Abstract

Introduction: Cerebral palsy (CP) is the most common cause in neurologically impaired children. Very few data on their testicular problems can be found in the literatüre. We aimed to present the incidence and etiology of undescended testis (UT) in these patients.

Material and Methods: Patients with cerebral palsy (1-15 years) treated in outpatient clinics of the pediatric surgery and pediatric neurology clinics in a four month’s period were enrolled in this study. All patients were examined neurologically and urogenitally; blood samples were collected for determination of hormon levels as follicule stimulating hormone, luteinizing hormone, free and total testosterone. Patients were divided into 2 groups according to coexistence of UT (Group 1 pts without UT, Group 2 pts with UT). Results were statistically compared.

Results: Sixty patients (Group 1 n=36, Group 2 n=24) were included in this study; mean age was 6.1 years. Majority of patients (37, 61.6%) had tetraparesia; and diparesia, hemiparesia, triparesia or dyschinesia were present in 12 (20%), 5 (8.3%), 4 (6.7%) and 2 (3.3%) patients, respectively. Five (6.9%) scrotal testicles in 3 patients were atrophic in Group 1, and there were 11 unilateral and 13 bilateral UT in Group 2. Twenty-one (56.8%) of 37 UT located in inguinal canale and 7 (18.9%) of them was located in high scrotal regions; there were 9 non-palpable testis (18.9%) in five patients in this group. Comparisons of groups’ hormone levels, testis localizations and volumes were statistically insignificant.

Conclusion: This cross-sectional study indicates that undescended testis is very common among patients with cerebral palsy with 40% incidence. Hormonal anomalies are insufficient to clarify the etiology of undescended testis. Due to high rate of spasticity, other neurological causes such as increased muscular tonus may play primary role in the etiology of undescended testis in these patients. Further studies are needed to specify this pathology.