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Cryptorchidism in boys with congenital abdominal wall defects
A Koivusalo1, S Taskinen, R J Rintala
1Children's Hospital, University of Helsinki, Finland.
Insights
Cryptorchidism (undescended testes) is common in boys with omphalocele, often linked to midline defects. In gastroschisis, it
Area of Science:
- Pediatric Surgery
- Developmental Biology
- Neonatology
Background:
- Cryptorchidism (CPT) is frequently observed in boys with congenital abdominal wall defects (CAWD).
- Hypotheses suggest low intra-abdominal pressure and brain malformations contribute to CPT in omphalocele (OMP) and gastroschisis (GS).
Purpose of the Study:
- To determine the incidence of CPT in boys with OMP and GS.
- To assess the relationship between CPT and abdominal wall defect (AWD) size, prematurity, and other anomalies.
Main Methods:
- Retrospective review of hospital records and autopsy reports.
- Analysis of 113 boys with CAWD (75 OMP, 38 GS).
Main Results:
- 16.0% of OMP patients had CPT, significantly higher than healthy children; bilateral CPT occurred in 41.0% of these cases.
- CPT in OMP was associated with congenital cardiac anomalies and cleft lip/palate (P < 0.05).
- 5.0% of GS patients had unilateral CPT, possibly related to prematurity.
Conclusions:
- CPT incidence is significantly elevated in OMP, correlating with midline defects.
- CPT in GS is less common and may be linked to prematurity.
- AWD management strategies may need to consider associated CPT risks.
Abstract:
Cryptorchidism (CPT) has been suggested to be common in boys with congenital abdominal wall defects (CAWD). It has been hypothesized that the low intra-abdominal pressure in both omphalocele (OMP) and gastroschisis (GS) and brain malformations in patients with OMP contribute to the high incidence of CPT. To determine the incidence of CPT in boys with OMP and GS and to assess the relationship of CPT to the size of the AWD, prematurity, and concomitant anomalies, the hospital records and autopsy reports of 113 boys with CAWD (OMP n = 75; GS n = 38) were reviewed. Twelve (16.0%) boys with OMP had undescended testes; 5 (41.0%) of those had bilateral and 4 (23.5%) intraabdominal undescended testes. The occurrence of CPT in OMP patients did not correlate with the size of the AWD, birth weight, or gestational age. However, congenital cardiac anomalies and cleft lip and palate were significantly more common (P < 0.05) among those with CPT. Two (5.0%) boys with GS, both of whom were born prematurely, had unilateral CPT. In patients with OMP, the incidence of CPT was significantly higher than that of healthy children. There was a correlation between CPT and congenital midline defects such as cardiac anomalies and cleft lip and palate. In patients with GS, the incidence of CPT only slightly exceeded that of normal children and may have been related to prematurity.