Clinical and Pathological Features of Ascending Testis

BACKGROUND: The clinical features and principles of surgery of the Ascending Testis (AT), in which the testis ascends from the scrotum with age, are controversial. We selected AT that met the treatment guidelines and examined the clinical features and principles of surgery. METHODS: We retrospectively reviewed the medical charts of 12 AT and 530 Congenital Undescended Testis (CUDT) patients to investigate the statistics of AT among all CUDT, the side of the maldescent, the associated disorders, and the clinical course. The patients were compared in terms of testicular volume (TV), mean tubular diameter (MTD), and testicular fertility index (TFI) between the AT group and the CUDT group. RESULTS: AT was observed in 2.2% of all CUDT patients: 10 had left AT and 2 had bilateral AT. Among the 12 AT patients, 8 patients had associated disorders. The TV, MTD, and TFI of 7 AT and 7 CUDT were 0.74 +/- 0.20 and 0.77 +/- 0.59 cm3, 38.7 +/- 3.7 and 35.9 +/- 9.1 microm, and 0.19 +/- 0.07 and 0.11 +/- 0.11, respectively. CONCLUSIONS: In order to examine the clinical features of AT, it is essential to strictly rule out CUDT and retractile testis. In our study, the clinical features are that AT is a rare disorder, occurs more frequently on the left side, and many patients with AT have associated disorders. Since AT causes histological damage equivalent to that caused by CUDT, we should perform orchidopexy for patients with AT immediately after diagnosis.