[Acquired undescended testes: treatment and consequences for future fertility].

1-3% of boys develop an acquired undescended testes (UDT), meaning that the testes cannot be returned into the scrotum after previously having been located in a stable scrotal position. Fertility issues for patients with acquired UDT are comparable to those for patients with congenital UDT. Hypothetically speaking, patients with acquired UDT are at lower risk of testicular cancer than patients with congenital UDT.

Sperm DNA damage measured by sperm chromatin structure assay in men with a history of undescended testes.

The aim of this study was to compare sperm DNA damage between men with a history of congenital undescended testis (UDT) and men with a history of acquired UDT. A long-term follow-up study of men with previous UDT was performed. Fifty men with congenital UDT who had undergone orchiopexy at childhood age, 49 men with acquired UDT after a 'wait-and-see'-protocol (e.

INSL3 and AMH in patients with previously congenital or acquired undescended testes.

Background: In previous reports no differences in Leydig and Sertoli cell function were found between congenital undescended testis (CUDT) and acquired UDT (AUDT) on the basis of serum levels of LH, testosterone, FSH or inhibin B. This study tried to detect differences in Leydig and Sertoli cell function between CUDT and AUDT using insulin-like peptide 3 (INSL3) and anti-Müllerian hormone (AMH).

Method: 118 men with a history of UDT (CUDT N=55 (6/55 bilateral), AUDT N=63 (15/63 bilateral)) were investigated.

Scrotal ultrasound findings in previously congenital and acquired unilateral undescended testes and their contralateral normally descended testis.

The aim of this study was to report on different anomalies found by physical examination and scrotal ultrasound in men with previously unilateral congenital undescended testes (UDT; N = 50), acquired UDT (N = 49), their contralateral normally descended testis (CNDT) and control testes (N = 53). Acquired UDT significantly more often had a testicular volume being <15 mL than congenital UDT (88% vs. 68%).

Acquired undescended testes and fertility potential: is orchiopexy at diagnosis better than awaiting spontaneous descent?

The aim of this study was to evaluate testicular function in men with previous acquired undescended testis (UDT) in whom orchiopexy was performed at diagnosis compared with a similar group of men in whom spontaneous descent was awaited until puberty. Secondly, we examined the influence of age at orchiopexy on fertility parameters in adult life. A total of 169 men of the 'orchiopexy at diagnosis' group and 207 men of the 'wait and see' protocol group were invited for participation.

Ethical aspects of care in the newborn surgical patient.

This article places focus on three main subjects that are all related to the ethical aspects of care of newborns undergoing major surgical interventions. The first concerns the communication between the surgeon, as a representative of the treatment team, and the parents. The second is the way to handle new developments in neonatal surgery.

Fertility potential in a cohort of 65 men with previously acquired undescended testes.

Purpose: To evaluate testicular function in men with previously acquired undescended testes (AUDT) in whom spontaneous descent was awaited until puberty followed by orchiopexy in case of nondescent.

Methods: Andrological evaluation including paternity, scrotal ultrasound, reproductive hormones, and semen analysis was performed in three groups: men with AUDT, healthy controls, and men with previously congenital undescended testes (CUDT).

Results: In comparison with controls, men with AUDT more often had significantly abnormal testicular consistency, smaller testes, lower sperm concentration, and less motile sperm.

Fertility potential in men with a history of congenital undescended testes: a long-term follow-up study.

Men with a history of congenital undescended testes (UDT) have an increased risk of fertility problems. Despite no definitive proof, current guidelines recommend early surgical intervention because this may have a positive effect on future fertility potential by preventing degenerative changes of the testes in early life. Also surgical intervention facilitates observability of the testes in view of possible malignancy.

Different surgical findings in congenital and acquired undescended testes.

Objective: To compare surgical findings in congenital and acquired undescended testes (UDT).

Patients And Methods: A review of 139 boys with 158 congenital UDT and 69 boys with 84 acquired UDT was performed. The most caudal testicular position preoperatively, testis position at surgery, patency of the processus vaginalis and epididymal anomalies were prospectively recorded.

Surgical findings in acquired undescended testis: an explanation for pubertal descent or non-descent?

Aim: Surgical findings were studied to find an explanation for the phenomenon that some acquired undescended testes (UDT) descend spontaneously whereas others need orchiopexy.

Methods: In patients with acquired UDT spontaneous descent was awaited until at least Tanner stage P2G2. Orchiopexy was performed when a stable scrotal position had not been achieved by the end of follow-up.

Interdisciplinary structural follow-up of surgical newborns: a prospective evaluation.

Background: Information on physical and developmental outcomes of children with anatomical congenital anomalies (CAs) may indicate the need for early intervention and reduce impact on the child's life and parental burden.

Methods: From 1999 to 2003, 101 children with CA (76.5% of initial survivors) were seen 6-monthly in a tertiary children's hospital.

Testicular germ cell tumors in children: management and outcome in a series of 20 patients.

Testicular germ cell tumors occurring during childhood are extremely rare. This study reports the clinical presentation, pathological diagnosis, treatment methods and outcome in a series of 20 boys, aged between 3.5 months and 16 years (median: 1.

