had undergone unilateral and 18 (20.9%) bilateral orchiopexy. Bilateral orchiopexy was significantly associated with lower sperm concentration, total motility, and progressive motility than unilateral cases (P = 0.014, P = 0.001, and P = 0.031, respectively). Multivariate analysis identified UDT as a weak risk factor for low sperm concentration (odds ratio [OR]: 2.712, P = 0.078), with bilateral UDT further increasing this risk (OR: 6.314, P = 0.012). Jewish ethnicity and TT diagnosis were associated with a reduced risk of sperm concentrations below 5 × 106 sperm per ml. The findings indicate that initial diagnosis, surgical approach, and ethnicity markedly influence male fertility outcomes following pediatric orchiopexy.

Infertility, affecting one in six couples, is often related to the male partner's congenital and/or environmental conditions or complications postsurgery. This retrospective study examines the link between orchiopexy for undescended testicles (UDT) and testicular torsion (TT) in childhood and adult fertility as assessed through sperm analysis. The study involved the analysis of semen samples from 7743 patients collected at Soroka University Medical Center (Beer Sheva, Israel) between January 2009 and December 2017. Patients were classified into two groups based on sperm concentration: those with concentrations below 5 × 106 sperm per ml (AS group) and those above (MN group). Medical records and surgical histories were reviewed, categorizing orchiopexies by surgical approach. Among 140 individuals who had undergone pediatric surgery, 83 (59.3%) were placed in the MN group and 57 (40.7%) in the AS group. A higher likelihood of being in the MN group was observed in Jewish compared to Arab patients (75.9% vs 24.1%, P = 0.006). In cases of childhood UDT, 45 (78.9%) patients exhibited sperm concentrations below 5 × 106 sperm per ml (P < 0.001), and 66 (76.7%) had undergone unilateral and 18 (20.9%) bilateral orchiopexy. Bilateral orchiopexy was significantly associated with lower sperm concentration, total motility, and progressive motility than unilateral cases (P = 0.014, P = 0.001, and P = 0.031, respectively). Multivariate analysis identified UDT as a weak risk factor for low sperm concentration (odds ratio [OR]: 2.712, P = 0.078), with bilateral UDT further increasing this risk (OR: 6.314, P = 0.012). Jewish ethnicity and TT diagnosis were associated with a reduced risk of sperm concentrations below 5 × 106 sperm per ml. The findings indicate that initial diagnosis, surgical approach, and ethnicity markedly influence male fertility outcomes following pediatric orchiopexy. [ABSTRACT FROM AUTHOR]

Aim: To investigate underlying factors for previously reported shortcomings in child health centres' (CHC) referral process of boys with undescended testicles. Methods: A total of 386 physicians working at Swedish CHCs were surveyed regarding their knowledge about undescended testicles and their clinical management. Multivariate regression analyses were performed to identify risk factors of non‐adherence to guidelines and self‐reported lack of clinical skills. Results: The overall knowledge of the health benefits of undescended testicle surgery was high (89%), while two‐thirds were unaware of surgery being recommended <1 year of age. One‐fifth of respondents had never received guidance on examination techniques. Male gender (adjusted odds ratio [aOR] 0.51, 95% confidence interval [95% CI] 0.31–0.86), education in paediatrics (aOR 0.37, 95% CI 0.18–0.76) and more experience (aOR 0.02, 95% CI 0.01–0.09) significantly decreased the risk of unfamiliarity with examinations. More experience decreased the risk of stating the incorrect indications for undescended testicle surgery (aOR 0.17, 95% CI 0.03–0.95) and finding examinations difficult (aOR 0.22, 95% CI 0.07–0.72). Medical education outside Nordic countries was a risk factor for unawareness of guidelines (aOR 2.06, 95% CI 1.21–3.51). Conclusion: The knowledge and confidence level of the study population varied widely. The results indicate a need for further theoretical and practical education among Swedish CHC physicians. [ABSTRACT FROM AUTHOR]

