Epididymal anomalies in boys with undescended testis or hydrocele: Significance of testicular location.

BACKGROUND: Epididymal anomalies and patent processus vaginalis are frequently found in boys with cryptorchidism or hydrocele. We conducted this study to evaluate the association between epididymal anomalies and testicular location or patent processus vaginalis in boys with undescended testis or hydrocele. METHODS: Children undergoing surgery with undescended testis (group A, 136 boys and 162 testes) or communicating hydrocele (group B, 93 boys and 96 testes) were included. Testicular locations and epididymal anomalies were investigated prospectively. An anomalous epididymis was defined as anomalies of epididymal fusion that consisted of loss of continuity between the testis, the epididymis, and the long looping epididymis. The epididymis was considered normal when a normal, firm attachment between the testis, the caput, and the cauda epididymis was present. RESULTS: The mean ages of groups A and B were 24.6 ± 19.7 (range, 8-52 months) and 31.4 ± 20.6 months (range, 10-59 months). The incidence of epididymal anomalies was significantly higher in group A than that in group B (65.4 % vs. 13.5 %, P < .001). The incidence of epididymal anomalies in boys with undescended testis was significantly different according to testis location. Epididymal anomalies were observed in 100 %, 91.4 %, and 39.3 % of cases when the testis was located in the abdomen, inguinal canal, and distal to the external inguinal ring, respectively (P < 0.001). CONCLUSION: We conclude that epididymal anomalies were more frequent in boys with undescended testis than in boys with hydrocele, and that these anomalies were more frequent when undescended testis was at a higher level. These results suggest that testicular location is associated with epididymal anomalies rather than patent processus vaginalis.

The prognosis of patients less than 40 years with bladder cancer.

AIMS: Natural history of young patients with bladder cancer has not yet been known. So this study aimed to understand characteristics and prognosis of patients less than 40 years with bladder cancer. MATERIALS AND METHODS: We retrospectively analyzed 42 patients (group 1) less than 40 years with bladder cancer followed up for 6 months at least from October 1998 to January 2010. As controlled group (group 2) consisted 44 patients of 60 years or more who had same condition as above mentioned from January to December 2009 was set. Tumor size and number, pathological results, urine cytology results and recurrence rate were reviewed. RESULTS: The mean ages and the gender distribution in the two groups showed no difference. Tumor size (P = 0.021) and number (P = 0.016) in group 1 was smaller than control. The proportion of muscle invasive type was not significant, but pTa in group 1 was occupied larger portion than group 2 (P = 0.01). Group 1 had more low grade cancer (P = 0.013), and lower recurrence rate (7.1%) than group 2 (38.6%) (P = 0.001). In addition, the mean recurrence free duration of group 1 and 2 were 37.7 ± 6.3 and 9.9 ± 2.5 months, respectively. Group 1 showed later relapse than group 2 (P = 0.002). No progression in stage at recurrence was in group 1, but 1 case had progression in group 2. In grade, 1 case was worsen in group 1 and 3 cases were worsen in group 2.