Up or down?

Abstract

Cryptorchidism is one of the commonest indications for elective surgery in young boys. Current guidelines call for recognition and surgical management of the condition before the age of one year. We do not, however, have good population-based data on the condition, specifically the ages at which surgery is generally occurring. In the current volume of The Journal, Bergbrant et al provide very comprehensive data from Sweden addressing these questions. They provide us with information from every boy in the country in whom the diagnosis of cryptorchidism was made over a 15 year period—over 20,000 children in all. One of the most striking pieces of information is that over 94% of children had their surgery beyond the guideline-recommended age of one year. Even though Sweden is a country with near-universal health care for its children, there was considerable variation from region to region in the timeliness of surgery. Not all of these delays can be attributed to late recognition or referral; the bimodal age distribution, with another peak in school age likely reflects acquired cryptorchidism. Fortunately, there were few complications of surgery and no deaths. The study was not designed to address such long term questions such as fertility. Article page 197 ▶ Cryptorchidism in Sweden: A Nationwide Study of Prevalence, Operative Management, and ComplicationsThe Journal of PediatricsVol. 194PreviewTo review the cumulative prevalence, operative management, and complications of treatment for cryptorchidism in Sweden. Full-Text PDF