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首页> 外文期刊>BMC Pediatrics >Management of cryptorchidism: a survey of clinical practice in Italy
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Management of cryptorchidism: a survey of clinical practice in Italy

机译：隐睾症的治疗：意大利的临床实践调查

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Background An evidence-based Consensus on the treatment of undescended testis (UT) was recently published, recommending to perform orchidopexy between 6 and 12 months of age, or upon diagnosis and to avoid the use of hormones. In Italy, current practices on UT management are little known. Our aim was to describe the current management of UT in a cohort of Italian children in comparison with the Consensus guidelines. As management of retractile testis (RT) differs, RT cases were described separately. Methods Ours is a retrospective, multicenter descriptive study. An online questionnaire was filled in by 140 Italian Family Paediatricians (FP) from Associazione Culturale Pediatri (ACP), a national professional association of FP. The questionnaire requested information on all children with cryptorchidism born between 1/01/2004 and 1/01/2006. Data on 169 children were obtained. Analyses were descriptive. Results Overall 24% of children were diagnosed with RT, 76% with UT. Among the latter, cryptorchidism resolved spontaneously in 10% of cases at a mean age of 21.6 months. Overall 70% of UT cases underwent orchidopexy at a mean age of 22.8 months (SD 10.8, range 1.2-56.4), 13% of whom before 1 year. The intervention was performed by a paediatric surgeon in 90% of cases, with a success rate of 91%. Orchidopexy was the first line treatment in 82% of cases, while preceded by hormonal treatment in the remaining 18%. Hormonal treatment was used as first line therapy in 23% of UT cases with a reported success rate of 25%. Overall, 13 children did not undergo any intervention (mean age at last follow up 39.6 months). We analyzed the data from the 5 Italian Regions with the largest number of children enrolled and found a statistically significant regional difference in the use of hormonal therapy, and in the use of and age at orchidopexy. Conclusions Our study showed an important delay in orchidopexy. A quarter of children with cryptorchidism was treated with hormonal therapy. In line with the Consensus guidelines, surgery was carried out by a paediatric surgeon in the majority of cases, with a high success rate.
机译：背景技术最近发表了有关未降睾丸（UT）治疗的循证共识，建议在6至12个月大时进行睾丸检查，或在诊断后避免使用激素。在意大利，关于UT管理的当前实践鲜为人知。我们的目的是与共识指南相比较，描述一组意大利儿童目前对UT的管理。由于对可缩回睾丸（RT）的管理有所不同，因此分别描述了RT病例。方法我们的研究是一项回顾性，多中心的描述性研究。来自FP国家专业协会Associazione Culturale Pediatri（ACP）的140名意大利家庭儿科医生（FP）填写了在线问卷。问卷要求提供有关2004年1月1日至2006年1月1日之间出生的所有隐睾症儿童的信息。获得了169名儿童的数据。分析是描述性的。结果总体上24％的儿童被诊断为RT，76％的患者被诊断为UT。在后者中，隐睾症在10％的病例中自发消退，平均年龄为21.6个月。总体上，有70％的UT患者平均年龄为22.8个月（SD 10.8，范围1.2-56.4）接受了兰花手术，其中13％在一年之前。儿科外科医生对90％的病例进行了干预，成功率为91％。在82％的病例中，兰花科手术是一线治疗，在其余18％的患者中，首先进行激素治疗。激素治疗被用作23％的UT病例的一线治疗，据报道成功率为25％。总体而言，有13名儿童未接受任何干预（最近一次随访的平均年龄39.6个月）。我们分析了来自5个意大利地区的儿童人数最多的数据，发现在激素疗法的使用以及兰花科动物的使用和年龄方面存在统计学差异。结论我们的研究表明兰花科的重要延误。四分之一的隐睾症患儿接受了激素治疗。根据共识指南，大多数情况下，由小儿外科医师进行手术，成功率很高。

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