CryptorchidismOptimal Cutoff Value of Contralateral Testicular Size for Prediction of Absent Testis in Japanese Boys With Nonpalpable Testis
Section snippets
Material and Methods
From December 2003 to November 2009, we evaluated 55 Japanese boys <60 months old with a unilateral nonpalpable testis at a single institution. The age of the 55 boys was 8-46 months old (mean 19.4) at surgery. A nonpalpable testis was found on the left side in 43 boys. None had previously received human chorionic gonadotropin therapy.
The testis was found in 22 (40%) of the 55 boys at surgery. Nineteen testes were intra-abdominal undescended testes, including 3 “peeping” testes, and 3 testes
Results
The distribution of the contralateral testicular size in each group is listed in Table 1. In groups 1 and 3, 21 (95.5%) of 22 testes and 40 (100%) of 40 testes were ≤20 mm, respectively. In contrast, 27 (81.8%) of 33 testes were >20 mm in group 2.
The mean size of the contralateral testes is listed in Table 2. The contralateral testicular size in group 2 was 22.4 ± 2.6 mm or 2.20 ± 0.75 cm3 and was significantly larger than that of group 1 (16.6 ± 2.8 mm or 1.10 ± 0.39 cm3) and group 3 (16.6 ±
Comment
In the present study, we investigated the accuracy of contralateral testicular hypertrophy in Japanese boys with a nonpalpable testis. We determined the optimal cutoff value to predict the presence or absence of a nonpalpable testis.
To determine whether a nonpalpable testis is present or absent, physical examination, as well as, sometimes, diagnostic imaging such as ultrasonography and magnetic resonance imaging, is used. Although the diagnostic accuracy of these imaging studies has been
Conclusions
Our data have shown that contralateral testicular hypertrophy in boys who have a nonpalpable testis strongly indicates an absent testis in Japanese boys. The optimal cutoff value for contralateral testicular hypertrophy with calipers was 21 mm or 1.6 cm3. These results have provided valuable information for preoperative counseling and treatment planning for a nonpalpable testis.
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Cited by (25)
Undescended testis: A roundtable discussion based on clinical scenarios – Part 1
2024, Journal of Pediatric UrologyTesticular hypertrophy as predictor of contralateral nonpalpable testis among Chinese boys: An 18-year retrospective study
2020, Archives de PediatrieCitation Excerpt :In 1991, Koff reported that the degree of contralateral enlargement correlated with the nonpalpable testicular volume and that the optimal cutoff value for predicting a nonviable testis was 2 mL in volume and 20.0 mm in length [13]. Hurwitz et al. in 2001 and Snodgrass et al. in 2007 proposed 18 mm in length, while Braga proposed 19–20 mm and Yasuhiro Shibata proposed 21 mm based on sensitivity and specificity analysis [4,8–10]. In 2014, Hodhod demonstrated that an optimal cutoff value for significant enlargement was considered to be 2 mL [7].
Detection of monorchidism in boys with unilateral undescended testes: clinical benefits and limitations of contralateral testicular size
2020, Journal of Pediatric UrologyCitation Excerpt :In addition, the optimal cut-off value of contralateral testicular length and volume varied in previous reports. Cut-off value of testicular length ranged from 15.1 to 21.0 mm, whereas testicular volume from 0.54 to 2 ml [2–10]. In fact, inconsistency between promising predictive accuracy and huge differences among cut-off values has led to the study authors’ suspicion of its validity in prediction of monorchidism.
Nonpalpable testes: Ultrasound and contralateral testicular hypertrophy predict the surgical access, avoiding unnecessary laparoscopy
2018, Journal of Pediatric UrologyCitation Excerpt :Physical examination as a way of predicting surgical access in NPT is vague and was not regarded as appropriate in previous studies [7]. Published cut-off values for contralateral testis hypertrophy range from 15 to 20 mm [4,6,18], herein, we used a ≥17 mm cut-off. Contralateral hypertrophy as an isolated parameter proved not to be as sensitive as in other published series, because palpable nubbins were not included in this study.
The nonpalpable testis: A narrative review
2017, Journal of UrologyCitation Excerpt :Therefore, a solitary hypertrophic testis could potentially predict monorchidism. Many authors have evaluated this possible association in prepubertal males using various cutoffs in testicular size (table 1).6,16–18 Since perinatal torsion affects the left testis twice as often as the right, Belman and Rushton specifically evaluated 22 boys with a left NPT.6