Epididymal anomalies associated with hydrocele/hernia and cryptorchidism: implications regarding testicular descent.
Controversy exists regarding the role of the epididymis in testicular descent, as epididymal abnormalities have been reported in 36 to 79% of boys with an undescended testis. Although most undescended testes are associated with a patent processus vaginalis, the incidence of epididymal abnormalities in descended testes with a patent processus has not been reported. Epididymal morphology was examined in 81 boys with a hydrocele/hernia without cryptorchidism (90 testes) and 100 children undergoing orchiopexy (115 testes). Boys with an intra-abdominal undescended testis were excluded. Among 48 boys with a hydrocele/hernia 24 (50%) had an epididymal abnormality if the processus was patent and communicated with the testis (complete hernia), compared to 4 of 42 patients (10%) if there was not a communication with the testis (p less than 0.01). Among the 96 children with an undescended testis 68 (71%) had an epididymal abnormality if there was a patent processus, compared to 3 of 19 boys (16%) without a patent processus (p less than 0.01). These data suggest that most epididymal abnormalities probably do not contribute to testicular maldescent.
Department of Urology, Rainbow Babies and Childrens Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio.
J S
JS
Elder
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000150:complications* / Q000473:pathology; D004822:Epididymis / Q000002:abnormalities*; D006552:Hernia, Inguinal / Q000150:complications* / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D006848:Testicular Hydrocele / Q000150:complications* / Q000473:pathology