Docimo S G, Silver R I, Cromie W
University of Pittsburgh School of Medicine, Pennsylvania, USA.
Am Fam Physician. 2000 Nov 1;62(9):2037-44, 2047-8.
Early diagnosis and management of the undescended testicle are needed to preserve fertility and improve early detection of testicular malignancy. Physical examination of the testicle can be difficult; consultation should be considered if a normal testis cannot be definitely identified. Observation is not recommended beyond one year of age because it delays treatment, lowers the rate of surgical success and probably impairs spermatogenesis. By six months of age, patients with undescended testicles should be evaluated by a pediatric urologist or other qualified subspecialist who can assist with diagnosis and treatment. Earlier referral may be warranted for bilateral nonpalpable testes in the newborn or for any child with both hypospadias and an undescended testis. Therapy for an undescended testicle should begin between six months and two years of age and may consist of hormone or surgical treatment. The success of either form of treatment depends on the position of the testicle at diagnosis. Recent improvements in surgical technique, including laparoscopic approaches to diagnosis and treatment, hold the promise of improved outcomes. While orchiopexy may not protect patients from developing testicular malignancy, the procedure allows for earlier detection through self-examination of the testicles.
隐睾的早期诊断和治疗对于保留生育能力以及提高睾丸恶性肿瘤的早期发现至关重要。睾丸的体格检查可能存在困难；如果无法明确摸到正常睾丸，应考虑咨询专家。不建议超过一岁仍进行观察，因为这会延误治疗、降低手术成功率，还可能损害精子发生。到六个月大时，隐睾患者应由小儿泌尿外科医生或其他合格的专科医生进行评估，他们能够协助诊断和治疗。对于新生儿双侧无法摸到睾丸的情况或任何患有尿道下裂和隐睾的儿童，可能需要更早转诊。隐睾的治疗应在六个月至两岁之间开始，治疗方式可能包括激素治疗或手术治疗。任何一种治疗方式的成功与否都取决于诊断时睾丸的位置。外科技术的最新进展，包括腹腔镜诊断和治疗方法，有望带来更好的治疗效果。虽然睾丸固定术可能无法使患者免受睾丸恶性肿瘤的侵害，但该手术可通过自我检查睾丸实现更早的发现。
