Summary
Introduction
Consensus recommendations for surgical management of cryptorchidism recommend orchidopexy
between 6 and 18 months of age. The COVID-19 pandemic has impacted elective surgical
scheduling.
Objective
In response to the COVID-19 pandemic, we sought to review the available data regarding
the natural history, surgical management, and infertility- and cancer-related risks
associated with cryptorchid testes. The purpose of this review is to provide parents,
referring providers, and surgeons with information to inform their decisions to proceed
with or delay orchidopexy.
Methods
A retrospective review and analysis of all available articles relevant to the natural
history, surgical management, and infertility- and cancer-related risks of cryptorchidism
present on PubMed, SCOPUS, and Cochrane Library was conducted.
Results
The quality of historic literature pertaining to the effect of cryptorchidism on fertility
and malignancy differ, with poorer data available on fertility. Cryptorchid testes
may show histologic differences as early as birth, and some of these changes may have
prognostic value in future fertility. Formerly unilateral cryptorchid men have slightly
but not significantly reduced paternity rates compared to the general population.
Cryptorchid testes have an increased risk of germ cell carcinogenesis, and robust
data suggest the risk for malignancy in cryptorchid testes increases substantially
after puberty.
Conclusion
The current body of evidence regarding the risks for future infertility and testicular
cancer support the consensus recommendations for surgical correction of cryptorchidism
between 6 and 18 months of age. During the uncertain time of the COVID-19 pandemic,
decision for orchidopexy is a shared-decision between physician and parent. For an
infant or young boy with a unilateral undescended testes, delaying orchidopexy several
months until a time of decreased exposure risk is unlikely to result in substantial
or sustained fertility or malignant risks.
Keywords
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Article info
Publication history
Published online: January 22, 2021
Accepted:
January 14,
2021
Received in revised form:
January 12,
2021
Received:
October 6,
2020
Identification
Copyright
© 2021 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
