Sena Artur Venancio da Silva, Telles Luiza, Melo Paulo Henrique Moreira, Salomão Sarah Lopes, Uzeda Thaise Sestelo, Pereira Lima Beatriz Laus, Kratky Lauren, Mooney David P, Bustorff-Silva Joaquim
Universidade de Campinas (UNICAMP), São Paulo, Brazil.
Instituto de Educação Medica (IDOMED), Rio de Janeiro, Brazil.
J Pediatr Urol. 2025 Jul 29. doi: 10.1016/j.jpurol.2025.07.025.
Cryptorchidism refers to the extra-scrotal location of the testicle and is the most common male genital anomaly. Although the recommended age ranges for both hormonal and surgical treatments are well-established, within the Brazilian Unified Health System (SUS), children with cryptorchidism undergo surgery at varying ages across the country. As a time-sensitive procedure, delayed orchidopexy has consequences such as an increased risk of infertility or even testicular cancer. Correlating data on cryptorchidism treatment in SUS with geographic and socioeconomic indicators may help to understand how a population's profile influences the public healthcare system. This study explores the potential relationship between the age at which orchiopexy is performed and the quality of public healthcare services in Brazil while also assessing the impact of the COVID-19 pandemic on this surgery's backlog.
To achieve this, we collected data from the Department of Informatics of the Brazilian Public Health System (DATASUS) and indicators provided by the Brazilian Institute of Geography (IBGE) and the Institute for Applied Economic Research (IPEA). We cataloged and compiled the data for comprehensive analysis.
Between 2008 and 2022, 94,237 orchiopexies were performed in SUS in patients aged 0-15. Nationwide, this represents only 47.6 % of the expected procedures, ranging from 22.75 % in the North to 68.18 % in the South. The proportion of surgeries performed before age 2 was very low, ranging from 12 % in the North and Northeast to 24 % in the South. Most orchiopexies in Brazil were performed after the age of five. The COVID-19 pandemic significantly worsened this situation, causing a 44.45 % decline in surgeries in 2020 compared to 2019, disproportionately affecting all age groups and exacerbating the backlog of surgeries.
Our study indicates that many children with cryptorchidism remain undiagnosed or receive delayed treatment. The COVID-19 pandemic further worsened this scenario, temporarily reducing the number of operations. These findings underscore the urgent need for comprehensive public policies to improve healthcare access and prevent complications associated with untreated cryptorchism.
隐睾症是指睾丸位于阴囊外，是最常见的男性生殖器官异常。尽管激素治疗和手术治疗的推荐年龄范围已明确，但在巴西统一卫生系统（SUS）内，患有隐睾症的儿童在全国不同年龄接受手术。作为一种对时间敏感的手术，隐睾固定术延迟会带来诸如不孕风险增加甚至睾丸癌等后果。将SUS中隐睾症治疗数据与地理和社会经济指标相关联，可能有助于了解人群特征如何影响公共医疗系统。本研究探讨了在巴西进行隐睾固定术的年龄与公共医疗服务质量之间的潜在关系，同时评估了新冠疫情对该手术积压情况的影响。
为实现这一目标，我们收集了巴西公共卫生系统信息部（DATASUS）的数据以及巴西地理研究所（IBGE）和应用经济研究所（IPEA）提供的指标。我们对数据进行编目和整理以进行综合分析。
2008年至2022年期间，SUS对0至15岁患者进行了94237例隐睾固定术。在全国范围内，这仅占预期手术的47.6%，从北部的22.75%到南部的68.18%不等。两岁前进行手术的比例非常低，从北部和东北部的12%到南部的24%不等。巴西大多数隐睾固定术是在五岁以后进行的。新冠疫情使这种情况显著恶化，与2019年相比，2020年手术量下降了44.45%，对所有年龄组影响不均衡，加剧了手术积压。
我们的研究表明，许多患有隐睾症的儿童仍未得到诊断或接受延迟治疗。新冠疫情进一步恶化了这种情况，暂时减少了手术数量。这些发现凸显了迫切需要制定全面的公共政策，以改善医疗服务可及性并预防与未治疗的隐睾症相关的并发症。
