Thorup Jorgen, Cortes Dina
Department of Pediatric Surgery, Rigshospitalet, Copenhagen, Denmark.
Institute for Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Eur J Pediatr Surg. 2016 Oct;26(5):427-431. doi: 10.1055/s-0036-1592138. Epub 2016 Sep 2.
When considering long-term prognosis and results in adult age following treatment of cryptorchidism in childhood there are three main issues to be discussed: cosmetics, fertility, and malignancy. In the present review, the most recent research on the topics related to summaries of well-known knowledge on the field is presented.To some extent a smaller testis in a higher scrotal position than normal must be accepted as a fair cosmetic result after orchidopexy in childhood. The smaller testis size is related to the impaired fertility potential of the testis. In cases with atrophy, testicular prosthesis implantation is an option with good operative results. The risk of impaired fertility potential in adults treated in childhood for cryptorchidism is still significant and worst in bilateral disease. We need repetitive solid long-term follow-up data to show that orchidopexy performed within first year of life has markedly improved the fertility potential. Men previously having orchidopexy for cryptorchidism related to intra-abdominal testes, abnormal external genitalia and/or abnormal karyotype, and/or hypospadias are of special increased risk of developing testicular cancer. In these cases intratubular germ cell neoplasia may be diagnosed in prepubertal age. Early orchidopexy may lower the risk of developing testicular cancer.
在考虑儿童隐睾症治疗后成年期的长期预后和结果时，有三个主要问题需要讨论：外观、生育能力和恶性肿瘤。在本综述中，呈现了与该领域知名知识总结相关主题的最新研究。在某种程度上，儿童期睾丸固定术后阴囊位置较高但睾丸较小，必须被视为一个尚可接受的外观结果。睾丸较小与睾丸生育潜力受损有关。在睾丸萎缩的病例中，植入睾丸假体是一种手术效果良好的选择。儿童期接受治疗的成年人出现生育潜力受损的风险仍然很大，双侧患病的情况最糟。我们需要重复性的可靠长期随访数据来表明在生命的第一年内进行睾丸固定术能显著改善生育潜力。曾因腹腔内睾丸、异常外生殖器和/或异常核型以及/或尿道下裂相关的隐睾症接受睾丸固定术的男性，患睾丸癌的风险特别高。在这些病例中，青春期前可能会诊断出管内生殖细胞瘤。早期睾丸固定术可能会降低患睾丸癌的风险。
