Journal article
Management of the undescended testis in children: An American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee Systematic Review
Journal of pediatric surgery, v 57(7), pp 1293-1308
01 Jul 2022
PMID: 35151498
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose: Management of undescended testes (UDT) has evolved over the last decade. While urologic societies in the United States and Europe have established some guidelines for care, management by North American pediatric surgeons remains variable. The aim of this systematic review is to evaluate the published evidence regarding the treatment of (UDT) in children.
Methods: A comprehensive search strategy and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were utilized to identify, review, and report salient articles. Five principal questions were asked regarding imaging standards, medical treatment, surgical technique, timing of operation, and outcomes. A literature search was performed from 2005 to 2020.
Results: A total of 825 articles were identified in the initial search, and 260 were included in the final review.
Conclusions: Pre-operative imaging and hormonal therapy are generally not recommended except in specific circumstances. Testicular growth and potential for fertility improves when orchiopexy is performed before one year of age. For a palpable testis, a single incision approach is preferred over a two-incision orchiopexy. Laparoscopic orchiopexy is associated with a slightly lower testicular atrophy rate but a higher rate of long-term testicular retraction. One and two-stage Fowler-Stephens orchiopexy have similar rates of testicular atrophy and retraction. There is a higher relative risk of testicular cancer in UDT which may be lessened by pre-pubertal orchiopexy. (C) 2022 Elsevier Inc. All rights reserved.
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Details
- Title
- Management of the undescended testis in children: An American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee Systematic Review
- Creators
- Robert L. Gates - University of South CarolinaJulia Shelton - University of Iowa Stead Family Children’s HospitalKaren A. Diefenbach - Nationwide Children's HospitalMeghan Arnold - University of Michigan–Ann ArborShawn D. St Peter - Sisters of Mercy Health SystemElizabeth J. Renaud - Hasbro Children's HospitalMark B. Slidell - Comer Children's HospitalStig Somme - College Station Medical CenterPatricia Valusek - Children's MinnesotaGustavo A. Villalona - Nemours Children's Health SystemJarod P. McAteer - Providence Sacred Heart Medical CenterAlana L. Beres - University of California, DavisJoanne Baerg - Loma Linda University Children's HospitalRebecca M. Rentea - Children's Mercy HospitalLorraine Kelley-Quon - University of Southern CaliforniaAkemi L. Kawaguchi - The University of Texas Health Science Center at HoustonYue-Yung Hu - Northwestern UniversityDoug Miniati - Kaiser Permanente Roseville Medical CenterRobert Ricca - University of South CarolinaRobert Baird - University of British Columbia
- Publication Details
- Journal of pediatric surgery, v 57(7), pp 1293-1308
- Publisher
- Elsevier
- Number of pages
- 16
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000833528600019
- Scopus ID
- 2-s2.0-85124401528
- Other Identifier
- 991021969586204721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Pediatrics
- Surgery