Delayed Referral Despite Appropriate Knowledge in Cryptorchidism as a Cause of Delayed Orchidopexies in Austria

Springer, Alexander; Huber, Carl P.; Reck, Carlos A.; Fengler, David; Horcher, Ernst

doi:10.1055/s-0030-1248260

Cited by 21 publications

(17 citation statements)

References 30 publications

(39 reference statements)

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“…Reports from other countries have speculated that a possible reason may be delayed referral from primary physicians, differences in referral habits between pediatricians and primary physicians, cultural differences, parental delay, reoperative orchiopexy owing to iatrogenic trapping of testis, and the presence of AC [7-14]. Our data add new reasons to the current database, such as delay due to other medical conditions and parental request for persistent RT.…”

Section: Discussionmentioning

confidence: 66%

“…The Nordic consensus on the treatment of UDT advocates treatment at 6 to 12 months of age [5]. However, reports from several countries have indicated that these theoretical advantages or guidelines for early orchiopexy have not been applied in clinical practice [7-10]. Data from many surgical divisions in different countries show that orchiopexies are still being performed late in childhood despite several national and international recommendations.…”

Section: Introductionmentioning

confidence: 99%

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Reasons for Delayed Orchiopexies in a Korean Tertiary Care Hospital

et al. 2014

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PurposeSince the 1990s, it has been well known that orchiopexies should be performed by no later than 2 years of age. Nevertheless, studies from other countries report a substantial number of delayed orchiopexies. On the basis of an analysis of a tertiary care hospital database, we aimed to investigate the incidence of delayed orchiopexies performed in patients after 5 years of age and to understand the causes of such delays and the possible consequences.Materials and MethodsWe retrospectively analyzed the surgical database of Seoul National University Hospital between 2004 and 2012 and detected patients who underwent orchiopexy later than 5 years of age. Reasons for delayed orchiopexies were studied and the possible consequences of delayed orchiopexies were assessed with respect to surgical difficulty and testicular volume.ResultsWe found 160 cases of delayed orchiopexies, which accounted for about 15% of all orchiopexies performed. Two major reasons for delay were related to the parents of the child: parental delay and parental request for the treatment of persistent retractile testis. Acquired cryptorchidism was found in 21 cases (13.1%), mainly associated with hypospadias. Surgical difficulty, especially owing to a short testicular cord, was encountered in 48 cases (30.2%), and a comparison with age-matched normative values showed substantially smaller testicular volume.ConclusionsDespite well-established guidelines for the optimal age of surgery, 15% of orchiopexies were not performed at a proper time. Improved propagation of an optimal age limit is necessary to reduce the rate of delayed orchiopexies considering increases in surgical difficulty and potential testicular growth retardation.

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Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Reasons for Delayed Orchiopexies in a Korean Tertiary Care Hospital

et al. 2014

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“…We postulate that this may be to due a lack of awareness of the condition and its appropriate management among general practitioners and community paediatricians, as well as the general public. Certainly, as reported by Yiee et al and Springer et al , the type of referring provider plays a central role, where family practitioners and community paediatricians tend to refer later, even when possessing appropriate levels of knowledge of the condition 22 24…”

Section: Discussionmentioning

confidence: 96%

Undescended testis: 513 patients' characteristics, age at orchidopexy and patterns of referral

Nah

Yeo

How

et al. 2013

Archives of Disease in Childhood

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“…Many children with undescended testes are referred late in childhood, after long periods of expectant management. This has been shown both in the United States and elsewhere [2][3][4][5][6]. In the United States, a typical age for referral is well over 2 years of age despite literature recommending early consultation from a urologist [2].…”

Section: Introductionmentioning

confidence: 99%