Incidence of testicular ascent in boys with retractile testes.
OBJECTIVE
The incidence of testicular ascent of a previously descended but retractile testis is reported to be between 2% and 45%. It has been our bias that only a small percent of retractile testes ascend and ultimately require orchiopexy.


METHODS
We performed a retrospective review of all retractile testes diagnosed by any of 4 pediatric urologists at our institution from 1996 to 2005. A retractile testis was defined as one that could be brought to at least the mid scrotum without tension despite a history of maldescent or a retractile nature. Patients were excluded if followup was less than 6 months or they had a history of ipsilateral inguinal surgery. A followup telephone survey was done in patients not reexamined at resolution.


RESULTS
A total of 172 patients met our inclusion criteria and were followed to resolution. A total of 274 retractile testes were initially identified, including 26% unilateral and 74% bilateral testes. A total of 19 testes ascended and ultimately required orchiopexy within a followup of 6 to 101 months. A patent processus vaginalis was identified in 13 cases (68%). Another 235 patients initially seen with a diagnosis of retractile testis who had no followup examination at our institution were contacted via telephone. This set of boys initially had a total of 392 involved testes, of which 2 underwent orchiopexy elsewhere before resolution. The incidence of secondary ascent was 3.2% in the combined set of patients.


CONCLUSIONS
Retractile testes can ascend and, therefore, they require followup until resolution. In our experience most retractile testes do not require surgery.
Stec
Andrew A
AA
Division of Pediatric Urology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-9820, USA.
Thomas
John C
JC
DeMarco
Romano T
RT
Pope
John C
JC
Brock
John W
JW
Adams
Mark C
MC
D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000453:epidemiology* / Q000503:physiopathology*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013737:Testis / Q000503:physiopathology*