Hori Shunta, Aoki Katsuya, Nishimura Nobutaka, Morizawa Yosuke, Gotoh Daisuke, Fukui Shinji, Nakai Yasushi, Miyake Makito, Torimoto Kazumasa, Fujimoto Kiyohide
Department of Urology, Nara Medical University, Kashihara, Nara 634-8522, Japan.
Res Rep Urol. 2020 Sep 14;12:373-381. doi: 10.2147/RRU.S271869. eCollection 2020.
Cryptorchidism is one of the most common congenital abnormalities in pediatric urology, and orchiopexy is performed for the prevention of testicular damage and malignant transformation. We examined the distribution and outcomes of cryptorchidism under a single investigator at our institute.
This retrospective study included 283 boys diagnosed with cryptorchidism at our institute. Cryptorchidism was diagnosed based on the medical history and physical examination findings. Boys without spontaneous resolution after 6 months of age were indicated for orchiopexy. We investigated the 12-year trend in the distribution and outcomes of cryptorchidism at the institute.
The mean age at diagnosis, gestational age, and birth weight were 2 years, 37 weeks, and 2740 g, respectively. A total of 170 boys underwent orchiopexy under 2 years of age, and 136 boys underwent orchiopexy under the age of 1 year, while 62 boys underwent orchiopexy over the age of 3 years. Abnormalities of the epididymis and disclosure of the processus vaginalis were observed in 44 (25%) and 72 boys (41%), respectively. Comparison of boys with or without hypospadias showed that the age at orchiopexy was higher in boys with hypospadias than in those without hypospadias (P=0.028). In addition, boys without hypospadias had a higher rate of abnormality of the epidermis than those with hypospadias (P=0.024).
Our findings suggest that most boys with cryptorchidism are treated under the age of 2 years and the incidence of epididymal abnormality is relatively high, especially in boys with hypospadias. An understanding of the natural features of cryptorchidism could lead to better management and outcomes. Further research is warranted to develop an appropriate treatment timeline in boys with cryptorchidism.
隐睾症是小儿泌尿外科最常见的先天性异常之一,睾丸固定术用于预防睾丸损伤和恶变。我们在本机构由一名研究者对隐睾症的分布及治疗结果进行了研究。
这项回顾性研究纳入了在本机构诊断为隐睾症的283名男孩。隐睾症根据病史和体格检查结果进行诊断。6个月龄后未自行下降的男孩接受睾丸固定术。我们调查了本机构12年来隐睾症的分布及治疗结果趋势。
诊断时的平均年龄、孕周和出生体重分别为2岁、37周和2740克。共有170名男孩在2岁前接受了睾丸固定术,136名男孩在1岁前接受了睾丸固定术,62名男孩在3岁后接受了睾丸固定术。分别有44名(25%)和72名男孩(41%)观察到附睾异常和鞘状突未闭。比较有或无尿道下裂的男孩发现,有尿道下裂的男孩睾丸固定术的年龄高于无尿道下裂的男孩(P=0.028)。此外,无尿道下裂的男孩附睾异常发生率高于有尿道下裂的男孩(P=0.024)。
我们的研究结果表明,大多数隐睾症男孩在2岁前接受治疗,附睾异常的发生率相对较高,尤其是在有尿道下裂的男孩中。了解隐睾症的自然特征有助于更好的管理和治疗结果。有必要进一步研究制定隐睾症男孩合适的治疗时间线。