{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:09:06Z","timestamp":1789085346791,"version":"build-2803163510"},"reference-count":53,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,6,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVE:<\/jats:title>\n                  <jats:p>Controversy remains concerning the optimal treatment approach for cryptorchidism. The objective of this study was to assess effectiveness of hormone therapy or surgery for cryptorchidism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>We searched Medline and other databases from 1980 to February 2012. Two reviewers independently assessed studies against predetermined criteria. Two reviewers independently extracted data and assigned overall quality and strength of evidence ratings using predetermined criteria.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Fourteen studies addressed effectiveness of hormonal treatments, and 26 studies addressed surgical intervention outcomes. Hormonal treatment is associated with testicular descent in some children, but rates generally do not exceed those seen with placebo by &amp;gt;10%. Surgical treatment is associated with success rates of testicular descent ranging from 33% to 100%, depending on surgery. Weighted success averages were 78.7% for 1-stage Fowler-Stephens (FS), 86% for 2-stage FS, and 96.4% for primary orchiopexy. Descent rates were similar among studies comparing laparoscopic and open surgeries. Reported harms of hormonal treatments were mild and transient. Adverse effects specifically associated with surgical repair were rare.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>The body of the reviewed literature comprises primarily fair- and poor-quality studies, limiting our ability to draw definitive conclusions. Hormonal treatment is marginally effective relative to placebo but is successful in some children and with minimal harms, suggesting that it may be an appropriate trial of care for some patients. Surgical options are effective, with high rates of testicular descent (moderate strength of evidence for FS procedures, high for primary orchiopexy). Comparable outcomes occur with laparoscopic and open approaches.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2013-0072","type":"journal-article","created":{"date-parts":[[2013,5,21]],"date-time":"2013-05-21T00:48:16Z","timestamp":1369097296000},"page":"e1897-e1907","source":"Crossref","is-referenced-by-count":62,"title":["Effectiveness of Hormonal and Surgical Therapies for Cryptorchidism: A Systematic Review"],"prefix":"10.1542","volume":"131","author":[{"given":"David","family":"Penson","sequence":"first","affiliation":[{"name":"Department of Urology, Center for Surgical Quality and Outcomes,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanthi","family":"Krishnaswami","sequence":"additional","affiliation":[{"name":"Vanderbilt Evidence-based Practice Center, Institute for Medicine and Public Health,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astride","family":"Jules","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa L.","family":"McPheeters","sequence":"additional","affiliation":[{"name":"Vanderbilt Evidence-based Practice Center, Institute for Medicine and Public Health,"},{"name":"Obstetrics and Gynecology, Vanderbilt Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2013,6,1]]},"reference":[{"issue":"1","key":"2021120900392617800_B1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ucl.2008.08.004","article-title":"The demographic burden of urologic diseases in America.","volume":"36","author":"Miller","year":"2009","journal-title":"Urol Clin North Am"},{"issue":"6 pt 1","key":"2021120900392617800_B2","doi-asserted-by":"crossref","first-page":"2396","DOI":"10.1097\/01.ju.0000095793.04232.d8","article-title":"The epidemiology of congenital cryptorchidism, testicular ascent and orchiopexy.","volume":"170","author":"Barthold","year":"2003","journal-title":"J Urol"},{"key":"2021120900392617800_B3","volume-title":"Campbell-Walsh Urology","author":"Campbell","year":"2007","edition":"9th ed."},{"key":"2021120900392617800_B4","first-page":"464","article-title":"Undescended testes (cryptorchidism)","volume-title":"The 5-Minute Urology Consult","author":"White","year":"2010"},{"key":"2021120900392617800_B5","unstructured":"Penson DF, Krishnaswami S, Jules A, Seroogy JC, McPheeters ML. Evaluation and treatment of cryptorchidism. Comparative Effectiveness Review No. 88. (Prepared by the Vanderbilt Evidence-based Practice Center under Contract No. 290-2007-10065-I.) AHRQ Publication No. 13-EHC001-EF. Rockville, MD: Agency for Healthcare Research and Quality. November 2012. Available at: www.effectivehealthcare.ahrq.gov\/reports\/final.cfm. Accessed March 25, 2013"},{"key":"2021120900392617800_B6","unstructured":"Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org. Accessed March 25, 2013"},{"key":"2021120900392617800_B7","unstructured":"Wells GA, Shea B, O'Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available at: http:\/\/wwwohrica\/programs\/clinical_epidemiology\/oxfordasp. Accessed January 24, 2012"},{"issue":"8","key":"2021120900392617800_B8","doi-asserted-by":"crossref","first-page":"529","DOI":"10.7326\/0003-4819-155-8-201110180-00009","article-title":"QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies.","volume":"155","author":"Whiting","year":"2011","journal-title":"Ann Intern Med"},{"key":"2021120900392617800_B9","doi-asserted-by":"crossref","first-page":"S35","DOI":"10.1007\/BF00452867","article-title":"LH-RH nasal spray treatment for cryptorchidism. A double-blind, placebo-controlled study.","volume":"146","author":"De Muinck Keizer-Schrama","year":"1987","journal-title":"Eur J Pediatr"},{"issue":"8486","key":"2021120900392617800_B10","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1016\/S0140-6736(86)90986-4","article-title":"Double-blind, placebo-controlled study of luteinising-hormone-releasing-hormone nasal spray in treatment of undescended testes.","volume":"1","author":"deMuinck Keizer-Schrama","year":"1986","journal-title":"Lancet"},{"issue":"12","key":"2021120900392617800_B11","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1016\/S0022-3468(87)80732-7","article-title":"Why luteinizing-hormone-releasing-hormone nasal spray will not replace orchiopexy in the treatment of boys with undescended testes.","volume":"22","author":"Hazebroek","year":"1987","journal-title":"J Pediatr Surg"},{"issue":"4","key":"2021120900392617800_B12","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/BF00442181","article-title":"Treatment of undescended testes with intranasal application of synthetic LH-RH.","volume":"139","author":"Hagberg","year":"1982","journal-title":"Eur J Pediatr"},{"issue":"6","key":"2021120900392617800_B13","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1016\/S0022-3476(83)80708-2","article-title":"LHRH treatment in unilateral cryptorchidism: effect on testicular descent and hormonal response.","volume":"103","author":"Karpe","year":"1983","journal-title":"J Pediatr"},{"issue":"4-5","key":"2021120900392617800_B14","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1159\/000181058","article-title":"Treatment of cryptorchidism with human chorionic gonadotropin or gonadotropin releasing hormone. 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