Post-pubertal management of undescended testes from the malignancy risk point of view: a systematic review [version 3; peer review: 2 approved, 1 approved with reservations]

Background Undescended testes (UDT) is a condition where one or both testes is absent in the scrotum. The general age recommendation in which the treatment should be performed is before 18 months old due to the infertility risk and malignancy in later life. In post-pubertal UDT, the current guidelin...

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Main Authors: Arry Rodjani, Putu Angga Risky Raharja, Irfan Wahyudi, William Tendi, Gerhard Reinaldi Situmorang
Format: Article
Language:English
Published: F1000 Research Ltd 2024-11-01
Series:F1000Research
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Online Access:https://f1000research.com/articles/12-1226/v3
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author Arry Rodjani
Putu Angga Risky Raharja
Irfan Wahyudi
William Tendi
Gerhard Reinaldi Situmorang
author_facet Arry Rodjani
Putu Angga Risky Raharja
Irfan Wahyudi
William Tendi
Gerhard Reinaldi Situmorang
author_sort Arry Rodjani
collection DOAJ
description Background Undescended testes (UDT) is a condition where one or both testes is absent in the scrotum. The general age recommendation in which the treatment should be performed is before 18 months old due to the infertility risk and malignancy in later life. In post-pubertal UDT, the current guideline recommends orchiectomy; however, the strength rating of this recommendation is weak. Therefore, this study aimed to provide a systematic review of post-pubertal UDT treatment, focusing on the malignancy risk point of view. Methods A systematic search was performed using PubMed, Wiley Online Library and the Cochrane Library up to 5 March 2023. Any study with either post-pubertal orchiectomy or orchidopexy in patients with UDT and reporting the testicular malignancy was included. The exclusion criteria were studies with lack of information of UDT correction time, no history of correction and the full text wasn’t available. The data collected were the occurrence of testicular malignancy in post-pubertal UDT patients corrected with any method. Quality and bias assessment was assessed with Newcastle-Ottawa scale and Joanna Briggs Institute tools. Results Seven articles (three case reports and four observational studies) were reviewed with a total of 42 patients who underwent post-pubertal correction of either unilateral or bilateral UDT. The correction age ranged from 13 to 34 years old, with follow-up of 48.7–252 months. Among those who developed malignancies, the most common were seminoma, teratoma and carcinoma in situ of the testes. In addition, this study was able to propose an algorithm for post-pubertal UDT treatment strategy. Conclusions The scarce resource was the main limitation of this study. Nevertheless, this review showed that post-pubertal UDT management should be tailored individually. Several factors that should be considered include the condition of the contralateral descended testis, UDT location, serum testosterone level, patient’s age, comorbidities, and interest in fertility.
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spelling doaj-art-e3a790b4361c4164b30a5f0ea6549c442024-11-14T01:00:00ZengF1000 Research LtdF1000Research2046-14022024-11-0112173401Post-pubertal management of undescended testes from the malignancy risk point of view: a systematic review [version 3; peer review: 2 approved, 1 approved with reservations]Arry Rodjani0Putu Angga Risky Raharja1https://orcid.org/0000-0003-4951-2827Irfan Wahyudi2William Tendi3https://orcid.org/0000-0002-3953-1138Gerhard Reinaldi Situmorang4Department of Urology, Rumah Sakit Dr Cipto Mangunkusumo, University of Indonesia, Central Jakarta, Jakarta, 10430, IndonesiaDepartment of Urology, Rumah Sakit Dr Cipto Mangunkusumo, University of Indonesia, Central Jakarta, Jakarta, 10430, IndonesiaDepartment of Urology, Rumah Sakit Dr Cipto Mangunkusumo, University of Indonesia, Central Jakarta, Jakarta, 10430, IndonesiaDepartment of Urology, Rumah Sakit Dr Cipto Mangunkusumo, University of Indonesia, Central Jakarta, Jakarta, 10430, IndonesiaDepartment of Urology, Rumah Sakit Dr Cipto Mangunkusumo, University of Indonesia, Central Jakarta, Jakarta, 10430, IndonesiaBackground Undescended testes (UDT) is a condition where one or both testes is absent in the scrotum. The general age recommendation in which the treatment should be performed is before 18 months old due to the infertility risk and malignancy in later life. In post-pubertal UDT, the current guideline recommends orchiectomy; however, the strength rating of this recommendation is weak. Therefore, this study aimed to provide a systematic review of post-pubertal UDT treatment, focusing on the malignancy risk point of view. Methods A systematic search was performed using PubMed, Wiley Online Library and the Cochrane Library up to 5 March 2023. Any study with either post-pubertal orchiectomy or orchidopexy in patients with UDT and reporting the testicular malignancy was included. The exclusion criteria were studies with lack of information of UDT correction time, no history of correction and the full text wasn’t available. The data collected were the occurrence of testicular malignancy in post-pubertal UDT patients corrected with any method. Quality and bias assessment was assessed with Newcastle-Ottawa scale and Joanna Briggs Institute tools. Results Seven articles (three case reports and four observational studies) were reviewed with a total of 42 patients who underwent post-pubertal correction of either unilateral or bilateral UDT. The correction age ranged from 13 to 34 years old, with follow-up of 48.7–252 months. Among those who developed malignancies, the most common were seminoma, teratoma and carcinoma in situ of the testes. In addition, this study was able to propose an algorithm for post-pubertal UDT treatment strategy. Conclusions The scarce resource was the main limitation of this study. Nevertheless, this review showed that post-pubertal UDT management should be tailored individually. Several factors that should be considered include the condition of the contralateral descended testis, UDT location, serum testosterone level, patient’s age, comorbidities, and interest in fertility.https://f1000research.com/articles/12-1226/v3Orchidopexy Orchiectomy Testicular malignancy Undescended testeseng
spellingShingle Arry Rodjani
Putu Angga Risky Raharja
Irfan Wahyudi
William Tendi
Gerhard Reinaldi Situmorang
Post-pubertal management of undescended testes from the malignancy risk point of view: a systematic review [version 3; peer review: 2 approved, 1 approved with reservations]
F1000Research
Orchidopexy
Orchiectomy
Testicular malignancy
Undescended testes
eng
title Post-pubertal management of undescended testes from the malignancy risk point of view: a systematic review [version 3; peer review: 2 approved, 1 approved with reservations]
title_full Post-pubertal management of undescended testes from the malignancy risk point of view: a systematic review [version 3; peer review: 2 approved, 1 approved with reservations]
title_fullStr Post-pubertal management of undescended testes from the malignancy risk point of view: a systematic review [version 3; peer review: 2 approved, 1 approved with reservations]
title_full_unstemmed Post-pubertal management of undescended testes from the malignancy risk point of view: a systematic review [version 3; peer review: 2 approved, 1 approved with reservations]
title_short Post-pubertal management of undescended testes from the malignancy risk point of view: a systematic review [version 3; peer review: 2 approved, 1 approved with reservations]
title_sort post pubertal management of undescended testes from the malignancy risk point of view a systematic review version 3 peer review 2 approved 1 approved with reservations
topic Orchidopexy
Orchiectomy
Testicular malignancy
Undescended testes
eng
url https://f1000research.com/articles/12-1226/v3
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