Background: Cryptorchidism is considered to be one of the most common causes of non‐obstructive azoospermia. There are several surgical techniques to retrieve sperm in these patients. Microdissection testicular sperm extraction (m‐TESE) is a recent sperm retrieval technique which is considered to be a safe, non‐blind, and feasible method. Objectives: This study aimed to investigate sperm retrieval rate (SRR) by the mTESE method in patients who have undergone orchidopexy due to bilateral cryptorchidism. Materials and methods: In this retrospective study, 56 ex‐cryptorchid patients, who underwent mTESE due to post orchidopexy azoospermia, were included. Patients with hypogonadotropic hypogonadism, Klinefelter syndrome, azoospermia factors (AZF) microdeletion, or chromosomal translocation were excluded from the study. Data were obtained from medical files. Results: SRR in this study was 46%. Patients were divided into two groups of negative (n = 30) and positive (n = 26) based on the sperm extraction outcomes. There was no statistically significant difference between two groups regarding the mean age at mTESE, mean age at orchidopexy, testicular size, and serum testosterone concentration. However, testicular location, histological patterns, FSH, and LH level showed to have statistically significant relation with sperm retrieval results. But, according to our logistic regression, none of the included variable in the model including FSH, LH, histopathology, and testis location have a significant effect on the presence of the sperm. Discussion: In the present study, SRR was significantly higher in patients with scrotal testis and low level of FSH and LH. Conclusions: Performing mTESE could be recommended in ex‐cryptorchid patients with post orchidopexy NOA. Preoperative testicular biopsy seems to be unnecessary while clinical criteria can perfectly define NOA. [ABSTRACT FROM AUTHOR]

Sigmoid volvulus accounts for 20%–50% of colonic obstructions in Eastern countries. This occurs mostly in patients with a lack of mobility and a history of chronic constipation. There are some very known complications of a undescended intra‐abdominal testicle such as cancer, ischemia, and infertility; But the rotation of the colon around the spermatic cord of one UDT is a very rare phenomenon that there is no similar report. A 67‐year‐old man came to the emergency department with a complaint of abdominal pain and obstipation. On examination, patient was febrile (T: 38.5) and had mild general tenderness. According to the appearance of coffee beans in the X‐ray, the diagnosis of sigmoid volvulus was made. In the requested tests, leukocytosis was observed. Rectosigmoidoscopy was unsuccessful. The patient underwent laparotomy. After manual untwisting, a tubular structure at the base of the meso‐sigmoid was noticed. With further exploration, the testis was observed intra‐abdominally. Orchidectomy and sigmoidectomy were performed by Hartmann's method. Sigmoid volvulus is one of the common cases that surgeons frequently encounter. The case scenarios are often the same, and from experience, most cases result from a long meso and an elongated sigmoid secondary to prolonged constipation. Therefore, it is clear that a scrotal examination would not be part of the routine examination of a patient with sigmoid volvulus. In this article, by reporting a very rare etiology for a very common pathology, we tried to point out the importance of head‐to‐toe examination in all patients. [ABSTRACT FROM AUTHOR]

Cryptorchidism is the most common congenital malformation of the male genitourinary tract. An undescended testicle has a 10% chance of developing cancer, with an intra-abdominal testicle having the highest risk. We present a 24-year-old man with a history of bilateral cryptorchidism, complaining of lower abdominal mass for two months. An abdominal computed tomography scan showed an intra-abdominal mass lesion measuring 13 x 9 cm and displacing the bladder caudally. Exploratory laparotomy revealed a right intraabdominal testicular tumor. A right orchiectomy and left orchidopexy was performed. Histopathological examination revealed a testicular seminoma. The patient was discharged without complications and was referred to the oncology department for chemotherapy and further management. Our findings support the early treatment and close monitoring of cases of cryptorchidism due to the risk of malignancy as well as the necessity of routine scrotal examinations in all males presenting with an abdominal mass. [ABSTRACT FROM AUTHOR]

A 37-year-old man presented for infertility and visited an IVF clinic with the hope of having a baby. Semen analysis showed no sperm. The left testicle was nonpalpable: it was located within the inguinal canal, having not descended into the scrotum. Microdissection-testicular sperm extraction (MD-TESE) was performed on the right testis, which exhibited primary spermatocytes but no sperm.　Because the patient wished to continue with fertility treatment, a contralateral left orchidopexy was performed. After fixation of the left undescended testicle, ejaculated sperm appeared.　After the left orchiectomy, pregnancy was established by intracytoplasmic sperm injection (ICSI) and the couple were subsequently blessed with two children. 　Adult cryptorchidism is usually associated with a very high rate of infertility.　It is rare that ejaculated spermatozoa appear after testicular fusion of a unilateral undescended testicle in adulthood, as was experienced in the present case.　It is recommended that Orchidopexy should be considerd as an option for the treatment of infertility. [ABSTRACT FROM AUTHOR]

