Testicular volume at puberty in boys with congenital cryptorchidism randomised to treatment at different ages
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New article you should know by Dr. Cecilia Gigena, selected by the Chilean Society of Pediatric Surgeons
”Testicular volume at puberty in boys with congenital cryptorchidism randomised to treatment at different ages”
Authors: Claude Kollin, Agneta Nordenskjöld, Martin Ritzén
Full article: https://gcmd.co/3YlqLDO
Aim: To assess testicular volume at puberty for boys who underwent orchidopexy at 9 or at 36 months compared to boys with spontaneous postnatal descent.
Methods: At age 6 months, boys with congenital unilateral cryptorchidism were randomised to surgery at 9 or 39 months of age and followed to 16 years in parallel with boys with spontaneous postnatal descent. Ultrasound was done at 11 and 16 years to determine testicular volume. The ratio of the initially undescended testis to its scrotal counterpart was used to assess testicular growth.
Results: At age 16, the ratio was lower (p < 0.00) in the late group compared to the early group. At 16 years, the spontaneously descended testes were significantly smaller than their scrotal counterparts but larger than the operated groups (early p < 0.01 and late p < 0.00).
Conclusion: Our data at 16 years show that orchidopexy at 9 months results in better testicular growth compared to 3 years but did not reach the corresponding volumes of their scrotal counterparts. This indicates that earlier surgery is beneficial to testicular growth. At age 16, the postnatally descended testes were not only larger than the surgically treated testes but also exhibited impaired testicular growth.
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At what age do you descend and undescended testes? I'm Cecilia Jigena from Cincinnati Children's Hospital, and I think this is an article that you should know about. This is a prospective randomized study done in Sweden that aimed to compare the testicular volume at puberty in patients with undescended tested that have a spontaneous descent versus, A surgery at 9 months or at 3 years of age. They had 22 patients with spontaneous descent, 37 with a surgery at 9 months, and 48 with a surgery at 3 years of age, and they found that there was a significant difference in testicular volume being higher in spontaneous descent. Versus the 9 month and also significantly higher in those who are operated at 9 months versus those who were operated at 3 years of age. So it seems that the earlier we operate on this patient is better as long as we give them enough time to spontaneous descent. Let us know what you think and stay tuned for more articles that you should know about.