Evaluation and Treatment of Cryptorchidism: AUA Guideline
Evaluation and Treatment of Cryptorchidism: AUA Guideline
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DOI：
10.1016/j.juro.2014.05.005
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发表时间：
2014-08-01
影响因子：
6.6
通讯作者：
Barthold, Julia S.
中科院分区：
文献类型：
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作者：
Kolon, Thomas F.;Herndon, C. D. Anthony;Barthold, Julia S.
目的：隐睾症是一种最常见的儿科男性内分泌腺疾病，也是出生时最常见的生殖器疾病。本指南的目的是提供医生和非医生提供者（初级保健和专家）的原则和治疗计划的共识隐睾症（通常孤立的非综合征型）的管理。材料和方法：一个系统的回顾和荟萃分析发表的文献进行了控制词汇补充与隐睾症的相关概念的关键词。检索策略由参考图书馆员和方法学家制定和执行，以创建仅限于英语的已发表同行评审文献的证据报告。该综述产生了1980年至2013年发表的704篇文章，用于构成大多数指南声明。临床原则和专家意见被用于缺乏足够的循证数据的指南声明。结果：指南声明被创建以告知临床医生关于病史采集、体格检查和隐睾症男孩评估的正确方法，以及各种激素和手术治疗方案。隐睾的影像学检查不建议在转诊前进行，应在6个月大时进行。睾丸固定术（睾丸固定术是首选术语）是将睾丸重新安置到阴囊中的最成功的疗法，而不推荐激素疗法。成功的阴囊睾丸复位可以减少但不能防止潜在的长期不育和睾丸癌问题。对患者进行适当的咨询和随访至关重要。
Purpose: 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).Materials and Methods: A systematic review and meta-analysis of the published literature was conducted using controlled vocabulary supplemented with key words relating to the relevant concepts of cryptorchidism. The search strategy was developed and executed by reference librarians and methodologists to create an evidence report limited to English-language, published peer-reviewed literature. This review yielded 704 articles published from 1980 through 2013 that were used to form a majority of the guideline statements. Clinical Principles and Expert Opinions were used for guideline statements lacking sufficient evidence-based data.Results: Guideline statements were created to inform clinicians on the proper methods of history-taking, physical exam, and evaluation of the boy with cryptorchidism, as well as the various hormonal and surgical treatment options.Conclusions: Imaging for cryptorchidism is not recommended prior to referral, which should occur by 6 months of age. Orchidopexy (orchiopexy is the preferred term) is the most successful therapy to relocate the testis into the scrotum, while hormonal therapy is not recommended. Successful scrotal repositioning of the testis may reduce but does not prevent the potential long-term issues of infertility and testis cancer. Appropriate counseling and follow-up of the patient is essential.