PDF(Pubmed)
Abstract：
This case report presents a rare case of adult cryptorchidism, found incidentally in a 25-year-old gentleman who initially presented with abdominal and suprapubic pain and was successfully treated with staged orchidopexy. To our knowledge, to date, our case is the first published instance of bilateral cryptorchidism in an adult presenting with nonspecific suprapubic pain. Cryptorchidism is the most common genital abnormality in newborn boys, and due to its association with an increased risk of infertility and malignancy, current management involves surgical correction with orchidopexy by 12 to 18 months of life. Adult presentation of cryptorchidism is very unusual due to early intervention; therefore, bilateral cryptorchidism is even more rare. As a result, current guidelines do not address proper management for adult cryptorchidism. Therefore, after performing a thorough review of the literature on contemporary guidelines for cryptorchidism management, we aim to highlight our approach to management in this rare case of adult bilateral cryptorchidism. We suggest bilateral orchiectomy as the safest option, if the patient is amendable, or bilateral orchiopexy with long-term follow-up for testicular cancer. Although the American Urological Association guidelines recommend orchiectomy for postpubertal cryptorchid children, currently, no explicit guidelines exist for the preferred method of managing adult cryptorchidism. Due to the increased risk of infertility and testicular cancer with cryptorchidism, orchiectomy instead of orchiopexy may be the preferred surgical approach in some instances. Still, in the case of bilateral cryptorchidism, orchiectomy may not always be the most viable solution, making orchiopexy with long-term follow-up for testicular cancer the best option, such as in our case.
摘要：
此病例报告介绍了一例罕见的成人隐睾病例，偶然发现于一位25岁的绅士，他最初表现为腹部和耻骨上疼痛，并成功进行了分阶段的睾丸固定术。据我们所知,到目前为止,我们的病例是首次在成人出现非特异性耻骨上疼痛的双侧隐睾病例.隐睾是新生儿最常见的生殖器异常，由于它与不孕和恶性肿瘤的风险增加有关，目前的管理包括12至18个月的寿命内进行睾丸固定术的手术矫正。由于早期干预，成人隐睾的表现非常不寻常；因此，双侧隐睾更为罕见。因此,目前的指南没有解决成人隐睾的适当管理。因此,在对当代隐睾管理指南的文献进行了全面审查之后，我们的目标是强调我们在这种罕见的成人双侧隐睾病例中的管理方法。我们建议双侧睾丸切除术是最安全的选择，如果病人是可以接受的,或双侧睾丸固定术，长期随访睾丸癌。尽管美国泌尿外科协会的指南建议对青春期后隐睾患儿进行睾丸切除术，目前,对于治疗成人隐睾的首选方法,目前尚无明确的指南.由于隐睾不孕和睾丸癌的风险增加，在某些情况下，睾丸切除术代替睾丸固定术可能是首选的手术方法。尽管如此，在双侧隐睾的情况下，睾丸切除术可能并不总是最可行的解决方案，使睾丸固定术与睾丸癌的长期随访成为最佳选择，就像我们的情况一样。
