Testicule non descendu chez l’enfant: aspects épidémiologique, diagnostique et thérapeutique dans trois hôpitaux de référence de Douala, Cameroun

Abstract

Introduction: Undescended testis (UDT) refers to the actual absence of one or both testicles from their normal position in the scrotum. It can lead to testicular atrophy, malignancy and male infertility. Our study highlights the epidemiological, diagnostic and therapeutic aspects of UDT in 3 referral hospitals in Douala. Methods: we conducted a descriptive and retrospective study over 10 years (January 1, 2012 to December 31, 2021). We collected data from the medical records of patients aged 1 to 15 years, who underwent surgery for UDT. The sociodemographic, clinical, paraclinical and therapeutic data were collected, recorded and analyzed using CS Pro 7.3 and SPSS 23 software. Results: we reviewed 741 records, excluding 595 that were not managed during our study period, leaving 105 cases included. UDT accounted for 1.39% (741 out of 53,431 cases) of urological consultations. The average age was 6.65±3.13 years. Scrotal emptiness was the main reason for consultation (81.9%), discovered by a parent at home in 76.7% of cases (n=66). Six point seven percent of the patients (n=7) had a brother with a history of UDT and 2.8% (n=3) a father. The left testis was most commonly affected: 44.8% (n=47). The testis was palpable in the inguinal region in 91.4% of cases (n=96). The diagnosis was mainly clinical, with ultrasound performed in 14 patients (13.4%). Cryptorchidism was the most diagnosed condition: 85.7% (n=90). The average hospital stay was 1.85±0.74 days. Two surgical approaches were used: inguinal in 99 patients (94.3%) and laparoscopic in 6 patients (5.7%). Conclusion: from our study, we can conclude that UDT is a relatively uncommon condition in urological consultations, emphasizing the importance of proper diagnosis and management. Surgically, two approaches are available: the inguinal approach, which is the most commonly used, and laparoscopy, which is essential when the testicles are intra-abdominal or non-palpable in the inguinal region.