Causes of Late Diagnosis and Surgical Treatment of Abdominal Cryptorchidism in Children

Introduction. Cryptorchidism or undescended testicle is one of the most common congenital malformations in male newborns. The incidence varies and depends on gestational age: 1.0–4.6 % in full-term and 1.1–45.0 % in premature infants. Surgical treatment should be started at the age of 6 months and should be completed by 12 or 18 months. The aim of this work is to analyze the causes of late diagnosis and surgical treatment of children with abdominal cryptorchidism (AC). Materials and methods. During the period from 2020 to 2024, 699 children with cryptorchidism were treated in the Children’s City Clinical Hospital No. 9 Surgical Department No. 2. Impalpable testicle syndrome was detected in 105/699 (15 %) boys: 63/105 (60 %) — AC; 42/105 — (40 %) testicular regression syndrome. The patients were divided into 2 groups: I — boys were diagnosed with AC from birth (n = 52/63 (82.5 %)); II — AC was diagnosed at a later date, no malformation was detected at birth (n = 11/63 (17.5 %)). Results and discussion. All children with an impalpable testicle underwent ultrasound examination of the scrotum, abdominal cavity and inguinal canals to visualize the gonad. Only after this examination were indications for surgical treatment established. Only 6/52 (11.5 %) boys from group I were treated at the recommended optimal age. In the group II, not a single child aged 6–18 months was operated on. Discrepancies between ultrasound data and the intraoperative picture were detected in 25/63 (39.6 %) cases, which could lead to later surgical treatment. Conclusions. Optimization of diagnostic methods at all stages should begin with a complete objective examination of the child, including the external genitalia. Ultrasound screening of the scrotum and abdominal cavity in boys does not have absolute sensitivity, especially with non-palpable testicles.