UNDESCENDED TESTES - EARLY VERSUS LATE MALDESCENT

A review of 468 orchidopexies was undertaken to ascertain the importan ce of a complete hernial sac extending to or beyond the testis. A hern ial sac was present in 84% (171/202) of testes in patients under 5 yea rs of age, in contrast to 23% (61/266) in patients over 5 years. It se ems reasonable to presume that the failure of the hernial sac to close is secondary to failure of normal descent, which in turn is due to an tenatal factors and may be classified as ''early maldescent''. In the older age group maldescent is due to failure of the last stage of desc ent, which should occur in the 5- to 10-year prepubertal age period (' 'late maldescent'', or the ''ascending'' testis). The cause of late ma ldescent is not due to a short processus, as this increases in length with age (approximately 0.5 cm/year), unless the persistence of the pr ocessus itself is the cause. A classification of early or late maldesc ent is suggested.