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      Clinical and socioeconomic factors associated with delayed orchidopexy in cryptorchid boys in China: a retrospective study of 2423 cases

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          Abstract

          We investigated the associations of clinical and socioeconomic factors with delayed orchidopexy for cryptorchidism in China. A retrospective study was conducted on cryptorchid boys who underwent orchidopexy at Children's Hospital at Chongqing Medical University in China from January 2012 to December 2017. Of 2423 patients, 410 (16.9%) received timely repair by 18 months of age, beyond which surgery was considered delayed. Univariate analysis suggested that the laterality of cryptorchidism ( P = 0.001), comorbidities including inguinal hernia/scrotal hydrocele ( P < 0.001) or urinary tract disease ( P = 0.016), and whether patients lived in a poverty county ( P < 0.001) could influence whether orchidopexy was timely or delayed. Logistic regression analysis suggested that the following factors were associated with delayed repair: unilateral rather than bilateral cryptorchidism (odds ratio [OR] = 1.752, P < 0.001), absence of inguinal hernia or hydrocele (OR = 2.027, P = 0.019), absence of urinary tract disease (OR = 3.712, P < 0.001), and living in a poverty county (OR = 2.005, P < 0.001). The duration of postoperative hospital stay and hospital costs increased with the patient's age at the time of surgery.

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          Most cited references32

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          Evaluation and treatment of cryptorchidism: AUA guideline.

          Cryptorchidism is one of the most common pediatric disorders of the male endocrine glands and the most common genital disorder identified at birth. This guideline is intended to provide physicians and non-physician providers (primary care and specialists) with a consensus of principles and treatment plans for the management of cryptorchidism (typically isolated non-syndromic).
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            Nordic consensus on treatment of undescended testes.

            To reach consensus among specialists from the Nordic countries on the present state-of-the-art in treatment of undescended testicles. A group of specialists in testicular physiology, paediatric surgery/urology, endocrinology, andrology, pathology and anaesthesiology from all the Nordic countries met for two days. Before the meeting, reviews of the literature had been prepared by the participants. The group came to the following unanimous conclusions: (1) In general, hormonal treatment is not recommended, considering the poor immediate results and the possible long term adverse effects on spermatogenesis. Thus, surgery is to be preferred. (2) Orchiopexy should be done between 6 and 12 months of age, or upon diagnosis, if that occurs later. (3) Orchiopexy before age one year should only be done at centres with both paediatric surgeons/urologists and paediatric anaesthesiologists. (4) If a testis is found to be undescended at any age after 6 months, the patient should be referred for surgery--to paediatric rather than general surgeons/urologists if the boy is less than one year old or if he has bilateral or non-palpable testes, or if he has got relapse of cryptorchidism.
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              A meta-analysis of the risk of boys with isolated cryptorchidism developing testicular cancer in later life.

              Significant variability exists for the relative risk (RR) of testicular malignancy in isolated cryptorchidism.
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                Author and article information

                Journal
                Asian J Androl
                Asian J. Androl
                AJA
                Asian Journal of Andrology
                Wolters Kluwer - Medknow (India )
                1008-682X
                1745-7262
                May-Jun 2019
                18 December 2018
                : 21
                : 3
                : 304-308
                Affiliations
                [1 ]Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
                [2 ]Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing 400014, China
                [3 ]Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
                [4 ]China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China
                [5 ]Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
                Author notes
                Correspondence: Dr. SD Wu ( shengdewu@ 123456yeah.net )
                Article
                AJA-21-304
                10.4103/aja.aja_106_18
                6498732
                30632485
                e19e7a12-85db-4e18-9560-8879f66f14d2
                Copyright: © The Author(s)(2018)

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 19 March 2018
                : 23 October 2018
                Categories
                Original Article

                birth defect,children,congenital disorder,cryptorchidism,orchidopexy,poverty

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