Repair undescended testis before age 13
Clinical Question
What's the best time to correct undescended testis?Clinical Question
Bottom Line
The risk of testicular cancer doubles if you wait until after the patient is 12 years of age to surgically correct undescended testis. (LOE = 2b)Bottom Line
Reference
Pettersson A, Richiardi L, Nordenskjold A, Kaijser M, Akre O. Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med 2007;356:1835-1841. [PMID:17476009]Reference
Study Design
Cohort (prospective)Study Design
Funding
GovernmentFunding
Setting
Population-basedSetting
Synopsis
Although some previous case-control studies have suggested an increased risk of testicular cancer if repair was delayed till adolescence, results have been mixed and the case-control design is subject to considerable inherent bias. This Swedish study linked men in a registry of all hospital discharges with a second registry that tracked the incidence of cancer. They were able to gather data for 16,983 men who underwent surgery between 1964 and 1999, and followed them up for a mean of 12.4 years. The mean and median ages of orchipexy were 8.6 years and 8.5 years, respectively. The authors divided patients into groups according to the age at surgery, and found a clear spike in the risk of testicular cancer at 13 years or older. The standardized incidence ratio was 2.2 (95% CI, 1.6 - 3.1) for children younger than 13 years at the time of surgery compared with 5.4 (95% CI, 3.2 - 8.5) for children 13 years and older at the time of surgery. The absolute risk was relatively low, since there were only 56 cases of testicular cancer in the cohort (0.3%).Synopsis
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Citation
Barry, Henry, et al., editors. "Repair Undescended Testis Before Age 13." EE+ POEM Archive, John Wiley & Sons, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/infoPOEMs/426206/all/Repair_undescended_testis_before_age_13.
Repair undescended testis before age 13. In: Barry HH, Ebell MHM, Shaughnessy AFA, et al, eds. EE+ POEM Archive. John Wiley & Sons; 2019. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426206/all/Repair_undescended_testis_before_age_13. Accessed April 1, 2023.
Repair undescended testis before age 13. (2019). In Barry, H., Ebell, M. H., Shaughnessy, A. F., & Slawson, D. C. (Eds.), EE+ POEM Archive. John Wiley & Sons. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426206/all/Repair_undescended_testis_before_age_13
Repair Undescended Testis Before Age 13 [Internet]. In: Barry HH, Ebell MHM, Shaughnessy AFA, Slawson DCD, editors. EE+ POEM Archive. John Wiley & Sons; 2019. [cited 2023 April 01]. Available from: https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426206/all/Repair_undescended_testis_before_age_13.
* Article titles in AMA citation format should be in sentence-case
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T1 - Repair undescended testis before age 13
ID - 426206
ED - Barry,Henry,
ED - Ebell,Mark H,
ED - Shaughnessy,Allen F,
ED - Slawson,David C,
BT - EE+ POEM Archive
UR - https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426206/all/Repair_undescended_testis_before_age_13
PB - John Wiley & Sons
DB - Evidence Central
DP - Unbound Medicine
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