PurposeBoth pediatric urologists and pediatric surgeons perform hernia repairs, hydrocelectomies and orchiopexies. We hypothesized that surgeons perform more incarcerated and female hernia repairs while urologists perform more orchiopexies and hydrocelectomies.MethodsThe Vizient-AAMC Faculty Practice Solutions Center® database was queried from January 2009 to December 2014 to identify patients 10years or younger who underwent the above procedures performed by pediatric specialists. Age, gender, race, insurance, geographic region and surgeon volume were examined.ResultsIn the study 55,893 surgeries were identified: 26,073 primary hernia repairs, 462 recurrent hernia repairs, 3399 laparoscopic hernia repairs, 9414 hydrocele repairs and 16,545 orchiopexies. Pediatric surgeons performed 89% of primary hernia repairs with an annual median surgeon volume of 4 cases/year. Pediatric urologists performed 62% of hydrocelectomies and 83% of orchiopexies with annual median surgeon volumes of 6 and 24, respectively. Pediatric surgeons performed all procedures in younger patients and performed more female and incarcerated hernia repairs.ConclusionsPediatric surgeons operate on younger patients and treat more patients with inguinal hernias while pediatric urologists care for more boys with undescended testes and hydroceles. This knowledge of referral patterns and care between specialties with overlapping expertise will allow improvements in training and access.Levels of evidenceCost Effectiveness Study, Level of Evidence III.

Introduction: Undescended testis (UDT) refers to the actual absence of one or both testicles from their normal position in the scrotum. It can lead to testicular atrophy, malignancy and male infertility. Our study highlights the epidemiological, diagnostic and therapeutic aspects of UDT in 3 referral hospitals in Douala., Methods: we conducted a descriptive and retrospective study over 10 years (January 1, 2012 to December 31, 2021). We collected data from the medical records of patients aged 1 to 15 years, who underwent surgery for UDT. The sociodemographic, clinical, paraclinical and therapeutic data were collected, recorded and analyzed using CS Pro 7.3 and SPSS 23 software., Results: we reviewed 741 records, excluding 595 that were not managed during our study period, leaving 105 cases included. UDT accounted for 1.39% (741 out of 53,431 cases) of urological consultations. The average age was 6.65±3.13 years. Scrotal emptiness was the main reason for consultation (81.9%), discovered by a parent at home in 76.7% of cases (n=66). Six point seven percent of the patients (n=7) had a brother with a history of UDT and 2.8% (n=3) a father. The left testis was most commonly affected: 44.8% (n=47). The testis was palpable in the inguinal region in 91.4% of cases (n=96). The diagnosis was mainly clinical, with ultrasound performed in 14 patients (13.4%). Cryptorchidism was the most diagnosed condition: 85.7% (n=90). The average hospital stay was 1.85±0.74 days. Two surgical approaches were used: inguinal in 99 patients (94.3%) and laparoscopic in 6 patients (5.7%)., Conclusion: from our study, we can conclude that UDT is a relatively uncommon condition in urological consultations, emphasizing the importance of proper diagnosis and management. Surgically, two approaches are available: the inguinal approach, which is the most commonly used, and laparoscopy, which is essential when the testicles are intra-abdominal or non-palpable in the inguinal region., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts dans le cadre de cette étude., (Copyright: Frantz Guy Epoupa Ngalle et al.)

Background: The American Urological Association published guidelines in 2014 regarding management of undescended testicles (UDT). Despite these guidelines, prior studies have indicated discordance between guidelines and actual practice, especially in rural states. This study aims to identify if educating referring providers improves management of UDT. Methods: Patients with UDT referred to our institution were divided into two groups: those referred prior to (Group 1) and after (Group 2) targeted education. A retrospective review was performed to compare the groups in terms of age at time of referral and surgery, laterality, specialty, and practice setting of referring provider, and whether or not ultrasound (US) was performed prior to referral. Results: A total of 100 patients were identified in Group 1 and 168 in Group 2. No significant differences were noted between groups regarding age, variability of referring provider, or those receiving US prior to referral. Median age at referral was 20.7 months (range=0– 194) and 33 months (range=0– 205.1) in Groups 1 and 2, respectively (p=0.26). Sixty-two (37%) patients underwent surgical evaluation within 18 months of age or younger in Group 1 compared to 39 (39%) in Group 2 (p=0.73). Private practice pediatricians comprised the majority of referring providers in both cohorts. US was performed prior to referral in 41% of patients in Group 1 compared to 35.8% in Group 2 (p=0.51). The number of US ordered prior to referral significantly decreased from 10 (50%) to six (19%) following education among academic providers (p=0.02). No significant difference was found following education for private practice physicians (p=0.27). Conclusion: Targeted education did not improve age at referral in the short-term, which may reflect suboptimal healthcare access. Additionally, more research is needed to evaluate whether more diverse targeted education provided on a regular basis to both physician and mid-level providers would have a meaningful impact. [ABSTRACT FROM AUTHOR]

