Treatment Approach of Cryptorchidism in Developing Country

Abstract

The history of testicular descent is closely connected with the expression of masculinity and as such can be traced back to ancient Egypt. Research into testicular descent was initiated by Haller and Hunter. It was Hunter who discovered that the testes descend during embryonal life from dorsal abdominal wall into the scrotum.  In the study conducted by “John Radcliffe Hospital” the incidence of cryptorchidism is 1.58%, spontaneous descent occurred postnatal in the first three months, and beyond that time, it was rare[1, 2]. As with other pathologies treatment and timing had changed during the years.Very important part of modern medical infrastructure is a functioning informative system, where the data about patients are registered.  In the postwar developing country (Kosovo), rebuilding medical care and information system required a lot of effort and time. When the whole medical system needs to be rebuild and equipped, informative system is not in top priorities. What in normal circumstances can be one click away like history of patients, medical chart, lab exams, imagery studies, becomes lot of paper work that can easily be lost. Mainly difficulties were with patients in rural areas where awareness and access to specialist is not well covered. Providing medical care in these conditions can be quite challenging. The study was started after noticing that the patients that were diagnosed with cryptorchidism lost precious time until they were treated. In our series the mean age of patients was higher than recommended age for treating cryptorchidism.  Ideal age for treating cryptorchidism is from 6 month to 2 years of life. First signs of damage to testes are identified at about 6 month of age. We decided to study this pathology in 3 years period, after starting awareness program and systematic controls in schools and kindergartens.Conclusion: After starting systematic controls and awareness program, mean age of the patients diagnosed and treated for cryptorchidism is in decline.

Keywords: Cryptorchidism, Testes, Orchiopexy, Hormones, Medical risks, Modern treatment.