Objective: Cryptorchidism is a common congenital genito-urological anomali in males with increased risk of infertility and testicular cancer. In this retrospective study the results of operations for undescended testis at Landspitalinn University Hospital were reviewed with special emphasis on patients diagnosed with testicular cancer later in life.
Material and methods: The study includes 593 males with undescended testis who were operated on between 1970 and 1993. Information was gathered from hospital records, including birth-weight, age at diagnosis and operation, localization of the testes and complications to surgery. Information on patients diagnosed with testicular cancer was aquired from the Icelandic Cancer Registry.
Results: The average birth-weight was 3461 g, including 58 boys (10%) with low birth-weight (</=2500 g). Age at diagnosis was 3.0 year (range 0-14 year) and at operation 7.5 year (range 0-51 year). The undescended testis was more common on the right side (61%) (p<0.01) and 18% had bilateral undescended testis. In 50% of the cases the testis was located in the inguinal canal, intra-abdominal in 10% and 34% were ectopic. Complications to surgery was seen in 29 patients (5%), with hematoma (2.7%) and wound infection (1.2%) as the most common ones. Majority (52%) of the boys had inguinal hernia. Out of 593 males in this study, two have been diagnosed with testicular cancer (mean follow-up time 23 years), both with embryonal carcinoma, 13 and 14 years efter surgery (0.3%).
Conclusion: The surgical results are good in this study with a low complication-rate. Age at diagnosis is still high (3.0 year) but is decreasing. Age at operation is even higher (7.5 year) underscoring a significant delay in treatment, but only 5.4% of patients were operated on before the age of two as international guidelines recommend. In our cohort the frequency of testicular cancer was only 0.3% which is very low. Informations about infertility was not available in this study.