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Acquired cryptorchidism is frequent in infancy and childhood
Christine Wohlfahrt-Veje1, Kirsten A Boisen, Malene Boas
1University Department of Growth and Reproduction, GR-5064 Rigshospitalet, Copenhagen, Denmark. cwv@rh.regionh.dk
Insights
Acquired cryptorchidism, or testicular ascent, affects over half of childhood cases. Regular checks up to age three are recommended for all boys to monitor testis position.
Area of Science:
- Pediatric Endocrinology
- Urology
- Developmental Biology
Background:
- Acquired cryptorchidism prevalence data is limited.
- Systematic prospective studies on testicular ascent are lacking.
Purpose of the Study:
- To determine the prevalence of testicular ascent (ascensus testis) in childhood.
- To investigate the incidence of acquired cryptorchidism in a population-based cohort.
Main Methods:
- Prospective longitudinal population-based study in Copenhagen (1997-2007).
- Standardized examination of testicular position in 1072 boys at multiple time points from birth to 10 years.
- Defined ascensus testis as testicular ascent after normal scrotal position at birth.
Main Results:
- Ascensus testis prevalence was 0.6% at 18 and 36 months.
- Including recurrent cryptorchidism, prevalence reached 1.2% at 18 months and 0.8% at 36 months.
- Ascensus testis accounted for 58-71% of all cryptorchidism cases during childhood.
Conclusions:
- Ascensus testis is the primary cause of acquired cryptorchidism in childhood.
- Testicular position should be regularly monitored in boys up to three years of age.
Abstract:
Accurate prevalence data for acquired cryptorchidism are currently sparse and systematic prospective studies have not yet been reported. Our aim was to determine the prevalence of testicular ascent in childhood. In a prospective longitudinal population-based child cohort from Copenhagen, Denmark (1997-2007), testicular position was examined according to a standardised protocol in a total of 1072 boys, at birth (n = 1051), at 3 months (n = 983), 18 months (n = 888), 36 months (n = 790) and again once between 4 1/2 and 10 years of age (n = 509). Ascensus testis was defined as ascent of the testis into a cryptorchid position after normal scrotal position at birth. A congenital cryptorchid testis with spontaneous postnatal descent followed by recurrence of cryptorchidism was named recurrent cryptorchidism. Ascensus testis occurred in 0.2%, 0.6% and 0.6% of boys at 3, 18 and 36 months of age respectively. When including recurrent cryptorchidism the prevalence was 0.2%, 1.2% and 0.8% respectively. Ascensus testis accounts for 58% of all cases of cryptorchidism (congenital and acquired) at 18 months, 71% at 36 months and thereafter 69%. Ascensus testis accounts for more than half of cryptorchid testes seen in childhood and occurs in both previously scrotal and cryptorchid testes. We therefore recommend that all boys should have testis position checked regularly during childhood, at least up to 3 years of age.
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