# Cryptorchidism — GCMD Library living collection

Everything in the library about cryptorchidism — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 27 cited statements

## Episodes
### Evidence & Research
- [Age at Orchiopexy JPS Review](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147) — video · [machine version](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147.md)
- [Quick Literature Updates Ep 25](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294) — video · [machine version](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294.md)

### In-Depth Reviews
- [Cryptorchidism Rapid Fire Session: Update Course 2015](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907) — video · 6:03 · [machine version](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907.md)

## Chapters
- [0:00](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=0) Cryptorchidism Overview and Management Controversies (Ep 1)
- [4:52](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=292) Clinical Decision Points in Cryptorchidism Management (Ep 1)
- [5:37](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=337) Transition to Next Topic (Ep 1)
- [0:00](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147?t=0) Introduction and paper overview (Ep 2)
- [1:10](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147?t=70) Current practice patterns versus AUA guidelines (Ep 2)
- [2:19](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147?t=139) Lancet study on timing and testicular location (Ep 2)
- [3:30](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147?t=210) Summary and future research directions (Ep 2)
- [0:00](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=0) Introduction (Ep 3)
- [0:16](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=16) Lymphatic Malformations Management (Ep 3)
- [1:23](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=83) Gastrostomy Tube Quality Improvement Targets (Ep 3)
- [2:31](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=151) Orchiopexy Timing and Testicular Volume (Ep 3)
- [3:36](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=216) Closing (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- Cryptorchidism is one of the most common pediatric disorders of the male endocrine glands and the most common genital disorder identified at birth. (epidemiological) [Ep 1 · 0:00](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=0)
- There are two types of cryptorchidism: congenital (found at birth) and acquired (testicles previously descended but can no longer be brought down without discomfort). (clinical) [Ep 1 · 1:00](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=60)
- Treatment of cryptorchidism reduces risks including impaired fertility, testicular malignancy, risk of torsion, and treats associated inguinal hernia. (clinical) [Ep 1 · 2:00](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=120)
- The actual mechanism of action of hormonal therapy agents for cryptorchidism is unknown. (clinical) [Ep 1 · 3:00](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=180)
- Published studies on hormonal therapy included multiple treatment strategies with different doses and intervals, none showing good response rates or demonstrable long-term benefits. (clinical) [Ep 1 · 3:20](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=200)
- Hormonal therapy should not be used to induce testicular descent due to low response rates and lack of evidence for long-term efficacy. (guideline) [Ep 1 · 4:00](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=240)
- 70% of undescended testicles are palpable, though they may not be palpable during examination while the child is awake but are usually palpable under anesthesia. (clinical) [Ep 1 · 4:20](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=260)
- Ultrasound has a sensitivity of only 45% and specificity of only 78% in determining testicle location and size. (clinical) [Ep 1 · 4:50](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=290)
- Ultrasound cannot identify intra-abdominal testicles. (clinical) [Ep 1 · 5:10](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=310)
- Other imaging modalities are expensive, require anesthesia, or irradiate tissues, and no radiologic test is 100% accurate to determine whether a testicle is absent. (clinical) [Ep 1 · 5:20](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=320)
- Surgical exploration (diagnostic laparoscopy or open exploration) must be performed on all non-palpable unilateral and many bilateral cryptorchid patients. (guideline) [Ep 1 · 5:50](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=350)
- Imaging should not be performed for cryptorchidism as it is not helpful and can actually delay treatment. (guideline) [Ep 1 · 6:20](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=380)
- There is no advantage for laparoscopic versus open exploration for intra-abdominal testicles. (clinical) [Ep 1 · 6:40](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=400)
- For salvageable intra-abdominal testicles, three surgical options exist: primary orchiopexy, one-stage Fowler-Stevens, or two-stage Fowler-Stevens. (clinical) [Ep 1 · 7:00](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=420)
- The decision tree for intra-abdominal testicles prioritizes sparing testicular vessels if possible. (clinical) [Ep 1 · 7:30](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=450)
- There is no apparent advantage of one-stage versus two-stage Fowler-Stevens procedure when testicular vessels cannot be spared. (clinical) [Ep 1 · 6:03](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=363)
- Orchiectomy may be prudent in the presence of a normal contralateral descended testicle. (opinion) [Ep 1 · 6:03](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=363)
- Most of the time the testes can be brought down without needing to divide the testicular vessels. (opinion) [Ep 1 · 4:58](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=298)
- For prepubertal patients (e.g., 10 years old), orchiopexy should be attempted; for pubertal patients (e.g., 14 years old), orchiectomy is preferred; 12 years old is a difficult decision point. (opinion) [Ep 1 · 5:15](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=315)
- The teaching is that if the patient is prepubertal, orchiopexy can be attempted, but if going through puberty, orchiectomy should be performed. (guideline) [Ep 1 · 5:17](https://origin-library.globalcastmd.com/watch/cryptorchidism-rapid-fire-session-update-course-2015-907?t=317)
- The American Urological Association released guidelines that orchiopexy should be done around one year of age but not later than 18 months. — Augustino Piero (guideline) [Ep 2 · 1:10](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147?t=70)
