Main Article Content
Abstract
ABSTRACT
INTRODUCTION
Undescended testis is a frequent disorder. The early diagnosis and treatment are necessary because of the risk of atrophy, infertility and cancer and the psychological impact of the absence of the testis in the scrotum. The aim of the study was to determine the factors which interfere with treatment.
PATIENTS AND METHODS
We reviewed 172 files of undescended testis that were operated from 1999 to 2011. We recorded the age at the moment of the operation, the qualification of the person who delivered, and the factors which interfered with the early management.
RESULTS
Patients were aged from 1 to 48 years (mean 8) at the moment of diagnosis. Only 21 patients were operated within normal time delay, before two years. In 93 cases, there was a lack of information from medical personnel, a fear of the operation in 42 cases, financial problems in 14 cases, and the parents’ ignorance in 7 cases.
CONCLUSION
Insufficient knowledge of caregivers and parents, fear of surgery and insufficient financial resources are the main causes of surgical delay. The medical personnel have a responsibility in the early diagnosis and treatment of the undescended testis.
RÉSUMÉ
INTRODUCTION
L’ectopie testiculaire est fréquente. Le diagnostic et la prise en charge précoces sont nécessaires à cause des risques d’atrophie, de cancérisation, de subfertilité, et les conséquences psychologiques en rapport avec l’absence d’un testicule dans une bourse. Cette prise en charge est tardive dans notre milieu. Le but de ce travail était d’étudier les facteurs interférant avec cette prise en charge.
MÉTHODOLOGIE
Nous avons revu 172 dossiers des patients opérés d’ectopie testiculaire de 1999 à 2012. Nous avons étudié l’âge au moment de l’opération, la qualification de la personne ayant assuré l’accouchement, les facteurs interférant avec la prise en charge et les résultats de cette prise en charge.
RÉSULTATS
L’âge des patients au moment de la chirurgie variait de 1 à 48 ans, avec une moyenne de 8 ans. Seuls 21 patients avaient été opérés dans les délais recommandés. L’information médicale avait été erronée ou insuffisante dans 93 cas. L’on retrouvait la peur de l’opération dans 42 cas, les problèmes financiers dans 14 cas, l’ignorance des parents dans 7 cas.
CONCLUSION
Le manque d’information des soignants ou des parents, la peur de l’opération et le manque de moyens financiers sont les principales causes de délai dans la prise en charge de l’ectopie testiculaire. Ce travail fait ressortir la responsabilité du personnel de santé dans le la prise en charge précoce de l’ectopie testiculaire.
Article Details
References
- Boggis A.R. J., Rowlatt R.J., A study of sources of delay in diagnosis and treatment of undescended testicle. J R Coll Gen Pract 1989; 34: 440-446.
- Chilvers C., Pike M.C., Forman D., Fogelman K., Wadsworth M.E.J., Apparent doubling of frequency of undescended testis in England and Wales in 1962-81, Lancet 1984; i: 330-332
- Gonzales R., Undescended testis In: Behrman RE., Kliegman RB., Nelson W., et al (eds) Nelson textbook of pediatrics, 14 th edn. Saunders, Philadelphia 1992; 1378-1379.
- Hedinger C.E., Histopathology of undescended testis. Eur J Pediatr 1982; 139: 266-271
- John Radeliffe Hospital Cryptorchidism Study Group, Cryptorchidism: an apparent substantial increase since 1960. BMJ 1986; 293: 1401-1404
- John Radeliffe Hospital Cryptorchidism group. Cryptorchidism a prospective study of 7500 consecutive male births. Archives of Disease in Childhood 1992; 67:892-899.
- KAHA S.K., Cordopexy : a new approach to the undescended testis. A review year follows up. J. Urol 1983; 129: 561.
- Kroorand R.L., Perlmuther A.D. anomalies of testis. In Behrman R. E., Vaughan V. C., eds. Nelson text book of pediatrics. Philadelphia: WB Saunders, 1983:1394
- Mieusset R., Fouda P. J.,Vaysse P., et Coll Increase in testicular temperature in case of cryptorchidism. Fertility and Sterility 1993; 59: 1319-1321.
- Pike M.C., Chilvers C., Peckham MJ. Effect of age at orchidopexy on risk of testicular cancer. Lancet 1986 ; II; 1246-1248
- Sarmah A., Late diagnosis of cryptorchidism: a failure of medical screening? Archives of Disease in Childhood 1992; 67:728-730.
