La gestione del bambino con testicolo ritenuto: Una sorveglianza della pratica clinica in Italia

Background: The aims of our study were to describe the current management of cryptorchidism among Italian family paediatricians (FP) and detect any difference from the recently published Nordic Consensus guidelines. Methods: An online questionnaire was filled in by 140 Italian FP from 18/20 Italian regions. The questionnaire requested information on all children with cryptorchidism born between 1/01/2004 and 1/01/2006, their characteristics and management. Results: Data on 169 children with undescended testis were obtained. Among those, 24% had at diagnosis a retractile testis, while 76% had a true cryptorchidism. Mean age at diagnosis was 9.6 months (SD 13.2; range 0-52.8). In 16% of cases cryptorchydism resolved spontaneously at a mean age of 25.2 months (SD 12; range 6-46.8). On the overall cases, 99 subjects (59%) underwent orchiopexy at mean age of 22.8 months (SD 10.8; range 1.2-56.4), 13% of which before 1 year of age. The intervention was performed by a paediatric surgeon in 89% of cases, with a success rate of 91%. Orchiopexy was the first line treatment in 82/99 cases (83%), while preceded by hormonal treatment in the other 17 cases. Hormonal treatment was used as first line in 20% of cases with a reported success rate of 25% (n=8/32). Overall, 18 children did not undergo any intervention (mean age at last follow up 44.4 months; SD 12; range 20.4-62.4). Conclusions: Our study showed an important delay in orchiopexy. Moreover, a high percentage of children with undescended testis was treated with hormonal therapy, although it is not recommended by the recent guidelines.