CRYPTORCHIDISM IN CHILDREN: TIMING OF ORCHIDOPEXY AND LONG-TERM RISKS OF INFERTILITY AND TESTICULAR CANCER
Keywords:
cryptorchidism, undescended testis, orchidopexy, infertility, testicular cancer, primary care, pediatric urologyAbstract
Cryptorchidism (undescended testis) is one of the most common congenital anomalies in boys and is associated with later infertility and testicular cancer. This review summarizes current recommendations on the timing of surgical correction, the evaluation of palpable and nonpalpable testes, and the reasons for delayed treatment, based on guidelines and published cohort studies. Consensus statements recommend orchidopexy between 6 and 18 months of age, and European guidance favors surgery before 12 months and by 18 months at the latest. Histological changes in the undescended testis, such as germ cell loss and interstitial fibrosis, progress with age and may become irreversible after the first year of life. Nevertheless, large reports indicate that 58–83% of boys worldwide undergo orchidopexy after 18 months, and in a series of 283 cases the mean age at surgery was 4.8 ± 5.6 years, with later surgery when the anomaly was first noticed by caregivers rather than by clinicians. Improved screening in primary care, avoidance of unnecessary imaging and counseling of patients about long-term risks are the priority measures.
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