- Scorer C.G., The incidence of incomplete descent testis at birth. Arch Dis Child 1964; 39: 605-609
- Sow M., Titres et travaux scientifiques Yaoundé 1989
- Swerdlow A.J., Kathryn H.W., Smith PG., A case-control study of the aetiology of cryptorchidism. J of Epidemiology and community health 1983; 37: 238 – 244.
- Takongmo S., Angwafo F., Masso P., and coll, intérêt du traitement chirurgical de la cryptorchidie à Yaoundé. Afr. Med 1996 ; 43 (4) :202-204
- Tamnhe R.L., Jarvis S. N., Waterston A.J.R., Auditing community screening for undescended testes. Arch Dis Child 1990; 65: 888-90
- Tatou Doumtsop J.G., Pathologie des bourses cez l’enfant a l’hôpital central de Yaoundé: épidémiologie, Clinique et prévention. Thèse de Doctorat en Médecine. Université de Yaoundé I : 2001
- Thon M.K., Lim C.T., Fatimah H., Undescended testis: incidence in 1002 consecutive male infants and outcome at 1 year age. Pediatr Surg Int 1988; 13: 37-41
References
Boggis A.R. J., Rowlatt R.J., A study of sources of delay in diagnosis and treatment of undescended testicle. J R Coll Gen Pract 1989; 34: 440-446.
Chilvers C., Pike M.C., Forman D., Fogelman K., Wadsworth M.E.J., Apparent doubling of frequency of undescended testis in England and Wales in 1962-81, Lancet 1984; i: 330-332
Gonzales R., Undescended testis In: Behrman RE., Kliegman RB., Nelson W., et al (eds) Nelson textbook of pediatrics, 14 th edn. Saunders, Philadelphia 1992; 1378-1379.
Hedinger C.E., Histopathology of undescended testis. Eur J Pediatr 1982; 139: 266-271
John Radeliffe Hospital Cryptorchidism Study Group, Cryptorchidism: an apparent substantial increase since 1960. BMJ 1986; 293: 1401-1404
John Radeliffe Hospital Cryptorchidism group. Cryptorchidism a prospective study of 7500 consecutive male births. Archives of Disease in Childhood 1992; 67:892-899.
KAHA S.K., Cordopexy : a new approach to the undescended testis. A review year follows up. J. Urol 1983; 129: 561.
Kroorand R.L., Perlmuther A.D. anomalies of testis. In Behrman R. E., Vaughan V. C., eds. Nelson text book of pediatrics. Philadelphia: WB Saunders, 1983:1394
Mieusset R., Fouda P. J.,Vaysse P., et Coll Increase in testicular temperature in case of cryptorchidism. Fertility and Sterility 1993; 59: 1319-1321.
Pike M.C., Chilvers C., Peckham MJ. Effect of age at orchidopexy on risk of testicular cancer. Lancet 1986 ; II; 1246-1248
Sarmah A., Late diagnosis of cryptorchidism: a failure of medical screening? Archives of Disease in Childhood 1992; 67:728-730.
Scorer C.G., The incidence of incomplete descent testis at birth. Arch Dis Child 1964; 39: 605-609
Sow M., Titres et travaux scientifiques Yaoundé 1989
Swerdlow A.J., Kathryn H.W., Smith PG., A case-control study of the aetiology of cryptorchidism. J of Epidemiology and community health 1983; 37: 238 – 244.
Takongmo S., Angwafo F., Masso P., and coll, intérêt du traitement chirurgical de la cryptorchidie à Yaoundé. Afr. Med 1996 ; 43 (4) :202-204
Tamnhe R.L., Jarvis S. N., Waterston A.J.R., Auditing community screening for undescended testes. Arch Dis Child 1990; 65: 888-90
Tatou Doumtsop J.G., Pathologie des bourses cez l’enfant a l’hôpital central de Yaoundé: épidémiologie, Clinique et prévention. Thèse de Doctorat en Médecine. Université de Yaoundé I : 2001
Thon M.K., Lim C.T., Fatimah H., Undescended testis: incidence in 1002 consecutive male infants and outcome at 1 year age. Pediatr Surg Int 1988; 13: 37-41