THE FATE OF UNDESCENDED TESTES IN PATIENTS WITH GASTROSCHISIS

Cryptorchidism is frequently associated with gastroschisis, yet little is published on its management in such circumstances. In a review of 10 consecutive boys with gastroschisis since 1980, 4 had undescended t estes. Gestational age and birth weight did not differ from the 6 boys with normally descended testes. The first two patients had associated arthrogryposis multiplex congenita. The first underwent bilateral orc hidopexy at 9 years of age for inguinal testes. In the second patient, the left testis was intraabdominal at the level of the sigmoid colon at birth; at 3 months of age, when a left inguinal hernia repair was r equired, left groin exploration revealed the testis at the internal ri ng and orchidopexy was performed successfully. In the third patient th e left spermatic Vessels were divided at the time of gastroschisis rep air and the testis anchored in the prebubic area. The second-stage orc hidopexy was performed at 16 months. In the last patient the intraabdo minal testis could be placed in a scrotal pouch without mobilisation o r division of the vessels. From our experience and a review of the lit erature we conclude that: 1) undescended testes are frequently associa ted with gastroschisis: 2) mechanical factors rather than prematurity are likely responsible for this association; 3) if the testis easily r eaches the scrotum, orchidopexy can be done safely at the time of gast roschisis repair; 4) if the testis does not reach easily and appears t o have a gubernaculum, it may be preferable to leave it in place since spontaneous descent can occur.