THE GLIDING TESTIS - MINOR DEGREE OF TRUE UNDESCENDED TESTIS

The gliding testis is located below the external ting; it can be manip ulated to the upper scrotum but tends to ascend to its original positi on. Histologic changes can be detected in these gonads by 7 years of a ge. We evaluated 427 consecutive prepubertal boys referred for cryptor chidism. One hundred and twenty-three had classical undescended testes : 71 ectopic, 55 retractile, and 178 (mean age 6 yrs. 2 mos.) gliding testes. The gliding testes were smaller than controlaterals in 24% of boys. All gliding testes were unilateral, whereas bilaterality was 85% in the retractile group (P<0.0001), 17.5% in the undescended (P<0.001 ), and 10% in the ectopic group (P<0.01). There was a history of one o r more of the following conditions: orchidopexy (3), hormonal treatmen t (5) late testicular descent (9), spermatic cord torsion (5), testicu lar pain (10), actual retractile testes (20) or actual gliding testis (58), was present in 93 (52.2%) of the fathers of the gliding group. F orty-seven (81%) paternal gliding testes were hypotrophic. Seventy-fiv e boys with gliding testis underwent initial hormonal therapy with tra nsient benefit, and 57 were operated on. Two anatomical findings are t ypical of the gliding testis: (i) the absence of the gubernaculum, and (ii), a processus vaginalis partially patent from the upper scrotum t o the mid groin area. This latter feature explains the mobility of the gliding testis from the external ring to the upper scrotum. The absen ce of the gubernaculum may be responsible for a higher incidence of sp ermatic cord torsion in this population. The gliding testis is a disti nct entity, representing the mildest degree of a true undescended test is. As hormonal treatment gives only transient results, orchidopexy sh ould be considered before testicular damage occurs.