Purpose of Review: The two-stage Fowler-Stephens orchiopexy is a well-described surgical approach for most pediatric urologists tackling the high intra-abdominal testis. Testicular ascent is a well-reported outcome of the surgery and a problem that could be fixed with a repeat procedure. The purpose of this review is to determine the rate of subsequent testicular ascent and repeat surgery after a two-stage Fowler-Stephens using best available evidence. Recent Findings/Result: We selected 16 studies that pertained to our topic. 0–13% of testicles were deemed to be in an inappropriate position on follow-up (6–37 months). The definition of appropriate postoperative position varied between studies and rates of repeat procedures were sparsely available. Available data reports a repeat orchiopexy rate of 2.6–7.5% after two-stage Fowler-Stephens. Summary: Two-stage Fowler-Stephens orchiopexy is a highly successful surgical technique to manage high intra-abdominal testes. Rates of testicular ascent are difficult to ascertain due to varying definitions and small sample sizes. While repeat procedures are typically indicated, the actual rate of repeat orchiopexy is rarely reported and long-term outcomes following a third procedure is sparse. [ABSTRACT FROM AUTHOR]

Purpose: To estimate how many boys with UDT must undergo orchiopexy to prevent one case of TC, one death from TC and one exposure to TC treatment beyond radical orchiectomy as compared to being treated at an older age. Methods: This retrospective study utilized data from a 2007 Swedish study of males who underwent orchiopexy for UDT (Pettersson et al.). TC incidence for boys undergoing orchiopexy for UDT was assessed based on the age at orchiopexy (0–6 years, 7–9 years, 10–12 years, 13–15 years). The incidence of TC in each age cohort was calculated and used to determine the number needed to treat (NNT) for each age group using assumptions based on published TC outcomes. Results: For an index patient ≤ 6 years, 372 boys need to undergo orchiopexy to prevent a single case of TC, 1488 boys to prevent exposure to TC therapy beyond radical orchiectomy, and 5315 boys to prevent a single TC-related death compared to treatment at an older age. Conclusion: While there is evidence supporting benefits of early orchiopexy, the NNT to affect TC outcomes is very high. Even those with delayed orchiopexies have low risk for TC poor outcomes. This information can be used when counseling patients and families faced with UDT about the risks related to TC, especially with comorbidities. [ABSTRACT FROM AUTHOR]

The optimal management of a high undescended testicle (UDT) remains debated. When tethering is due to shortened spermatic vessels, a one-stage or two-stage Fowler-Stephens Orchiopexy (FSO) can be performed. Published series suggest a higher success rate with a two-stage FSO, though its superiority has not been ascertained. The authors examine patient and surgical factors associated with success of one-stage FSO and compare our outcomes with the established literature. We retrospectively reviewed the charts of 43 boys who underwent one-stage FSO for 45 testes from 2003 to 2018 by a single surgeon at our institution. Patient factors, surgical approach, and postoperative results were reviewed. Radiographic success was a testis with intact vascular flow or normal echotexture on scrotal ultrasound. Clinical success was a non-atrophic, intrascrotal testis at postoperative follow-up. Radiographic and clinical success was compared. Data analysis was performed with Fisher's exact test and t -test for categorical and continuous variables respectively. Follow-up (mean 29 months; 0.5 months-14.5 years) was available for 40 patients (42 testes; 21 bilateral, 21 unilateral). Average age at surgery was 21.8 months (4 months–10.4 years). Associated conditions were seen in 14 patients. Twenty-nine patients had postoperative scrotal Doppler ultrasound with radiographic success in 25/29 (86.2%). Overall clinical success was 34/42 (81%) with 4 (9.5%) each of atrophy and ascent. A second surgery to address ascent in four patients allowed correction in three for a success rate of 88%. Radiographic and clinical success was significantly associated (P = 0.01). Clinical success was also significantly associated with inguinal rather than laparoscopic testis mobilization (P = 0.03) but not to patient's age, associated conditions, unilaterality/bilaterality, or pre-operative hypoplasia or location. Greater than 3 years of follow-up was available in 11 (26.2%) cases, of which seven had successful results. All adverse outcomes occurred within 8 months after surgery. Success was otherwise durable. This is the largest series of one-stage FSO to date. The success rate of one-stage FSO in this series matches that published in the literature for two-stage FSO; equal success is achieved with fewer surgeries. Postoperative Doppler ultrasound demonstrating intact vascular flow or normal testis echotexture is significantly associated with clinical success and highlights the utility of postoperative ultrasound in patients with an equivocal exam. Summary Fig. Image 1 [ABSTRACT FROM AUTHOR]

