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首页> 外文期刊>African journal of urology >Management of cryptorchidism in adolescent and adult males
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Management of cryptorchidism in adolescent and adult males

机译：青少年和成年男性的密码刺激

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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.MethodsA 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.ResultsThe 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.ConclusionContrary 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.
机译：背景：在发展中国家，对于已经成年期呈现的未经测试的睾丸（UDT）并不罕见，对UDT的后期检测可能是有问题的。在UDT中看到的恶性生育能力和增加的潜力增加了许多作者，向建议植物切除术而不是植物中心，为患有隐窝刺激性的成年患者。通过冲突的数据，大多数指南旨在获得普国普国前普国普及患者的焦点小组，有很多不确定性存在于呈现隐睾症的成年人的管理。这可能导致该患者群体管理方法的变化。在手术时12岁或以上的患者对患者进行了患者的患者。检索下列数据：患者年龄，医疗和以前的外科历史，UDT（横向，位置和大小），手术日期，手术内发现和程序进行的临床特征。将管理决定与最近的准则进行比较。106个科目的平均年龄为25.4年。植物切除术的总共进行了124个睾丸单元的30（24.2％）。大多数睾丸，91（73.4％），保留了这一组。其中43岁（47.3％）超过18岁，据报道，33岁（36.2％），具有正常对侧睾丸的单侧UDT，并在9（9.8％）这些病例中，被描述为保存的睾丸萎缩。在Pubertal群体（> 18岁）的大多数（59.7％）的UDT由兰氏蛋白酶管理。控制该组患者的推荐治疗，睾丸保存一般趋势。上市手术团队提出了关于外科管理的决定。这不仅展示了UDT管理的变化，而且还可以反映出缺乏足够的指导方针，以便在普及特的患者中呈现出udt后的妇女患者。在通过成年期通过成年期间，需要进一步研究，以改进该组患者的最佳管理指南。

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