Cryptorchidism in Sweden: A Nationwide Study of Prevalence, Operative Management, and Complications

Area of Science:

• Pediatric Surgery
• Urology
• Public Health

Background:

• Cryptorchidism, the failure of one or both testes to descend into the scrotum, affects a significant number of male infants.
• Timely surgical intervention (orchiopexy) is crucial for optimal outcomes and fertility preservation.

Purpose of the Study:

• To determine the cumulative prevalence of cryptorchidism in Sweden.
• To analyze the operative management, including age at surgery and procedure type.
• To assess complications, such as surgical site infections, following treatment.

Main Methods:

• A nationwide observational study utilizing longitudinal register data.
• Inclusion of all Swedish-born boys aged 0-18 diagnosed with cryptorchidism between 2001 and 2014.
• Primary outcomes: occurrence and age at primary surgery; Secondary outcomes: procedure type and surgical site infection.

Main Results:

• The cumulative childhood prevalence of cryptorchidism was 1.8%, with higher rates in premature or low birth weight infants.
• Median age at surgery decreased but remained significantly delayed (3.4 years in 2014), with 94.1% operated after the recommended age of 1 year.
• Surgical site infection rate was low (1.4%), with no 30-day post-operative mortality.

Conclusions:

• Cryptorchidism prevalence is substantial, though surgical complications are infrequent.
• A significant proportion of boys undergo delayed surgery, indicating suboptimal adherence to clinical guidelines.
• Considerable regional variations in surgical timing highlight the need for improved, standardized care pathways for congenital cryptorchidism.