Stein R, Reschke F, Ludwikowski B
Zentrum für Kinder‑, Jugend- und rekonstruktive Urologie, Medizinische Fakultät Mannheim, Universitätsklinikum Mannheim GmbH, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Anstalt des öffentlichen Rechts des Freistaates Sachsen, Dresden, Deutschland.
Urologe A. 2020 Mar;59(3):300-306. doi: 10.1007/s00120-020-01129-5.
It has been known for more than 20 years that early treatment of maldescended testicles can have a positive effect on fertility and a negative effect on the development of tumors. In certain circumstances, hormone therapy is still recommended in German-speaking countries. However, its benefit is still controversially discussed. Therapy is usually initiated by the pediatrician, who is usually the first to detect undescended testicles. Since therapy may involve early hormone therapy as well as surgery, acceptance among pediatricians and also the parents may be reduced. The question also arises as to how far the implementation is practicable. In patients with nonpalpable testis, there are many controversies concerning the value of ultrasound investigations. In the following two case studies, the treatment decisions for undescended testes in infancy are exemplified. Furthermore, the available evidence from the literature and guidelines is presented to provide assistance for daily routine care and to critically discuss potential fields of application and limitations of existing guidelines.
20多年来,人们已经知道,对隐睾进行早期治疗对生育能力有积极影响,对肿瘤的发展有消极影响。在某些情况下,德语国家仍推荐激素治疗。然而,其益处仍存在争议。治疗通常由儿科医生发起,儿科医生通常是最早发现隐睾的人。由于治疗可能涉及早期激素治疗以及手术,儿科医生和家长的接受度可能会降低。实施的可行性也存在疑问。在无法触及睾丸的患者中,关于超声检查的价值存在许多争议。在以下两个案例研究中,举例说明了婴儿期隐睾的治疗决策。此外,还介绍了文献和指南中的现有证据,以协助日常护理,并批判性地讨论现有指南的潜在应用领域和局限性。