Study Links Lower Limb Spasticity in Cerebral Palsy to Increased Risk of Orchidopexy

Key Quote

"While we are unable to definitively determine the reason for the association using this database, the associative effect is strong, and it may be related to affected muscles in the groin or the muscles attached to the testicle itself. Ultimately, it is important that for these boys, where other medical complexity is present, to make sure to continue to perform the testicle exam at check-ups to confirm that cryptorchidism isn't present."

—Eric Bortnick, MD, corresponding author, Boston Children's Hospital, Massachusetts

In a recent study published in Developmental Medicine & Child Neurology, researchers have shed light on the link between lower limb spasticity (LLS) and the risk of orchidopexy for cryptorchidism in individuals with cerebral palsy (CP).

"In this largest series to date on CP and cryptorchidism, we show a relationship between LLS and orchidopexy in the population with CP, as well as [an] association between the location and severity of LLS and the probability of orchidopexy," researchers wrote.

The study used data from the Pediatric Health Information System Database to identify 4451 males with CP, of whom 1.6% underwent orchidopexy at a median age of 7 years and 8 months.

Their findings revealed a significant association between the presence of LLS and a higher rate of orchidopexy, with an odds ratio of 1.33. Among the 7134 CP patients with LLS, those who underwent intervention had substantially higher orchidopexy rates, with odds ratios of 2.47 for injection procedures and 2.60 for surgical procedures.

The study also highlighted the significance of LLS proximity to the groin, which was also linked to a higher orchidopexy rate, with an odds ratio of 2.52.

These results support the hypothesis that cremasteric spasticity is a critical factor in cryptorchidism among individuals with CP, emphasize the importance of ongoing vigilance for cryptorchidism as individuals with CP grow older, and underscore the potential role of spasticity management in preventing this condition.

References

Bortnick EM, Logvinenko T, Wang HS, et al. Association between lower limb spasticity and cryptorchidism in males with cerebral palsy. Dev Med Child Neurol. 2023;10.1111/dmcn.15644. doi:10.1111/dmcn.15644

News Medical Life Sciences. Spasticity in the lower extremities linked to higher odds of cryptorchidism in boys with cerebral palsy. June 7, 2023. Accessed October 12, 2023.