Clinical classification for undescended testes: experience in 1,010 orchidopexies

A clinical classification for undescended testes based on location, size, and mobility of the testis in the inguinal canal was performed. The latter was artificially divided into three sections. The lower portion was considered position I; the mid part, position II; the upper part, position III; and the abdominal (nonpalpable) part, position IV). Normal-size testes were considered as being size A; testes reduced up to 30% in volume, size B; and gonads reduced more than 30% of the estimated normal, size C. According to these criteria, a case of chryptorchidism can then be classified as I, II, III, or IV and A, B, or C and fixed or movable. This classification was used in 1,010 orchidopexies conducted under a uniform surgical technique by the same surgeon and followed annually up to a maximum of 23 years. Retractile testes were excluded from this series. In most cases, the clinical diagnosis matched the surgical findings. Results are presented in two groups, unilateral and bilateral, since the main problem for the latter is fertility, and they should be considered separately in any study. For both groups, the most frequent finding was the normal-sized testis (size A), in location I. For positions II and III, size B was the most common; and in position IV (intraabdominal), size C had a substantially higher incidence. Surgical technique was simpler and the outcome better, as expected, when the testicles were of good size, located in a low position, and operated at an early age. A worthwhile finding was the long-term cosmetic improvement in an important percentage of the surgically descended B-sized testes.(ABSTRACT TRUNCATED AT 250 WORDS)