Cryptorchidism or undescended testicle (UDT) is one of the most common congenital anomaly in boys. Cryptorchidism occurs in approximately 3% of male newborn children and increases significantly in premature newborns. The complications of a UDT includes: testicular torsion, testicular cancer and infertility. The correct and cautious treatment significantly reduces the rate of these complications. The best treatment of UDT remains controversial nowadays, both for the palpable testicle and especially for the non-palpable testicle. Laparoscopy has a special advantage in the management of the intraabdominal testicle: both from a diagnostic and therapeutic point of view. In this article, we analyzed current trends in the diagnosis and treatment of the intra-abdominal testicle. [ABSTRACT FROM AUTHOR]

Introduction and objectives: Adult undescended testicles (UDTs) often present to fertility specialists with subfertility or azoospermia and with either an intra‐abdominal or inguinal testicle(s). Performing an orchidopexy followed by a surgical sperm retrieval (SSR) is a potential option to retrieve spermatozoa. A microdissection TESE (mTESE) procedure is performed to retrieve mature spermatozoa for use in ICSI. This paper reviews the outcomes of mTESE in adults following an orchidopexy. Material and methods: A cohort of azoospermic patients underwent adult orchidopexy over a 10‐year period at a single specialist centre. Data were collected retrospectively from the patient records retrieved from an institutional database. All patients underwent pre‐operative imaging to localize the testicles, serum testosterone levels and a semen analysis. Separate intraoperative testicular biopsies were performed to exclude intratubular germ cell neoplasia (ITGCN) and to analyse the Johnsen score. Results: Twelve patients (age range 18–36 years) underwent orchidopexy procedures for either intra‐abdominal or inguinal testicles. Mean follow‐up was 34 months (range 13–58). Ninety per cent of patients had bilateral UDT with azoospermia. Pre‐operative testosterone levels were within the normal range (mean 13.9 nmol/L; range 9.1–24.2). Five pelvic testicles (from four patients) were brought down and underwent a delayed mTESE. A total of nine inguinal orchidopexy procedures were carried out in eight men, and spermatozoa were found and preserved in three patients. None of the men with intra‐abdominal testicles had mature spermatozoa present following a delayed mTESE. Overall, SSR was successful in 37.5% of the patients. Histological analysis showed no cases of ITGCN and the Johnsen scores ranged from 1 to 3.3. Conclusions: Microdissection TESE following orchidopexy for inguinal testicles can result in a successful SSR in over 1/3rd of patients. Intra‐abdominal testicles appear to lack spermatogonia although the testicles can still be preserved for endogenous hormone production. Adult orchidopexy allows preservation of endogenous testosterone, easier self‐examination and an immediate or delayed mTESE in azoospermic patients. [ABSTRACT FROM AUTHOR]

Cryptorchidism - the absence of one or both testes in the normal scrotal position - is the most common birth defect of the male genitalia. In full-term newborn boys its incidence is estimated at 2-5%. During the first three months of life, in half of these boys the testicles will descend spontaneously into the scrotum, but at the end of the first year of life 1% of boys will have cryptorchidism. Among boys born prematurely, about 30% of them have undescended testicles at birth, but also in such cases approximately 80% of undescended testes descend by the third month of life. The authors discuss the epidemiology, pathophysiology, aetiology, and treatment of undescended testicle in boys. [ABSTRACT FROM AUTHOR]

