K T Lim1, R G Casey, F Lennon, P Gillen, M Stokes. 1. Department of General Surgery, Our Lady of Lourdes Hospital, Drogheda, Co Louth, Ireland. garyktlim@hotmail.com
Abstract
BACKGROUND: The treatment of cryptorchidism has changed, with surgery now advocated before the age of two years. Delayed treatment affects fertility, malignant potential and psychological stress. AIMS: To assess the pattern of referral of cryptorchid patients to a surgical clinic, management and follow-up. METHODS: A four-year review of 114 cryptorchid patients examined age at presentation, waiting time, timing of surgery and length of follow-up. RESULTS: The mean age at presentation to the surgical clinic was 6.7 years (neonatal to 71). The mean age at orchidopexy was 5.6 years. Seventy per cent had a surgical procedure within eight weeks of presentation to a surgeon. Seven per cent were kept under surveillance until a maximum age of three years before orchidopexy was considered. Only 29% proceeded to surgery before the age of two. Seventeen were referred to a paediatric urology unit for further management. CONCLUSIONS: Orchidopexy seems prudent between one and two years of age. Only one-quarter of patients underwent early orchidopexy. It is vital that it is detected early, by paediatricians at birth or the general practitioners (GPs) at the six-week check up. Prompt referral to a surgeon with a paediatric interest is essential in order to permit surveillance or surgery.
BACKGROUND: The treatment of cryptorchidism has changed, with surgery now advocated before the age of two years. Delayed treatment affects fertility, malignant potential and psychological stress. AIMS: To assess the pattern of referral of cryptorchid patients to a surgical clinic, management and follow-up. METHODS: A four-year review of 114 cryptorchid patients examined age at presentation, waiting time, timing of surgery and length of follow-up. RESULTS: The mean age at presentation to the surgical clinic was 6.7 years (neonatal to 71). The mean age at orchidopexy was 5.6 years. Seventy per cent had a surgical procedure within eight weeks of presentation to a surgeon. Seven per cent were kept under surveillance until a maximum age of three years before orchidopexy was considered. Only 29% proceeded to surgery before the age of two. Seventeen were referred to a paediatric urology unit for further management. CONCLUSIONS: Orchidopexy seems prudent between one and two years of age. Only one-quarter of patients underwent early orchidopexy. It is vital that it is detected early, by paediatricians at birth or the general practitioners (GPs) at the six-week check up. Prompt referral to a surgeon with a paediatric interest is essential in order to permit surveillance or surgery.
Authors: Georg Hrivatakis; Wolfgang Astfalk; Andreas Schmidt; Andreas Hartwig; Thomas Kugler; Thomas Heim; Axel Clausner; Albrecht Frunder; Harduin Weber; Steffan Loff; Joerg Fuchs; Verena Ellerkamp Journal: Dtsch Arztebl Int Date: 2014-09-26 Impact factor: 5.594