Antson, Anne

Astover, Valve

Kübarsepp, Viljo

Merila, Mirjam

Nellis, Georgi

Punab, Margus

Salundi, Urve

Varendi, Heili

Varik, Karin

Veinla, Maie

English

Journals from University of Tartu

447EESTI ARST 100 EESTI UURINGUID MAAILMA TEADUSAJAKIRJADES Eesti Arst 2022; 101(8):447* Tegu on pilditõmmisega artikli päisest.1 TÜ kirurgiakliinik,2 TÜ Kliinikumi kirurgiakliinik,3 TÜ lastekliinik,4 TÜ Kliinikumi lastekliinik,5 TÜ Kliinikumi androloogiakeskusTaustKrüptorhism ehk peitmunandilisus on poistel kõige sagedasem uroge-nitaaltrakti arenguanomaalia, mida on etiopatogeneetiliselt seostatud hüpospaad ia ,  spermatogeneesi häirete ja munandi vähkkasvajaga, nimetades neid kokku testikulaarse düsgeneesi sündroomiks ( TDS). Varasemates uuringutes on leitud, et Eesti meeste sperma kvaliteet on parem ning munandi vähkkas-vajasse haigestumus väiksem kui teiste Põhja- ja Baltimaade meestel. Krüptorhismi esinemissagedus on erinevate riikide prospektiivsete uuringute põhjal 1,6–9%, sh Põhja- ja Baltimaade piirkonnas Soomes 2,4%, Taanis 9% ja Leedus 5,7%. Uuringu eesmärk oli hinnata krüp-torhismi esinemissagedust Eestis ja võrrelda seda Põhja- ja Baltimaade andmetega.MeetodidAastatel 2012–2015 hinnati kõigil Tartu Ülikooli Kliinikumis vastsün-dinud poistel munandite asetsust ja krüptorhismi esinemist. Kõiki krüp-torhismiga poisse jälgiti vähemalt 6 kuu jooksul, et hinnata sünnijärgset munandite iseeneselikku laskumist.TulemusedAastatel 2012–2015 sündis kliini-kumis kokku 5014 poissi, kellest 104-l (2,1%) oli üks või mõlemad munandid laskumata. Vasempoolset k r üptorh ismi esines 28 juhu l , parempoolset samuti 28 juhul, bila-teraalset krüptorhismi 46 juhul ja 2 Krüptorhismi esinemissagedus Eestis*juhul oli tegemist ühepoolse peri-neaalse ektoopiaga. Kokku jaotati 150 laskumata munandit asukoha järgi järgmiselt: 2 (1,3%) – kõrge skrotaalne; 37 (21%) – suprask-rotaalne; 29 (19%) – ingvinaalne, 80 (53%) – mittepalpeeritav ning 2 (1,3%) – ektoopi l ine asetsus. Krüptorh ismi esinemissagedus sünnihetkel oli enneaegsetel poistel 11,9%, madala sünnikaaluga poistel 16,7% ning poistel, kellel oli gestat-sioonivanuse kohta madal sünnikaal, 14%. Samas oli ajaliste ja normaal-kaaluliste poiste hulgas krüptor-hismi esinemissagedus ainult 1,1%.Jälgimisperioodi vältel laskusid munandid spontaanselt 62%-l krüp-torhismiga sündinud poistest. Eriti sage ol i laskumine enneaegsete poiste – 92% – ja madala sünnikaa-luga poiste hulgas – 93%. Ajalistel poistel laskusid munandid sünni järel ainult 29%-l ning normaalkaa-lulistel 34%-l. Spontaanse laskumise tulemusena võrdsustus krüptor-hismi esinemissagedus 6. elukuuks nii madala sünnikaaluga kui ka normaalkaalulistel poistel, vastavalt 1% ja 0,7%, samuti enneaegsetel ja ajalistel poistel, vastavalt 0,9% ja 0,7%. Suuremaks jäi krüptorhismi esinemissagedus gestatsioonivanuse kohta madala sünnikaaluga poistel võrreldes gestatsioonivanuse suhtes normaalkaaluliste poistega – vasta-valt 4% ja 0,7%.Töö käigus hinnati rahvuse mõju krüptorhismi esinemissagedusele, kuid mitte-eestlaste ja eestlaste vahel erinevust esile ei tulnud.JäreldusedUuringu käigus võrreldi krüptor-hismi esinemissagedust Eestis teiste riikide andmetega ja leiti, et Eestis on krüptorhismi esinemissagedus sünnihetkel märgatavalt väiksem kui teistes Põhja- ja Baltimaade piirkonna riikides. Kergeid krüptor-hismi vorme, mida on kirjanduses seostatud keskkondlike teguritega, esines meie uuringurühmas ainult 1,3%, samas kui teistes ri ik ides oli kergete krüptorhismivormide osakaal suurem. Sellest lähtuvalt ei saa siiski väita, et Eestis on kesk-kondlik mõju munandi laskumisele väiksem ja sel lest tulenevalt on krüptorhismi vähem. Selle väite kinnitamiseks oleks vaja teha palju laiapõhjalisemaid mitut keskust haaravaid uuringud.Uuringu käigus hinnatud riskite-gurid nagu madal sünnikaal, enne-aegsus ja madal sünnikaal gestat-sioonivanuse kohta mängisid rolli just sünnihetkel, kuid 6. elukuuks jäi riskiteguritest oluliseks ainult madal sünnikaal gestatsioonivanuse kohta. Sel lest võis järeldada, et munandite laskumise häire madala sünnikaaluga ja enneaegsetel poistel on pigem füsioloogiline seisund, mis laheneb ajaga ja on tingitud poisi ebaküpsusest, mitte genitaaltrakti arenguanomaaliast.Received: 20 August 2021 Revised: 19October 2021 Accepted: 20October 2021DOI: 