Late presentation of gastric tube ulcer perforation after oesophageal atresia repair.

Ulcer formation in intrathoracic grafts after oesophageal replacement is considered an infrequent complication of the procedure. We present a rare case of a gastric tube ulcer with perforation, more than 30 years after gastric tube interposition for oesophageal atresia.

Total esophagogastric dissociation in adult neurologically impaired patients with severe gastroesophageal reflux: an alternative approach.

Patients with neuromuscular impairment, such as cerebral palsy or myotonic dystrophy, often suffer from oropharyngeal neuromuscular incoordination and severe gastresophageal reflux (GER). In 1997, Bianchi proposed total esophagogastric dissociation (TEGD) as an alternative to fundoplication and gastrostomy to eliminate totally the risk of recurrence of GER in neurologically impaired children. Little information exists about the best management for adult patients with severe neurological impairment in whom recurrent GER develops after failed fundoplication.

Influence of tumor site and histology on long-term survival in 193 children with extracranial germ cell tumors.

Aims: Although germ cell tumors (GCT) supposedly share the same cell type of origin, their clinical course differs considerably depending on tumor site and histology. The aim of this work was to study long-term survival stratified for tumor site and tumor histology.

Materials And Methods: The medical records of 193 consecutive infants and children with extracranial GCT were studied.

Cost-effectiveness of neonatal surgery: first greeted with scepticism, now increasingly accepted.

Mortality rates in neonatal surgery have dropped markedly, illustrating the enormous progress made. Yet, new questions have arisen. To mention one, health care budgets have tightened.

Further evidence for spontaneous descent of acquired undescended testes.

Purpose: It is still controversial whether acquired undescended testis can best be managed by orchiopexy or by the wait and see method. We prospectively evaluated spontaneous descent of acquired undescended testes and possible predictive factors in prepubertal boys.

Materials And Methods: From 1982 to 2004 spontaneous descent was awaited until at least Tanner stage P2G2 in 109 boys with a total of 83 unilateral and 52 bilateral acquired undescended testes.

Nonpalpable testes: is there a relationship between ultrasonographic and operative findings?

Background: Ultrasonography (US) as a diagnostic tool in the work-up of boys with nonpalpable testes (NPT) is still controversial.

Objective: To evaluate the relation between US and operative findings in boys with NPT.

Materials And Methods: During a 7-year period we saw 135 boys with 152 NPT.

Mediastinal germ cell tumors: clinical aspects and outcomes in 7 children.

Background: Mediastinal germ cell tumors presenting during childhood are extremely rare. Publications on this entity are very scarce. This paper reports on the clinical presentations, method(s) of treatment, complications, results and outcomes in a series of children with mediastinal germ cell tumors.

Can pyloromyotomy for infantile hypertrophic pyloric stenosis be performed in any hospital? Results from two teaching hospitals.

In order to document the incidence of perioperative complications in patients with infantile hypertrophic pyloric stenosis, a descriptive cohort study was performed in two teaching hospitals in the Netherlands. One hospital specialized in pediatric surgery and the other was a general surgery teaching hospital. All consecutive infants who underwent pyloromyotomy for the diagnosis hypertrophic pyloric stenosis in both hospitals between 1998 and 2002 were included.

Study of the factors associated with recurrence in children with sacrococcygeal teratoma.

Purpose: The aim of this study was to explore effects of (1) histological involvement of resection margins with microscopic residue, (2) incomplete removal of coccyx, and (3) tumor spillage on recurrence and on survival in children operated upon for sacrococcygeal teratoma (SCT).

Methods: Retrospective review of 70 patients treated between 1960 and 2003.

Results: Fifty-four girls and 16 boys presented with SCT diagnosed prenatally (12), at birth (37), or later (21).

Ovarian germ cell tumors in children: a clinical study of 66 patients.

Background: Ovarian germ cell tumors are rare in childhood. The aim of this study is to review clinical presentation, management, and outcome in a two-center series of girls with ovarian germ cell tumor.

Procedure: The records of 66 patients (median age 9 years) with histologically proven ovarian germ cell tumor (either benign or malignant), treated over a 44-year-span, were reviewed.

Retroperitoneal germ cell tumors: a clinical study of 12 patients.

Purpose: The aim of the study was to examine the clinical presentation, method(s) of treatment, complications, and results in newborns and infants with retroperitoneal germ cell tumors (GCTs).

Methods: A retrospective chart review of all patients treated between 1974 and 2002 for GCT located in the retroperitoneum in 2 institutions identified 12 patients with histologically proven retroperitoneal GCT. Vital data concerning pregnancy and delivery were analyzed.

Success with hydrostatic reduction of intussusception in relation to duration of symptoms.

Background: It is widely believed that hydrostatic reduction of intussusception is less successful in children with prolonged symptoms prior to presentation.

Aim: To prospectively evaluate success in relation to duration of symptoms.

Methods: Prospective study in which children, regardless of symptom duration, underwent an attempt at hydrostatic reduction.