Zeitpunkt der operativen Therapie des Maldescensus testis im Kindesalter: Wunsch und Wirklichkeit

 

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Zusammenfassung

Hintergrund: Als häufigste Diagnose im kinderchirurgischen Alltag stellt die Retentio testis erwiesenermaßen einen der größten Risikofaktoren für spätere Unfruchtbarkeit und Malignität dar.

Material und Methoden: Angesichts der meist sehr verspätet durchgeführten Orchidopexien untersuchten wir die Therapiestrategien der Pädiater im Einzugsgebiet der Universitätsklinik Würzburg. Diese Studie beinhaltete eine kurze Umfrage, die an 100 lokal ansässige Pädiater verschickt wurde. Nach Rücksendung der Fragebögen wurden die gegebenen Antworten mit den retrospektiven 504 Fällen verglichen, die in unserer Klinik von 2005 bis 2010 wegen einer Retentio testis behandelt wurden.

Ergebnisse: Theoretisches Wissen bezüglich der Leitlinien für die Behandlung der Retentio testis ist bei den Pädiatern in und um Würzburg in zufriedenstellendem Maße vorhanden. Trotzdem ist die anfängliche Therapie von konservativem Charakter und führt häufig zu unnötiger Verzögerung der Operation. Das Durchschnittsalter der Jungen, die an unserer Klinik zwischen 2005 und 2010 einer Orchidopexie unterzogen wurden, belief sich auf 3,3 Jahre.

Fazit: In Anbetracht der Leitlinien war das Durchschnittsalter kryptorcher Jungen, die zwischen 2005 und 2010 in der Uniklinik Würzburg orchidopexiert wurden, wesentlich zu hoch. Dieses Faktum kann zum Teil von einer zögerlichen Therapieweise der Pädiater abgeleitet werden. Eine Verbesserung des Operationszeitpunkts ist in jedem Fall möglich und notwendig, um die Therapieergebnisse zu optimieren.

Abstract

Background: Maldescensus testis constitutes the most common diagnosis in the daily routine of a paediatric surgeon and is proved to be one of the most established risk factors for future infertility and malignancy.

Material and Methods: We examined therapy strategies of paediatricians in the catchment area of the University Clinic of Würzburg in the light of the late time of orchidopexy. This study consists of a short survey sent to 100 local paediatricians. After return, the given answers were put in comparison to the 504 cases of retentio testis treated in our clinic from 2005 to 2010.

Results: Theoretical knowledge regarding guidelines for the treatment of retentio testis is abundant among paediatricians in and around Würzburg. Nevertheless, the initial therapy is of a hesitant character and often leads to an unnecessary delay in operation. The average age of boys receiving orchidopexy at our clinic between 2005 and 2010 amounted to 3.3 years.

Conclusion: Regarding guidelines the average age of cryptorchid boys receiving orchidopexy at the University Clinic of Würzburg was way too high between 2005 and 2010. To some extent this fact can be attributed to the hesitant manner of therapy shown by local paediatricians. An improvement in the time of operation is definitely possible and necessary in order to optimise the outcome.

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