Institute for Maternal and Child Health IRCCS Burlo Garofolo, Department of Paediatrics, Trieste, Italy.
BMC Pediatr. 2012 Jan 10;12:4. doi: 10.1186/1471-2431-12-4.
An evidence-based Consensus on the treatment of undescended testis (UT) was recently published, recommending to perform orchidopexy between 6 and 12 months of age, or upon diagnosis and to avoid the use of hormones. In Italy, current practices on UT management are little known. Our aim was to describe the current management of UT in a cohort of Italian children in comparison with the Consensus guidelines. As management of retractile testis (RT) differs, RT cases were described separately.
Ours is a retrospective, multicenter descriptive study. An online questionnaire was filled in by 140 Italian Family Paediatricians (FP) from Associazione Culturale Pediatri (ACP), a national professional association of FP. The questionnaire requested information on all children with cryptorchidism born between 1/01/2004 and 1/01/2006. Data on 169 children were obtained. Analyses were descriptive.
Overall 24% of children were diagnosed with RT, 76% with UT. Among the latter, cryptorchidism resolved spontaneously in 10% of cases at a mean age of 21.6 months. Overall 70% of UT cases underwent orchidopexy at a mean age of 22.8 months (SD 10.8, range 1.2-56.4), 13% of whom before 1 year. The intervention was performed by a paediatric surgeon in 90% of cases, with a success rate of 91%. Orchidopexy was the first line treatment in 82% of cases, while preceded by hormonal treatment in the remaining 18%. Hormonal treatment was used as first line therapy in 23% of UT cases with a reported success rate of 25%. Overall, 13 children did not undergo any intervention (mean age at last follow up 39.6 months). We analyzed the data from the 5 Italian Regions with the largest number of children enrolled and found a statistically significant regional difference in the use of hormonal therapy, and in the use of and age at orchidopexy.
Our study showed an important delay in orchidopexy. A quarter of children with cryptorchidism was treated with hormonal therapy. In line with the Consensus guidelines, surgery was carried out by a paediatric surgeon in the majority of cases, with a high success rate.
最近发布了一份关于隐睾症（UT）治疗的循证共识，建议在 6 至 12 个月龄或诊断后进行睾丸固定术，并避免使用激素。在意大利，目前对 UT 管理的实践知之甚少。我们的目的是描述意大利儿童队列中 UT 的当前管理情况，并与共识指南进行比较。由于对回缩睾丸（RT）的管理方式不同，因此分别描述了 RT 病例。
这是一项回顾性、多中心描述性研究。意大利儿童保健医师协会（ACP）的 140 名家庭儿科医生在线填写了一份问卷。该问卷要求提供所有 2004 年 1 月 1 日至 2006 年 1 月 1 日期间出生的隐睾症儿童的数据。共获得 169 名儿童的数据。分析为描述性的。
总体而言，24%的儿童被诊断为 RT，76%的儿童被诊断为 UT。在后者中，10%的病例在平均 21.6 个月龄时自发缓解。总体而言，70%的 UT 病例在平均 22.8 个月龄（标准差 10.8，范围 1.2-56.4）时进行了睾丸固定术，其中 13%的病例在 1 岁前进行。90%的病例由小儿外科医生进行手术，成功率为 91%。在 82%的病例中，睾丸固定术是一线治疗，而在其余 18%的病例中，睾丸固定术之前先进行了激素治疗。激素治疗在 23%的 UT 病例中作为一线治疗，报告的成功率为 25%。总体而言，13 名儿童未接受任何干预（最后随访时的平均年龄为 39.6 个月）。我们分析了来自儿童人数最多的 5 个意大利地区的数据，发现激素治疗的使用、睾丸固定术的使用和年龄在统计学上存在显著的地区差异。
我们的研究显示睾丸固定术存在显著延迟。四分之一的隐睾症儿童接受了激素治疗。根据共识指南，手术由小儿外科医生在大多数病例中进行，成功率较高。
