Guideline Statements Diagnosis 诊断 1. Providers should obtain gestational history at initial evaluation of boys with suspected cryptorchidism. (Standard; Evidence Strength: Grade B) 1. 对疑似隐睾症的男孩进行初步评估时需了解其母的妊娠史。(标准;证据强度:B级) 2. Primary care providers should palpate testes for quality and position at each recommended well-child visit. (Standard; Evidence Strength: Grade B)2. Primary care providers should palpate testes for quality and position at each recommended well-child visit. (Standard; Evidence Strength: Grade B) 2. 初级保健工作者应在每次接诊常规体检的男孩时,对睾丸的质地和位置进行检查。(标准;证据强度:B级) 3. Providers should refer infants with a history of cryptorchidism (detected at birth) who do not have spontaneous testicular descent by six months (corrected for gestational age) to an appropriate surgical specialist for timely evaluation. (Standard; Evidence Strength: Grade B) 3. 对于有隐睾病史(出生时即被检测到)的婴儿,如果在六个月内没有自发性睾丸下降(经妊娠年龄修正),应当将其转介给适当的外科专家,以便及时进行评估。(标准;证据强度:B级) 4. Providers should refer boys with the possibility of newly diagnosed (acquired) cryptorchidism after six months (corrected for gestational age) to an appropriate surgical specialist. (Standard; Evidence Strength: Grade B) 4. 对于在出生后六个月(经妊娠年龄修正)的男孩,在有新发(即获得性)隐睾症的可能性时,需将其转介给适当的外科专家。(标准;证据强度:B级) 5. Providers must immediately consult an appropriate specialist for all phenotypic male newborns with bilateral, nonpalpable testes for evaluation of a possible disorder of sex development (DSD). (Standard; Evidence Strength: Grade A) 5. 对于双侧未能触及睾丸的男性新生儿,应当立即咨询相应的专家,以评估是否存在性发育障碍(DSD)的可能性。(标准;证据强度:A级) 6. Providers should not perform ultrasound (US) or other imaging modalities in the evaluation of boys with cryptorchidism prior to referral as these studies rarely assist in decision making. (Standard; Evidence Strength: Grade B) 6. 在转诊前,没有必要对隐睾症男孩进行超声波(US)或其他影像学检查,因为这些检查很少有助于诊疗决策。(标准;证据强度:B级) 7. Providers should assess the possibility of a disorder of sex development (DSD) when there is increasing severity of hypospadias with cryptorchidism. (Recommendation; Evidence Strength: Grade C) 7. 对于同时伴发尿道下裂的隐睾症患儿,需要高度重视存在性发育异常(DSD)的可能性。(建议;证据强度:C级) 8. In boys with bilateral, nonpalpable testes who do not have congenital adrenal hyperplasia (CAH), providers should measure Müllerian Inhibiting Substance (MIS or Anti- Müllerian Hormone [AMH]) level), and consider additional hormone testing, to evaluate for anorchia. (Option; Evidence Strength: Grade C) 8. 对于双侧不能触及睾丸的男孩,如果无先天性肾上腺增生(CAH)应检测Müllerian抑制物(Müllerian Inhibiting Substance ,MIS;或抗-Müller [Anti-Müllerian Hormone ,AMH])激素水平,并考虑进行相关其它激素检测,以评估是否存在无睾畸形的可能。(可选;证据强度:C级) 9. In boys with retractile testes, providers should monitor the position of the testes at least annually to monitor for secondary ascent. (Standard; Evidence Strength: Grade B) 9. 对于有回缩性睾丸的男孩,需要观察睾丸的位置变化,至少每年1次,以监测是否有继发性睾丸上升的可能。(标准;证据强度:B级) Treatment 治疗 10. Providers should not use hormonal therapy to induce testicular descent as evidence shows low response rates and lack of evidence for long-term efficacy. (Standard; Evidence Strength: Grade B) 10. 不应使用激素疗法来诱导睾丸下降,因为有证据表明该疗法的反应率低,并且缺乏长期有效的证据。(标准;证据强度:B级) 11. In the absence of spontaneous testicular descent by six months (corrected for gestational age), specialists should perform surgery within the next year. (Standard; Evidence Strength: Grade B) 11. 对于出生后6个月(经孕龄修正)没有自发性睾丸下降的患儿,应当在下一年内进行手术。(标准;证据强度:B级) 12. In prepubertal boys with palpable, cryptorchid testes, surgical specialists should perform scrotal or inguinal orchidopexy. (Standard; Evidence Strength: Grade B) 12. 对于可触及睾丸的青春期前隐睾症,应进行经阴囊或腹股沟的睾丸固定术。(标准;证据强度:B级) 13. In prepubertal boys with nonpalpable testes, surgical specialists should perform examination under anesthesia to reassess for palpability of testes. If nonpalpable, surgical exploration and, if indicated, abdominal orchidopexy should be performed. (Standard; Evidence Strength: Grade B) 13. 对于未能触及睾丸的青春期前隐睾症,应在麻醉下进行检查,以重新评估睾丸能否被发现的可能性。如果仍不可触及睾丸,有必要进行手术探查,在具备指征的情况,可进行经腹途径的睾丸探查及固定术。(标准;证据强度:B级) 14. At the time of exploration for a nonpalpable testis in boys, surgical specialists should identify the status of the testicular vessels to help determine the next course of action. (Clinical Principle) 14. 在探查不可触及的隐睾时,应确定睾丸血管的状况,以协助决定进一步措施。(临床原则) 15. In boys with a normal contralateral testis, surgical specialists may perform an orchiectomy (removal of the undescended testis) if a boy has a normal contralateral testis and either very short testicular vessels and vas deferens, dysmorphic or very hypoplastic testis, or postpubertal age. (Clinical Principle) 15. 对于青春期后隐睾,在对侧睾丸正常的情况下,如果发现患侧睾丸存在明显的血管和输精管过短、形态异常或发育不良,则可以考虑切除未降隐睾。(临床原则) 16. Providers should counsel boys with a history of cryptorchidism and/or monorchidism and their parents regarding potential long-term risks and provide education on infertility and cancer risk. (Clinical Principle) 16. 对于隐睾症或者单睾症,应就潜在的不孕症和癌症方面的长期风险向患者及其父母提供咨询、指导。(临床原则) |
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