A Lawson1, M N de La Hunt. 1. Department of Paediatric Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, England.
Abstract
BACKGROUND: Cryptorchidism (CPT) is associated with gastroschisis, but the quoted incidence varies widely. The rarity of this combination of conditions has made it difficult to determine optimal clinical management. The aim of this study was to determine the incidence of CPT in gastroschisis and assess the outcome of different treatments. METHODS: Retrospective review of consecutive baby boys with gastroschisis treated during the 10-year period ending December 1997 was conducted. RESULTS: Fifty-one boys with gastroschisis were identified. Sixteen (31%) had CPT (9 left, 3 right, 4 bilateral). Ten of 20 undescended testes were extraabdominal ectopic (EAE). Of these, 2 had orchidopexy at the time of abdominal wall repair: 1 testis atrophied, and 1 is still undescended. Eight EAE testes were replaced into the abdomen at the time of repair. Of these, 3 descended to the scrotum and now are clinically normal, 3 later had orchidopexy and are clinically normal, and 2 had orchidectomy. Of the 10 testes that were CPT, but not EAE, 1 was absent, 7 descended without operative intervention, 1 had a good result after orchidopexy, and 1 was removed. CONCLUSIONS: These cases of gastroschisis had a 31% incidence of cryptorchidism. Because early conservative management led to normal descent in 10 of 17 testes, and a good result after later orchidopexy in a further 4, we recommend this treatment option.
BACKGROUND: Cryptorchidism (CPT) is associated with gastroschisis, but the quoted incidence varies widely. The rarity of this combination of conditions has made it difficult to determine optimal clinical management. The aim of this study was to determine the incidence of CPT in gastroschisis and assess the outcome of different treatments. METHODS: Retrospective review of consecutive baby boys with gastroschisis treated during the 10-year period ending December 1997 was conducted. RESULTS: Fifty-one boys with gastroschisis were identified. Sixteen (31%) had CPT (9 left, 3 right, 4 bilateral). Ten of 20 undescended testes were extraabdominal ectopic (EAE). Of these, 2 had orchidopexy at the time of abdominal wall repair: 1 testis atrophied, and 1 is still undescended. Eight EAE testes were replaced into the abdomen at the time of repair. Of these, 3 descended to the scrotum and now are clinically normal, 3 later had orchidopexy and are clinically normal, and 2 had orchidectomy. Of the 10 testes that were CPT, but not EAE, 1 was absent, 7 descended without operative intervention, 1 had a good result after orchidopexy, and 1 was removed. CONCLUSIONS: These cases of gastroschisis had a 31% incidence of cryptorchidism. Because early conservative management led to normal descent in 10 of 17 testes, and a good result after later orchidopexy in a further 4, we recommend this treatment option.