Spasticity Key to Undescended Testicles in Cerebral Palsy
The presence and severity of lower limb spasticity (LLS) is associated with orchidopexy for cryptorchidism among boys with cerebral palsy (CP).
The study used 2016-2020 information from the Pediatric Health Information System (PHIS), an administrative database that includes more than 49 children’s hospitals.
The authors stratified study participants by whether they had, or didn’t have, LLS, and by spasticity location, and compared the occurrence of orchidopexy for cryptorchidism using diagnostic and surgical codes.
The study included 44,561 males with CP. Of these individuals 1.6% underwent orchidopexy at a median age of 7 years 8 months.
Presence of LLS was significantly associated with higher incidence of orchidopexy for cryptorchidism compared with no limb spasticity (odds ratio [OR] 1.33; 95% CI, 1.10 – 1.59; P = .003)
Upper limb spasticity was not associated with orchidopexy risk compared with no limb spasticity (OR, 0.51; 95% CI, 0.16 – 1.19; P = .177)
Need for intervention for LLS, which indicates severity, was significantly associated with higher rate of orchidopexy (injection procedures vs none: OR, 2.47; 95% CI, 2.27 – 6.39; P = .034; limb surgery vs none: OR, 2.60; 95% CI, 1.22 – 6.76; P = .026)
“These findings support a hypothesis that cremaster muscle spasticity could be an important factor of UDT in CP” the authors write, adding that given the potential for secondary ascent of testes in this population, “providers should continue to examine for cryptorchidism in males with CP as they age, particularly those with more severe LLS.”
The study was conducted by experts in the Departments of Urology and Orthopedics at Boston Children’s Hospital and at the Spaulding Rehabilitation Hospital, Boston, Massachusetts. It was published online today in Developmental Medicine & Child Neurology.
The study was retrospective. The PHIS database doesn’t include all hospitals where patients may seek care, so may be prone to missing data, and there could be inaccuracies related to misclassification from coding errors.
The investigators list no relevant financial relationships.
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