Reasons for Delayed Orchiopexies in a Korean Tertiary Care Hospital
안현수, 이한이, 박관진, Choi Hwang,
소속 상세정보
안현수 ( Ahn Hyun-Soo )
Seoul National University Department urology
이한이 ( Lee Hahn-Ey )
Seoul National University College of Medicine Department of Urology
박관진 ( Park Kwan-jIn )
Seoul National University Hospital Department of Pediatric Urology
( Choi Hwang )
Armed Foces Capital Hospital
KMID : 0358320140550010069
Abstract
Purpose: Since the 1990s, it has been well known that orchiopexies should be performed by no later than 2 years of age. Nevertheless, studies from other countries report a substantial number of delayed orchiopexies. On the basis of an analysis of a tertiary care hospital database, we aimed to investigate the incidence of delayed orchiopexies performed in patients after 5 years of age and to understand the causes of such delays and the possible consequences.
Materials and Methods: We retrospectively analyzed the surgical database of Seoul National University Hospital between 2004 and 2012 and detected patients who underwent orchiopexy later than 5 years of age. Reasons for delayed orchiopexies were studied and the possible consequences of delayed orchiopexies were assessed with respect to surgical difficulty and testicular volume.
Results: We found 160 cases of delayed orchiopexies, which accounted for about 15% of all orchiopexies performed. Two major reasons for delay were related to the parents of the child: parental delay and parental request for the treatment of persistent retractile testis. Acquired cryptorchidism was found in 21 cases (13.1%), mainly associated with hypospadias. Surgical difficulty, especially owing to a short testicular cord, was encountered in 48 cases (30.2%), and a comparison with age-matched normative values showed substantially smaller testicular volume.
Conclusions: Despite well-established guidelines for the optimal age of surgery, 15% of orchiopexies were not performed at a proper time. Improved propagation of an optimal age limit is necessary to reduce the rate of delayed orchiopexies considering increases in surgical difficulty and potential testicular growth retardation.
키워드
Cryptorchidism; Orchiopexy; Tertiary care centers
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