ORIGINAL ARTICLES

The descriptive epidemiology of congenital and acquired cryptorchidism in a UK infant cohort

C L Acerini¹, H L Miles¹, D B Dunger¹, K K Ong^1,2, I A Hughes¹

¹ Department of Paediatrics, University of Cambridge, Cambridge, UK
² MRC Epidemiology Unit, Cambridge, UK

^{Correspondence to} Dr C L Acerini, Department of Paediatrics, Level 8/Box 116, Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK; cla22{at}cam.ac.uk

Introduction: Recent studies in other European countries suggest that the prevalence of congenital cryptorchidism continues to increase. This study aimed to explore the prevalence and natural history of congenital cryptorchidism in a UK centre.

Methods: Between October 2001 and July 2008, 784 male infants were born in the prospective Cambridge Baby Growth Study. 742 infants were examined by trained research nurses at birth; testicular position was assessed using standard techniques. Follow-up assessments were completed at ages 3, 12, 18 and 24 months in 615, 462, 393 and 326 infants, respectively.

Results: The prevalence of cryptorchidism at birth was 5.9% (95% CI 4.4% to 7.9%). Congenital cryptorchidism was associated with earlier gestational age (p<0.001), lower birth weight (p<0.001), birth length (p<0.001) and shorter penile length at birth (p<0.0001) compared with other infants, but normal size after age 3 months. The prevalence of cryptorchidism declined to 2.4% at 3 months, but unexpectedly rose again to 6.7% at 12 months as a result of new cases. The cumulative incidence of "acquired cryptorchidism" by age 24 months was 7.0% and these cases had shorter penile length during infancy than other infants (p = 0.003).

Conclusions: The prevalence of congenital cryptorchidism was higher than earlier estimates in UK populations. Furthermore, this study for the first time describes acquired cryptorchidism or "ascending testis" as a common entity in male infants, which is possibly associated with reduced early postnatal androgen activity.

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