Evidence map›Paper›PMID 30236382›Full record

ArticleThe Lancet. Child & adolescent health2018

Association between male genital anomalies and adult male reproductive disorders: a population-based data linkage study spanning more than 40 years.

Francisco J Schneuer, Elizabeth Milne, Sarra E Jamieson, Gavin Pereira, Michele Hansen, Andrew Barker, Andrew J A Holland, Carol Bower, Natasha Nassar

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in The Lancet. Child & adolescent health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06628375 (Exposure to Endocrine Disruptors and Occurrence of Hypospadias), which is not on this map. Cited by 37 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 3 pooled it
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06628375 recruitingnot on this mapstarted 2024, after this paper: background citation

Exposure to Endocrine Disruptors and Occurrence of Hypospadias: Toxicological, Environmental and Hormonal Imbalance Study

TypeobservationalSponsorUniversity Hospital, MontpellierRan2024 to 2027Enrolled200ConditionsHypospadiasArmsConsultation visit (Visit 1)
3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 68 citations in OpenAlex.

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  20. The fate of germ cells in cryptorchid testis.Frontiers in endocrinology · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 1 country.

Francisco J SchneuerChild Population and Translational Health Research, The Children's Hospital at Westmead Clinical School, The University of Sydney, NSW, Australia. Electronic address: francisco.schneuer@sydney.edu.au.
Elizabeth MilneTelethon Kids Institute, University of Western Australia, Perth, WA, Australia.
Sarra E JamiesonTelethon Kids Institute, University of Western Australia, Perth, WA, Australia.
Gavin PereiraTelethon Kids Institute, University of Western Australia, Perth, WA, Australia; School of Public Health, Curtin University, Perth, WA, Australia.
Michele HansenTelethon Kids Institute, University of Western Australia, Perth, WA, Australia.
Andrew BarkerDepartment of Paediatric Surgery, Princess Margaret Hospital for Children, Perth, WA, Australia.
Andrew J A HollandDiscipline of Child and Adolescent Health, The Children's Hospital at Westmead Clinical School, The University of Sydney, NSW, Australia.
Carol BowerTelethon Kids Institute, University of Western Australia, Perth, WA, Australia.
Natasha NassarChild Population and Translational Health Research, The Children's Hospital at Westmead Clinical School, The University of Sydney, NSW, Australia.
University of Western Australia · AUUniversity of Sydney · AUChildren's Hospital at Westmead · AUCurtin University · AUPrincess Margaret Hospital for Children · AUThe Kids Research Institute Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe male genital anomalies hypospadias and undescended testes have been linked to adult male reproductive disorders, testicular cancer, and decreased fertility. Few population-based studies have evaluated their effects on adult fertility outcomes and, in the case of undescended testes, the importance of early corrective surgery (orchidopexy).

methodsWe did a population-based cohort study of all liveborn boys in Western Australia in 1970-99, and followed them up until 2016 via data linkage to registries for hospital admissions, congenital anomalies, cancer, and assisted reproductive technologies (ART). Study factors were hypospadias or undescended testes, and study outcomes were testicular cancer, paternity, and use of ART for male infertility. Cox regression was used to calculate hazard ratios (HRs) for the associations between genital anomalies and testicular cancer or paternity, and log-binomial regression was used to calculate relative risks (RRs) for the associations between genital anomalies and use of ART.

findingsThe cohort comprised 350 835 boys, of whom 2484 (0·7%) had been diagnosed with hypospadias and 7499 (2·1%) with undescended testes. There were 505 (0·1%) cases of testicular cancer, 109 471 (31·2%) men had fathered children, and 2682 (0·8%) had undergone fertility treatment with ART. Undescended testes was associated with a more than two times increase in risk of testicular cancer (HR 2·43, 95% CI 1·65-3·58) and hypospadias with an almost 40% increase (1·37, 0·51-3·67), although this increase was not significant. Both hypospadias and undescended testes were associated with a 21% reduction in paternity (adjusted HR 0·79 [95% CI 0·71-0·89] for hypospadias and 0·79 [0·74-0·85] for undescended testes). Undescended testes was associated with a two times increase in use of ART (adjusted RR 2·26, 95% CI 1·58-3·25). For every 6 months' delay in orchidopexy, there was a 6% increase in risk of testicular cancer (HR 1·06, 95% CI 1·03-1·08), a 5% increase in risk of future use of ART (1·05, 1·03-1·08), and a 1% reduction in paternity (RR 0·99, 95% CI 0·98-0·99).

interpretationUndescended testes is associated with an increased risk of testicular cancer and male infertility, and decreased paternity. We provide new evidence to support current guidelines for orchidopexy before age 18 months to decrease the risk of future testicular cancer and infertility.

fundingNational Health and Medical Research Council and Sydney Medical School Foundation.

Indexed as

AdultCryptorchidismHumansHypospadiasInfertility, MaleInformation Storage and RetrievalMaleMiddle AgedProportional Hazards ModelsReproductive Techniques, AssistedRisk FactorsTesticular NeoplasmsWestern AustraliaYoung Adult

Identifiers

PMID30236382
OpenAlexW2888902292

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.