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CONGRESS OF THE ESPU
14:20–14:23
S9-4 (PP)
LATE ASCENDED TESTES: IS ECTOPIC GUBERNACULAR
INSERTION A CRITERION FOR AN EMBRYOLOGIC
PATHOGENETIC BACKGROUND?
Bernhard HAID
1
, Anne-Françoise SPINOIT
2
, Anna RADFORD
3
, Patrick REIN
1
,
Josef OSWALD
1
and Mesrur-Selcuk SILAY
4
1) Ordensklinikum Linz, Hospital of the Sisters of Charity, Department of Pediatric Urology, Linz, AUSTRIA - 2) University
Clinic Ghent, Department for Urology, Ghent, BELGIUM - 3) Leeds Children's Hospital Hospital, NHS, Department
for Pediatric Surgery, Leeds, UNITED KINGDOM - 4) Istanbul Medeniyet University, Department for Pediatric Urology,
Istanbul, TURKEY
PURPOSE
Ascension of testes from a scrotal position is described with an incidence of up to 45 % in those,
who are operated after the age of 4 with a high potential for damage to their germ cells if treatment
is deferred. Speculations with regard to etiology of late ascension of testes include the fixation of
the testis by a non-occluded processus vaginalis peritonei and growth of the child. We aimed at
investigating a pathologic gubernacular insertion in boys with late ascended testis as a possible
causative factor pointing at a primary, embryologic etiology of ascended testes.
MATERIAL AND METHODS
A multicenter prospective study was carried out between 05/2016 and 09/2017 in children with
well-documented ascended testes in 4 pediatric urology centers. Children with previous inguinal
surgery and those with retractile testes were excluded. All patients were evaluated regarding their
gubernacular insertion during orchidopexy. The presence of a patent processus vaginalis and dis-
sociation between the epididymis and testis were documented.
RESULTS
77 patients were included prospectively. Mean age at surgery was 73.1 months. The previous
scrotal position of the testis was documented in 49.4 % by a pediatric urologist and in 50.4 % by
a pediatrician.
In 3.9 % we found an orthotopic, deep scrotal gubernacular insertion, whereas it was non-orthotopic
in 96,1 % (34.2 % groin, 63.2 % high scrotal). 35.1 % had an open processus vaginalis peritonei,
15.6 % had a small, dysplastic appearing testis with testis-epididymis dissociation.
CONCLUSIONS
Our results point at a causative role of an ectopic gubernacular insertion and therefore an embryo-
logic pathogenetic background in patients with well-documented ascending testes.
14:23–14:26
S9-5 (PP)
LONG-TERM EFFECTS OF TESTICULAR TORSION
ON PATERNITY AND QUALITY OF SEX-LIFE
Eija MÄKELÄ and Seppo TASKINEN
Helsinki University Hospital, Paediatric Surgery, Helsinki, FINLAND
PURPOSE
To evaluate the long-term effects of pediatric testicular torsion on male fertility and sexual function.