10.1111/andr.13121OR I G I N A L A RT I C L EPrevalence of congenital cryptorchidism in EstoniaViljo Kübarsepp1,2 Karin Varik1,2 Heili Varendi3,4 AnneAntson4 Maie Veinla4Georgi Nellis3,4 MirjamMerila4 Urve Salundi4 Valve Astover4 Margus Punab1,51 Department of Surgery, Institute of ClinicalMedicineUniversity of Tartu, Tartu, Estonia2 Department of Paediatric Surgery, Clinic ofSurgery, Tartu University Hospital, Tartu,Estonia3 Department of Paediatrics, Institute ofClinical MedicineUniversity of Tartu, Tartu,Estonia4 Department of Neonatology, Children’sClinic, Tartu University Hospital, Tartu, Estonia5 Andrology Centre, Tartu University Hospital,Tartu, EstoniaCorrespondenceViljoKübarsepp,Departmentof Surgery,InstituteofClinicalMedici e,University ofTartu, Puusepa8, Tartu50406, Estonia.Email: viljo.kybarsepp@kliinikum.eeAbstractBackground: Cryptorchidism is one of the most common urogenital malformations.Cryptorchidism prevalence varies greatly in different countries and populations. Theaim of the current study was to determine and analyse cryptorchidism prevalence inEstonia.Materi ls andmethods:During 2012–2015, all consecutively born 5014 boys a TartuUniversity Hospital were examined for cryptorchidism. All the subjects with cryp-torchidism were followed up for at least 6 months to assess spontaneous testiculardescent.Results: Note that 2.1% cases had one or both testicles undescended at birth, 1.6%cases at expected date of birth, 1% cases at 3 months of age, and 0.8% cases at theage of 6 months had cryptorchidism. Cryptorchidism prevalence at birth was higher inpreterm boys (11.9%), boys of low birth weight (16.7%) and boys small for gestationalage (14%) but was lower in full-term newborn boys (1.1%). During follow-up, testesdescended spontaneously in 61.6% of boys, more commonly in prematurely born boys(92%) andboyswith lowgestationalweight (93%) as compared to full-termcryptorchidboys (29.2%) and cryp orchid boys with normal birth weight (34%). At the age of 6months, cryptorchidism prevalence was equalized in preterm boys (0.9%) and boyswith low birth weight (1%) as compared to full-term boys (0.7%) and boys with nor-mal birthweight (0.7%). Boys SGA required surgical interventionmore commonly thanboys with normal birth weight. Ethnically, cryptorchidism prevalence at birth was sim-ilar among Estonians and non-Estonians.Conclusion:Our data revealed that cryptorchidism prevalence, especially in full-termboys, is lower in Estonia than reported in the other Nordic-Baltic countries and world-wide.KEYWORDScryptorchidism, cryptorchidism prevalence, testicular dysgenesis syndrome, unde cendedtesticles© 2021 American Society of Andrology and European Academy of AndrologyAndrology. 2022;10:303–309. wileyonlinelibrary.com/journal/andr 303Received: 20 August 2021 Revised: 19October 2021 Accepted: 20October 2021DOI: 10.1111/andr.13121OR I G I N A L A RT I C L EPrevalence of congenital cryptorchidism in EstoniaViljo Kübarsepp1,2 Karin Varik1,2 Heili Varendi3,4 AnneAntson4 Maie Veinla4Georgi Nellis3,4 MirjamMerila4 Urve Salundi4 Valve Astover4 Margus Punab1,51 Department of Surgery, Institute of ClinicalMedicineUniversity of Tartu, Tartu, Estonia2 Departme t of Paediatric Surgery, Clinic ofSurgery, Tartu University Hospital, Tartu,Es onia3 Department of Pa diatrics, Institute ofClinical MedicineUniversity of Tartu, Tartu,Estonia4 Department of Neonatology, Children’sClinic, Tartu University Hospital, Tartu, Estonia5 A drology Centre, Tartu Un versity Hospital,Tartu, EstoniaCorrespondenceViljoKübarsepp,Departmentof Surgery,InstituteofClinicalMedicine,University ofTartu, Puusepa8, Tartu50406, Estonia.Email: viljo.kybarsepp@kliinikum.eeAbstractBackground: Cryptorchidism is one of the most common urogenital malformations.Cryptorchidism prevalence varies greatly in different cou tries a d popu ations. Theaim of the current study was to determine and analyse cryptorchidism revalence inEstonia.Materi ls andm thods:During 2012–2015, all consecutively born 5014 boys at TartuUniv sity Hospital were examined for cryptorchidism. Al the subjects with cryp-torchidism were followed up for at least 6 months to assess spontan ous testi ulardes ent.R ults: Note that 2.1% cases had one or both testicles undescended at birth, 1.6%cases at expected date of birth, 1% cases at 3 mon hs of