Management of cryptorchidism in children: guidelines. Swiss medical weekly : official journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology [Swiss Med Wkly] Journal article | | Title | Management of cryptorchidism in children: guidelines. | | Author(s) | Gapany C, Frey P, Cachat F, Gudinchet F, Jichlinski P, Meyrat BJ, Ramseyer P, Theintz G, Burnand B | | Institution | Service of Pediatric surgery, Centre Hospitalier Universitaire Vaudois, and University of Lausanne, Lausanne, Switzerland. Christophe.Gapany@chuv.ch | | Source | Swiss Med Wkly 2008 Aug 23; 138(33-34):492-8. | | MeSH | Child
Child, Preschool
Cryptorchidism
Evidence-Based Medicine
Humans
Infant
Infant, Newborn
Laparoscopy
Male
Practice Guidelines as Topic
Prevalence
Prognosis
Switzerland
Urologic Surgical Procedures, Male
| | Abstract | QUESTION: To develop clinical guidelines for the management of cryptorchidism in pre-pubertal boys, from early diagnosis through therapy to long-term follow-up and prognosis.
METHOD: Systematic review of articles from the medical literature, referenced since 1966, using validated search strategies through the following databases: Medline, Cochrane Database of Systematic Reviews, Cochrane Register of Controlled Trials, EMBASE, DARE, ACP Journal Club, National Guidelines Clearinghouse, Guidelines International Network. Relevant articles published after 1988 were taken as the basis for the statements. Each statement was graded on the basis of the study design and on its methodological quality (GRADE approach). A multidisciplinary panel of local experts discussed and evaluated each statement on the strength of this evidence.
RESULTS: 28 statements based on the best available evidence were drafted. The experts agreed with all but two statements, which were rated uncertain.
CONCLUSIONS: Cryptorchidism is best diagnosed clinically, and treated by surgical orchiopexy at age 6-12 months, without a routine biopsy. If no testis is palpable, or if other signs of hypovirilisation such as hypospadias are present, the chromosomal sex and hormonal status must be assessed. Laparoscopy is the best way of diagnosing and managing intra-abdominal testes. | | Language | eng | | Pub Type(s) | Journal Article
Review
| | PubMed ID | 18726735 |
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