ULTRASONOGRAPHY AND COLOR DOPPLER FLOW IN THE TESTES OF ADULT PATIENTS AFTER TREATMENT OF CRYPTORCHIDISM

Objective To analyse the prevalence of post-operative structural, pare nchymal and vascular testicular abnormalities and the incidence of epi didymal abnormalities in adult men treated for undescended testes in c hildhood. Patients and methods The testes and epididymi of 76 adult me n treated for cryptorchidism in childhood were evaluated 16 to 27 year s after treatment, using colour Doppler ultrasonography. Results The 6 1 spontaneously descended testes were significantly (P<0.01) larger (m ean [SD], 22 [8] mL) than the 90 undescended testes (13 [6] mL). The e cho pattern in all the spontaneously descended testes was normal, wher eas in 15 cases (17%) the testicular tissue was abnormal after cryptor chidism. In 12 of these 15 cases, the echo pattern was very irregular, and two other cases had microlithiasis of the testicular parenchyma, one of them bilaterally, No normal testicular artery was detected in t wo cases (3%) of normally descended testes, against 18 (20%) amongst t hose with undescended testes. Epididymal abnormalities were found in t wo (3%) of the group of normally descended testes against 32 (36%) in the undescended group. Conclusions Infertility in patients with crypto rchidism may be a result not only of primary parenchymal degenerative changes of the testis directly due to the condition, but also of opera tive vascular trauma and epididymal anomalies. Operative trauma may be more common than has generally been believed. Ultrasonography is a su itable method to evaluate postoperatively the prevalence of the testic ular abnormalities analysed in the present study.