- The paper reviewed two major databases in the United States and found that 70% of children get orchiopexy six months beyond the suggested ideal time. — Augustino Piero (epidemiological) [Ep 2 · 1:10](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147?t=70)
- What matters is not the timing of surgery, it depends whether the patient has unilateral cryptorchidism or bilateral cryptorchidism or if their testis is palpable or impalpable. — Pam Choi (clinical) [Ep 2 · 2:19](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147?t=139)
- In a Lancet study, 142 adults who had orchiopexy between ages 7 and 13 years were examined for semen analysis. — Pam Choi (clinical) [Ep 2 · 2:19](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147?t=139)
- Semen analysis was normal or acceptable in patients who had unilateral cryptorchidism. — Pam Choi (clinical) [Ep 2 · 2:19](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147?t=139)
- Patients who had bilateral palpable testes in the superficial pouch had semen which was normal or acceptable. — Pam Choi (clinical) [Ep 2 · 2:19](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147?t=139)
- Patients who had bilateral impalpable testes (either in the abdomen or canalicular) were all azoospermic. — Pam Choi (clinical) [Ep 2 · 2:19](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147?t=139)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- Wertheim et al. performed a systematic review of management and outcomes of pediatric lymphatic malformations, published by the APSA Outcomes and Evidence-Based Practice Committee. — The host summarizing a resource [Ep 3 · 0:16](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=16)
- The systematic review focused on 200 articles published from 1990 to 2021. — The host summarizing a resource [Ep 3 · 0:42](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=42)
- Sclerotherapy had a success rate of over 90% for macrocystic lymphatic malformation lesions. — The host summarizing a resource [Ep 3 · 0:52](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=52)
- Sirolimus is helpful for extensive lymphatic malformations that are refractory to surgery and/or sclerotherapy. — The host summarizing a resource [Ep 3 · 1:00](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=60)
- Sirolimus is used as an initial treatment for extensive lymphatic malformations that compromise the airway. — The host summarizing a resource [Ep 3 · 1:08](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=68)
- Small asymptomatic lymphatic malformation lesions can be observed. — The host summarizing a resource [Ep 3 · 1:16](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=76)
- Large symptomatic lymphatic malformation lesions need to be divided into macrocystic, microcystic, or mixed lesions for treatment planning. — The host summarizing a resource [Ep 3 · 1:19](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=79)
- For localized lymphatic malformation lesions, surgery or sclerotherapy is effective. — The host summarizing a resource [Ep 3 · 1:19](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=79)
- Mo et al. performed a retrospective cohort analysis of the NSQIP pediatric database looking at all pediatric patients who underwent G-tube placement in 2023. — The host summarizing a resource [Ep 3 · 1:23](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=83)
- G-tube placement made up 5.3% of all cases submitted to NSQIP pediatric. — The host summarizing a resource [Ep 3 · 1:48](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=108)
- Upper GI studies were obtained in 45% of G-tube cases with significant interhospital variability. — The host summarizing a resource [Ep 3 · 1:54](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=114)
- In the first 30 days postoperatively after G-tube placement, 14% of patients went to the ED. — The host summarizing a resource [Ep 3 · 2:02](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=122)
- In the first 30 days postoperatively after G-tube placement, 5.2% of patients experienced G-tube dislodgement. — The host summarizing a resource [Ep 3 · 2:10](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=130)
- There is high postoperative G-tube related morbidity as well as high variability in preoperative upper GI use, which can both serve as targets for future quality improvement projects. — The host summarizing a resource [Ep 3 · 2:17](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=137)
- Colin et al. conducted a prospective randomized study in Sweden comparing testicular volume at puberty in patients with undescended testes that had spontaneous descent versus surgery at 9 months or at 3 years of age. — The host summarizing a resource [Ep 3 · 2:31](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=151)
- The study included 22 patients with spontaneous descent, 37 with surgery at 9 months, and 48 with surgery at three years of age. — The host summarizing a resource [Ep 3 · 2:58](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=178)
- There was a significant difference in testicular volume being higher in spontaneous descent versus the 9 month surgery group. — The host summarizing a resource [Ep 3 · 3:08](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=188)
- Testicular volume was significantly higher in those who were operated at 9 months versus those who were operated at three years of age. — The host summarizing a resource [Ep 3 · 3:18](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=198)
- The earlier orchiopexy is performed, the better the testicular volume outcome, as long as patients are given enough time for spontaneous descent. — The host summarizing a resource [Ep 3 · 3:27](https://origin-library.globalcastmd.com/watch/quick-literature-updates-ep-25-11294?t=207)
- The median time for orchiopexy is between four and five years of age. — Todd Ponsky summarizing the discussion [Ep 2 · 1:53](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147?t=113)
- The AUA recommends making the diagnosis of undescended testicle at six months of age with repair by 18 months. — Todd Ponsky summarizing the discussion [Ep 2 · 3:30](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147?t=210)
- Patients with palpable testicles who had orchiopexy at a later age had completely normal semen. — Todd Ponsky summarizing the discussion [Ep 2 · 3:30](https://origin-library.globalcastmd.com/watch/age-at-orchiopexy-jps-review-1147?t=210)

## Changelog
- Sep 25: 3 items added automatically

---
Educational content from recorded physician discussions — not medical advice. Cite the canonical URL or the ?t= deep link. Policy: https://origin-library.globalcastmd.com/ai