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The management of cryptorchidism in Brazil: An ecological overview

Artur Venancio da Silva Sena1, Luiza Telles2, Paulo Henrique Moreira Melo3

  • 1Universidade de Campinas (UNICAMP), São Paulo, Brazil.

Journal of Pediatric Urology
|August 21, 2025
PubMed

Insights

Delayed treatment for cryptorchidism (undescended testicles) is common in Brazil, with most surgeries occurring after age five. The COVID-19 pandemic worsened this backlog, highlighting the need for improved public health policies.

Area of Science:

  • Pediatric Surgery
  • Public Health Policy
  • Urology

Background:

  • Cryptorchidism, the most common male genital anomaly, requires timely treatment to prevent infertility and testicular cancer.
  • Treatment guidelines for cryptorchidism exist, but surgical timing varies significantly within Brazil's public healthcare system (SUS).
  • Geographic and socioeconomic factors may influence healthcare access and treatment outcomes for cryptorchidism in Brazil.

Purpose of the Study:

  • To analyze the age at which orchiopexy (surgical correction of undescended testicles) is performed in Brazil's public healthcare system.
  • To investigate the relationship between orchiopexy timing and public healthcare service quality.
  • To assess the impact of the COVID-19 pandemic on the backlog of cryptorchidism surgeries.

Main Methods:

  • Data on 94,237 orchiopexies performed between 2008 and 2022 were collected from the Department of Informatics of the Brazilian Public Health System (DATASUS).
  • Geographic and socioeconomic indicators were obtained from the Brazilian Institute of Geography (IBGE) and the Institute for Applied Economic Research (IPEA).
  • Analysis correlated surgical timing with regional data and pandemic-related trends.

Main Results:

  • Nationwide, only 47.6% of expected orchiopexies were performed, with significant regional disparities (22.75% in the North to 68.18% in the South).
  • The majority of surgeries occurred after age five, with a low proportion (12-24%) performed before age two, particularly in the North and Northeast regions.
  • The COVID-19 pandemic caused a 44.45% decrease in surgeries in 2020, exacerbating the existing backlog.

Conclusions:

  • A significant number of children with cryptorchidism experience delayed diagnosis or treatment in Brazil.
  • The COVID-19 pandemic severely impacted surgical rates, worsening the delay in treatment.
  • Urgent public health policies are needed to enhance healthcare access and prevent long-term complications of untreated cryptorchidism.
Abstract

Keywords:
CryptorchidismOrchiopexySocial determinants of healthSurgeryUndescended testicle

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