Individualized Treatment Guidelines for Postpubertal Cryptorchidism

Chung, Jong Shik

doi:10.5534/wjmh.2015.33.3.161

Cited by 16 publications

(15 citation statements)

References 28 publications

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“…Even though the testicular volume increased as increasing age, the stiffness was not correlated with age in the CGN group. Previous studies also demonstrated that the UDTs could affect contralateral descended testes, causing pathological changes and increased risk of malignancy than normal testes [27,28]. Our results support the difference of the contralateral descended testes showing lack of normal elasticity change.…”

Section: Discussionsupporting

confidence: 82%

Testicular volume and elasticity changes in young children with undescended testes

et al. 2017

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Aims: To evaluate the differences and changes of testicular volume and elasticity in normal (NL) testes and undescended testes (UDTs) of children using shear wave elastography (SWE).Materials and methods: Testicular ultrasound images from children younger than 60 months old were retrospectively reviewed. Testicular volumes and elasticities were compared between the UDT group and NL group. In patients with unilateral UDT (uUDT), we also compared the values between uUDT and contralateral grossly normal (CGN) testis groups.Results: There were 25 UDTs including 4 bilateral in the UDT groupand 54 normal testes in the NL group. While testicular volume was significantly smaller in UDT (vs. NL) and uUDT (vs. CGN) groups, the elasticity was not different. Testicular volume was positively correlated with age in both NL (r=0.474) and CGN (r=0.729) groups (p<0.001), while there was no correlation in the UDT group. Testicular stiffness showed negative correlation with age in the NL group (r=-0.390, p=0.004) and positive correlation in the UDT group (r=0.426, p=0.034).Conclusions: Instead of increasing volume and decreasing stiffness of normal testes during development of the early 60 months, UDTsexhibited smaller volume and increasing stiffness. The CGN testes of uUDT patients showed increasing volume without stiffness change.

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Section: Discussionsupporting

confidence: 82%

Testicular volume and elasticity changes in young children with undescended testes

et al. 2017

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“…Similarly, two separate studies by Shin et al [24] and Lin et al [25] reported cases which demonstrated commencement of spermatogenesis resulting in pregnancy, after late surgical correction of UDT. In a review article, Chung et al [29] made a case for testicular preservation in patients who still desire parenthood, but also the elderly, where there is no further risk of malignancy. In his conclusion, he proposed guidelines for this specific group of patients which is similar to what OH et al proposed, with the added recommendation: in post-pubertal patients with a non-palpable UDT, laparoscopic orchidectomy is preferred.…”

Section: Discussionmentioning

confidence: 99%

Management of cryptorchidism in adolescent and adult males

Viljoen¹,

Zarrabi

Merwe

2020

Afr J Urol

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Background In developing countries, it is not unusual for patients with undescended testes (UDT) to present in adulthood and the late detection of UDT can be problematic. The limited contribution to fertility and increased potential of malignancy seen in UDT have swayed many authors towards recommending orchidectomy, rather than orchidopexy, for the adult patient presenting with cryptorchidism. With conflicting data, and most guidelines aimed at first world countries with pre-pubertal patients as their focus group, a lot of uncertainty exists regarding the management of adults who present with cryptorchidism. This may result in variation in the approach to management of this patient population. Methods A retrospective review was conducted of patients with cryptorchidism, aged 12 years or older at the time of surgery. The following data were retrieved: patient’s age, medical and previous surgical history, clinical features of UDT (laterality, position and size), date of surgery, intra-operative findings and procedure performed. Management decisions were compared to the most recent guidelines. Results The mean age of the 106 subjects was 25.4 years. An orchidectomy was performed in a total of 30 (24.2%) of the 124 testicular units. The majority of testes, 91 (73.4%), in this group were preserved. Of these, 43 (47.3%) were older than 18 years of age, 33 (36.2%) were reported as having unilateral UDT with a normal contralateral testis and in 9 (9.8%) of these cases, the preserved testes were described as being atrophic. The majority (59.7%) of UDT in the post-pubertal group (> 18 years) were managed by orchidopexy. Conclusion Contrary to the recommended treatment for this group of patients, there was a general tendency towards testicular preservation. The decision on surgical management was made by the attending surgical team. This not only demonstrates variation in the management of UDT, but could also be a reflection of the lack of sufficient guidelines as to the management of the post-pubertal patient presenting with UDT. Further studies, following cryptorchidism through adulthood, are needed to refine guidelines for the optimal management of this group of patients.

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“…If the testes are palpable in the groin then the patient needs to be told about their increased risk of testicular cancer, which is approximately 1.7%. 14 There is a 74% increased risk of cancer in the contralateral testes, with approximately a six times increased risk in the ipsilateral testis. If the undescended testis is unilateral this will have almost no effect on fertility, but bilateral cryptorchidism may lead to a marked change in characteristics seen on testicular biopsy and semen paramenters.…”

Section: Varicocelementioning

confidence: 99%

“…It is essential that patients are warned that if the testis cannot be safely mobilised on its blood supply then it will be removed. 14 If a testis is impalpable in an adolescent/adult then it is important to gain as much history and documentation as possible. It is not uncommon to find (but not safe to assume) that a testis has been removed, but it is important not to ignore an unrecognised intraabdominal testis.…”

Section: Varicocelementioning

confidence: 99%

“…In adolescents there are little in the way of data or guidelines. If the testes are palpable in the groin then the patient needs to be told about their increased risk of testicular cancer, which is approximately 1.7% 14 . There is a 74% increased risk of cancer in the contralateral testes, with approximately a six times increased risk in the ipsilateral testis.…”

Section: Testes Not Found In the Scrotummentioning

confidence: 99%

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