1. Guideline implementation for the treatment of undescended testes: Still room for improvement.
- Author
-
Ellerkamp V, Schmid A, Blumenstock G, Hrivatakis G, Astfalk W, Loff S, Fuchs JJ, and Zundel S
- Subjects
- Child, Preschool, Humans, Infant, Infant, Newborn, Male, Practice Guidelines as Topic, Retrospective Studies, Cryptorchidism epidemiology, Cryptorchidism surgery
- Abstract
Background: Early orchidopexy (OP) around the age of 1 year is recommended in boys with congenital undescended testis (UDT) worldwide since decades. Former retrospectives studies did not distinguish congenital from acquired UDT with a consecutive negative bias concerning the age at surgery., Methods: In a retrospective analysis, data of all boys who underwent OP in eight pediatric surgery institutions from 2009 to 2015 were analyzed. Congenital or acquired UDT were differentiated. Patients were categorized into 3 groups of age at surgery: (1) <12 months, (2) 12-24 months, (3) >24 months. Data of one institution were analyzed in detail: exact age of first referral, exact age at surgery, intraoperative findings., Results: Out of 4448 boys, 3270 boys had congenital UDT. In 81% (2656 cases) surgery was performed beyond the age of 1 year, in 54.4% (1780) beyond the age of 2 years. chi-Square statistics showed a higher rate of early operations in hospitals compared to outpatient services and in Germany compared to Switzerland. In 694 congenital detailed cases, median age at referral was 13 months [range 0-196], median age at surgery was 15 months [range 0-202]., Conclusion: Delayed referral is the main reason for guideline non-conform delayed surgery in UDT., Type of Study: Clinical Research paper., Level of Evidence: Level III: Treatment Study., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF