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The Epidemiology of Congenital Cryptorchidism, Testicular Ascent and Orchiopexy

2003; Lippincott Williams & Wilkins; Volume: 170; Issue: 6 Linguagem: Inglês

10.1097/01.ju.0000095793.04232.d8

1527-3792

Julia Spencer Barthold, Ricardo González,

Sperm and Testicular Function

No AccessJournal of UrologyPEDIATRIC UROLOGY: Review Article1 Dec 2003The Epidemiology of Congenital Cryptorchidism, Testicular Ascent and Orchiopexy JULIA SPENCER BARTHOLD and RICARDO GONZÁLEZ JULIA SPENCER BARTHOLDJULIA SPENCER BARTHOLD More articles by this author and RICARDO GONZÁLEZRICARDO GONZÁLEZ More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000095793.04232.d8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The frequency, significance and possible etiology of testicular ascent (acquired cryptorchidism) are characterized in light of the known incidence and natural history of congenital cryptorchidism, and data provided by longitudinal and epidemiological studies of ascended testes and orchiopexy rates. Materials and Methods: We comprehensively reviewed the literature addressing the epidemiology of congenital and acquired cryptorchidism and orchiopexy. Results: The incidence of congenital cryptorchidism in full-term males at birth (2% to 4%) and at age 1 year (approximately 1%) has not increased in the last few decades. The risk of ascent may be as high as 50% in cases where 1 testis is significantly retractile. Ascended testes are typically unilateral (77%), identified in mid childhood and located distal to the inguinal canal (77%). Ascended and significantly retractile testes may be prone to the same germ cell maldevelopment seen in congenital cryptorchidism. Cumulative orchiopexy rates in defined populations are 2% to 4%, and mean age at orchiopexy remains higher than expected (greater than 4 years), despite a long held standard of care that includes recommendation for surgery by age 2. These data suggest that cryptorchidism may be acquired in a significant subset of cases. Conclusions: With close monitoring of young boys spontaneous ascent of testes from a scrotal to a suprascrotal position may be observed with time, due to either true or apparent testicular ascent, with possible adverse effects on germ cell development and fertility potential. Patients with significant testicular retractility appear to be at highest risk for acquired cryptorchidism, and should be followed closely at yearly intervals until puberty. References 1 : The descent of the testis. Arch Dis Child1964; 39: 605. Google Scholar 2 : Incidence of testicular pathology. Bull US Army Med Dept1946; 5: 312. Google Scholar 3 : Apparent doubling of frequency of undescended testis in England and Wales in 1962–81. Lancet1984; 2: 330. Google Scholar 4 : Undescended testis—the need for a standard classification. Br J Urol1992; 70: 1. Google Scholar 5 : Nomenclature of cryptorchidism. Eur J Pediatr1993; 152: S17. 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Volume 170Issue 6December 2003Page: 2396-2401 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordstestis/abnormalitiestestis/surgerycryptorchidism/epidemiologyMetricsAuthor Information JULIA SPENCER BARTHOLD More articles by this author RICARDO GONZÁLEZ More articles by this author Expand All Advertisement PDF downloadLoading ...