age, and 0.8% cases at theage of 6 months ha cryptorchidism. Cryptorchidism prevalence at birth was higher inpreterm boys (11.9%), boys of low birth weight (16.7%) and boys small for gestationalag (14%) but was lower in fu l-term ne born boys (1.1%). During foll w-up, testesdescended spont ne usly 61.6% of boys, more commonly in prematurely born boys(92%) andboyswith l wgestationalweight (93 ) as co pared to full-termcryptorchidboys (29.2%) and crypt rchid boys ith normal birth weight (34%). At the age of 6m nths, cryptorchidism prevalence as equalized in preterm boys (0.9%) and b yswith low birth weight (1%) as compared to ful -t rm boys (0.7%) and boys with n r-mal birthweight (0.7%). Boys SGA required surgical interventionmore commonly thanboys wit normal birth weight. Ethnically, cryptorchidism prevalence at birth was sim-ilar among Estonians and non-Esto ians.Conclusion:Our data revealed that cryptorchidism prevalence, especially in full-termboys, is lower in Estonia than repor ed in he other Nordic-Baltic countries and world-wide.KEYWORDScryptorchidism, cryptorchidism prevalence, testicular dysgenesis sy drome, undescendedtesticles© 2021 American Society of Andrology and European Academy of AndrologyAndrology. 2022;10:303–309. wileyonlinelibrary.com/journal/andr 303Received: 20 August 2021 Revised: 19October 2021 Accepted: 20October 2021DOI: 10.1111/andr.13121OR I G I N A L A RT I C L EPrevalence of congenital cryptorchidism in EstoniaViljo Kübarsepp1,2 Karin Varik1,2 Heili Varendi3,4 AnneAntson4 Maie Veinla4Georgi Nellis3,4 MirjamMerila4 Urve Salundi4 Valve Astover4 Margus Punab1,51 Department of Surgery, Institute of ClinicalMedicineUn versity of Tartu, Tartu, Estoni2 epart ent of Paediatric Surgery, Clinic ofSurgery, Tartu University Hospital, Tartu,Estonia3 Department of Paediatrics, Institute ofClinical MedicineUniversity of Tartu, Tartu,Estonia4 Department of Neonatology, Children’sClinic, Tartu University Hospital, Tartu, Estonia5 Andrology Centre, Tartu University Hospital,Tartu, EstoniaCorrespondenceViljoKübarsepp,Departmentof Surgery,InstituteofClinicalMedicine,University ofTartu, Puusepa8, Tartu50406, Estonia.Email: viljo.kybarsepp@kliinikum.eeAbstractBackground: Cryptorchidism is one of the most common urogenital malformations.Cryptorchidism prevalence varies greatly in different countries an populations. Theaim of the current study was to determine and analyse cryptorchidism prevalence inEstonia.Materials andmethods:During 2012–2015, all consecutively born 5014 boys at TartuUniversity Hospital were examined for cryptorchidism. All the subjects with cryp-torchidism were followed up for at least 6 months to assess spontaneous testiculardescent.Results: Note that 2.1% cases had one or both testicles undescended at birth, 1.6%cases at expected date of birth, 1% cases at 3 months of age, and 0.8% cases at theage of 6 months h d cryptorchidism. Cryptorchidism prevalence at birth was higher inpreterm boys (11.9%), boys of low birth weight (16.7%) and boys small for gestationalage (14%) but was lower in full-term ewborn boys (1.1%). During follow-up, testesdescended spontaneously in 61.6% of boys, more commonly in prematurely born boys(92%) andboyswith lowgestationalweight (93%) as compared to full-termcryptorchidboys (29.2%) and cryptorchid boys with normal birth weight (34%). At the age of 6months, cryptorchidism prevalence was equalized in preterm boys (0.9%) and boyswith low birth weight (1%) as compared to full-term boys (0.7%) and boys with nor-mal birthweight (0.7%). Boys SGA required surgical interventionmore commonly thanboys with normal birth weight. Ethnically, cryptorchidism prevalence at birth was sim-ilar among Estonians and non-Estonians.Conclusion:Our data revealed that cryptorchidism prevalence, especially in full-termboys, is lower in Estonia than reported in the other Nordic-Baltic countries and world-wide.KEYWORDScryptorchidism, cryptorchidism prevalence, testicular dysgenesis syndrome, undescendedtesticles© 2021 American Society of Andrology and European Academy of AndrologyAndrology. 2022;10:303–309. wileyonlinelibrary.com/journal/andr 303

Krüptorhismi esinemissagedus Eestis

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Krüptorhismi esinemissagedus Eestis

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