This study is designed to provide paediatric surgeons' perspectives on the relative importance of the criteria for choosing a surgical mode for undescended testicle treatment between open surgery (orchiopexy) or laparoscopic surgery and determine the suitable surgical mode by using the multicriteria decision‐making method. The analytic hierarchy process (AHP), the technique for order preference by similarity to ideal solution (TOPSIS), and Vise Kriterijumska Optimizacija I Kompromisno Resenje (VIKOR) methods are utilized. A decision hierarchy is set with a goal, criteria, and alternatives. Our model is developed on the basis of four main criteria (time‐related, patient‐related, recovery‐related, and complication‐related factors) and 11 subcriteria (operation duration, length of stay in hospital, preoperative preparation time, recovery period after surgery, age of patient, weight of patient, aesthetic appearance, quality of life satisfaction, recurrence, possibility of infection, and vital function) as well as two alternatives, laparoscopy and open surgery. An online questionnaire was sent to the paediatric surgeons; responses from the 31 experts (i.e., paediatric surgeons) indicate that the most important criteria are found to be the time‐related factors, especially preoperative preparation time. On the other hand, the least important criteria are found to be complication‐related factors. Moreover, laparoscopy is chosen as the most suitable method for the undescended testicle using the AHP, TOPSIS, and VIKOR methods. This study helps paediatric surgeons' decision making by elucidating their priority criteria and representing their decision‐making process in terms of quantity with the help of AHP, TOPSIS, and VIKOR methodologies. [ABSTRACT FROM AUTHOR]

In this report, we discuss the case of a four-year-old boy known to have global developmental delay (GDD) and infantile spasm. The child was brought to the emergency department (ER) with a tender inguinal swelling and fever. Notably, there was no previous indication of an undescended testicle (UDT), and the scrotum was not examined in the ER initially. The abdominal radiograph was unremarkable, and an ultrasound of the groin was requested to investigate the nature of the swelling. The ultrasound yielded a differential diagnosis of direct or indirect inguinal hernia containing intestinal loops or a necrotic lymph node. Ultimately, scrotal examination and repeated imaging confirmed the diagnosis of bilateral UDT with torsion and suspected infarction on the right side. Both UDT and testicular torsion (TT) are prevalent genitourinary disorders. However, the occurrence of torsion in an undescended testis is not commonly observed or documented, particularly within the age group presented in our case. TT is a surgical emergency, and its prognosis relies on early recognition and management in order to salvage the testis. In this case, there was a missed examination opportunity; therefore, it is imperative for emergency physicians to routinely include scrotal examination as part of the physical assessment when evaluating children with abdominal or groin pain in order to promptly identify such cases., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Alshaibani et al.)

Fusion of the undescended testes with splenic, renal and adrenal tissue have been described in several cases but hepato-testicular fusion is a very rare entity of undescended testes. Herein, we report a case of hepato-testicular fusion. To the best of our knowledge, this is the 2nd such case in the English literature.

Cystic dysplasia of the testis is a rare, benign pathologic finding. We present two recent cases of cystic dysplasia of the testis to our practice. The first case involves an 11 month old male presenting with a non-palpable, intra-abdominal left testis. The second case involves a 7 year old male with left scrotal swelling and a history of left renal agenesis. After review of the literature, the first case represents the first report of cystic dysplasia of the testis in an undescended, intra-abdominal testicle.

This article provides a comprehensive review regarding undescended testicles and other related conditions. We have included background information summarizing variable clinical presentations, epidemiology, and the implications of undescended testis (UDT) on fertility and malignancy risk. This article has an emphasis on the approach to diagnosis and surgical management for the UDT. The purpose of this review is to provide readers with useful clinical tools for assessing and treating patients with cryptorchidism., (Copyright © 2023 Elsevier Inc. All rights reserved.)

To systematically review the efficacy of hCG and LHRH on testicular descent in boys with cryptorchidism, comprehensive search was performed to identify randomized controlled trials (RCTs) in PubMed, EMBASE, the Cochrane Library, Wanfang Database, and China National Knowledge Infrastructure (CNKI) up to March 2014. Outcomes included testicular complete descent rate (TCDR) and cure rate of patients. Study quality was evaluated using the Jadad scale. Meta-analysis was performed using Review Manager software. finally, 13 studies were included. hCG and LHRH increased TCDR comparing with control group. The success rate of hCG and LHRH was 24 and 19 %, respectively. Further, hCG and LHRH had significant effect on bilateral cryptorchidism, but not on unilateral cryptorchidism. All side effects were transitory and not severe, but if they have long-term harms were not clear. hCG and LHRH can effectively increase TCDR and there was no significant difference between them. However, the hormones cannot be recommended for everyone because of their low success rates and potential long-term harms. Further studies are needed to determine the efficacy of hormonal treatment for subtypes of cryptorchidism. [ABSTRACT FROM AUTHOR]