Re: re; Undescended testis
We welcome the interest in our study reviewing the epidemiology and referral patterns for boys with cryptorchidism.
We are in agreement with Dr Hadziselimovic that the retractile testis is often misdiagnosed as undescended testis. However, we do not share his experience that over half of patients 'sent' for treatment meet the criteria for retractile testis. In our study, only 5% of boys had retractile testis. In addition, when comparing congenital with acquired testis, we only included those who had documented scrotal findings from the neonatal period. Our study does not attempt to draw conclusions about the 'results'of 'treatment', merely to evaluate trends of referral and management in relation to current recommended practice (References 4,5,6 in main article). We do not routinely offer surgery for retractile testes, but continue to follow them up as many later ascend resulting in acquired cryptorchidism( Agarwal)
We note the reservations of Dr Hadziselimovic regarding the impact of orchidopexy on fertility, and indeed share them, as stated in our paper. Although the final two statements in Dr Hadziselimovic's letter appear to directly contradict each other, we certainly acknowledge that orchidopexy at an early age may not prevent infertility and studies with much longer follow-up are required. Again, this is beyond the scope of our study.
Additional Reference Agarwal PK, Diaz M, Elder JS. Retractile testis--is it really a normal variant? J Urol. 2006 Apr;175(4):1496-9.
Conflict of Interest: