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Open Access 01-12-2020 | Zika Virus | Case report

Surgical findings in cryptorchidism in children with Zika-related microcephaly: a case series

Authors: Rômulo A. L. de Vasconcelos, Ricardo A. A. Ximenes, Adriano A. Calado, Celina M. T. Martelli, Andreia V. Gonçalves, Elizabeth B. Brickley, Thalia V. B. de Araújo, Maria A. W. Rocha, Demócrito de B. Miranda-Filho

Published in: BMC Urology | Issue 1/2020

Abstract

Background

Complications in the urinary tract related to congenital Zika syndrome have recently been reported. One complication, cryptorchidism, has been reported by the Microcephaly Epidemic Research Group/MERG, in Pernambuco/Brazil. The present article describes for the first time the surgical findings in a case series of boys with Zika-related microcephaly and cryptorchidism, who underwent surgical testicular exploration as a contribution to better understand the possible mechanisms involved in gonads formation and descent.

Methods

A total of 7 children (11 testicular units), aged 3 to 4 years, were submitted to inguinal or scrotal orchidopexy for the treatment of palpable cryptorchidism between August 2019 and January 2020. Characteristics of the gonads and its annexes related to appendixes, testis-epididymis dissociation, gubernacular insertion, and associated hydroceles and/or hernias were described. Measures in centimetres were taken for volume calculate.

Results

We found a low prevalence of testicular and epididymal appendix (66.7%), a high prevalence of testis-epididymis dissociation (55.6%), low mean testicular volume for their ages (lower for older boys) and ectopic gubernacular insertion in all cases. There was no evidence of associated hydroceles and/or hernias in any case. No surgical complication was registered or reported, and all explored gonads were properly placed in the scrotal sac.

Conclusions

We herein describe the surgical findings of these children's orchidopexies and discuss the possible mechanisms of viral action in embryogenesis and postnatal growth and development of the testes and annexes. These children need to be followed over time due to the higher risk of testicular atrophy and malignancy. Surgical timing seems to be relevant to avoid loss of testicular volume.

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Title: Surgical findings in cryptorchidism in children with Zika-related microcephaly: a case series
Authors: Rômulo A. L. de Vasconcelos
Ricardo A. A. Ximenes
Adriano A. Calado
Celina M. T. Martelli
Andreia V. Gonçalves
Elizabeth B. Brickley
Thalia V. B. de Araújo
Maria A. W. Rocha
Demócrito de B. Miranda-Filho
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Zika Virus
Orchidopexy
Published in: BMC Urology / Issue 1/2020
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/s12894-020-00721-3

At a glance: The STEP trials

Springer Medicine

Surgical findings in cryptorchidism in children with Zika-related microcephaly: a case series

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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