Identifying and addressing training deficiencies in the examination of cryptorchidism—a quality improvement study

Sharma, Devang; Sohn, Julia K.; Zillioux, Jacqueline; Herndon, C.D. Anthony; Corbett, Sean T.; Kern, Nora G.

doi:10.1016/j.jpurol.2019.11.003

Cited by 6 publications

(12 citation statements)

References 17 publications

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“…In the present cohort, approximately 50% of the boys were screened during health examinations as babies, and were referred to our institution. Sharma et al 9 investigated the accuracy of diagnosis of cryptorchidism by primary care providers; 62% of these reported little to no formal training in scrotal examination, 50% were self-taught, and 20% defined UDT incorrectly. Those findings suggest that primary care providers, including urologists, were insufficiently trained to perform examinations for diagnosing cryptorchidism.…”

Section: Discussionmentioning

confidence: 99%

Trends in treatment outcomes for retractile testis in Japanese boys: A single‐center study

et al. 2020

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Objectives To investigate the natural course of retractile testis by analyzing its prevalence and outcomes. Methods This retrospective study included 215 boys in whom retractile testis was diagnosed after reviewing the medical history and physical examinations of the patients. Orchiopexy was performed once the testis became undescended. We investigated the trends in the prevalence and outcomes of retractile testis and compared clinical factors between cases that resolved spontaneously and those that required orchiopexy. Results Of 215 boys, 145 were finally evaluated. The mean age at diagnosis was 2 years, and 100 boys were aged ≤2 years when they were hospitalized. Seventy‐three boys were referred to our institution through health examinations as babies. The condition improved spontaneously in 89 boys, while 43 boys underwent orchiopexy, and 13 boys remained under follow‐up. The follow‐up period between diagnosis and resolution was significantly longer in the spontaneous resolution group than in the surgical intervention group (P = 0.011). Bilateral retractile testis improved spontaneously in significantly more boys compared to unilateral retractile testis (P = 0.0010). Spontaneous resolution was observed in boys of all ages, but those diagnosed at ≤3 years of age had a significantly higher rate of spontaneous resolution compared to those who were diagnosed at >3 years of age (P = 0.0019). Conclusions Our findings suggest that retractile testis cannot be affirmed as a variant of normal testis. Performing examinations at a young age is critical for preventing misdiagnosis, screening failures, and unnecessary surgery.

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Section: Discussionmentioning

confidence: 99%

Trends in treatment outcomes for retractile testis in Japanese boys: A single‐center study

et al. 2020

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“…Surgical specialists rely on the pediatricians responsible for the health checkup for referrals to provide timely intervention and optimize patient outcomes. 7,8 However, scrotum examination and CO diagnostics in infants are difficult to perform. An accurate and timely CO diagnosis by physicians responsible for the health checkup is critical for oncologic and fertility outcomes.…”

Section: Introductionmentioning

confidence: 99%

Assessment of diagnostic accuracy for cryptorchidism and risk factors for delayed orchidopexy

Morizawa,

Aoki,

Fukui

et al. 2023

Int J of Urology

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ObjectivesCryptorchidism (CO) diagnosis by palpation is challenging. Patients with suspected CO are primarily referred to pediatric urologists by general pediatricians and urologists. Currently, surgical treatment for CO is recommended earlier than in previous guidelines. In this study, we evaluated factors that lead to diagnosis discordance and delayed orchidopexy in patients referred with suspected CO in addition to timing of initial screening.MethodsIn total, 731 patients (1052 testes) with suspected CO were included. Risk factors for diagnostic discrepancy in CO diagnosis by pediatric urologists and risk of delayed orchiopexy were evaluated.ResultsHerein, 659 (90%) patients were diagnosed during routine public health checkups for infants and young children, and 419 (57%) patients were referred by pediatric practitioners. Of 1052 testes, 374 (36%) were diagnosed with CO by pediatric urologists. In multivariate analysis, risk factors of diagnostic discrepancy for CO diagnosis by pediatric urologists were bilateral testis (odds ratio [OR] = 9.17, p < 0.0001), >6 months old at initial diagnosis (OR = 1.036, p < 0.0001), and pediatric referral (OR = 4.60, p < 0.0001). In total, 296 patients underwent orchiopexy for CO. In multivariate analysis, risk factors for delayed orchiopexy were presence of comorbidities (OR = 3.43, p = 0.003) and >10 months old at referral (OR = 12.62, p < 0.0001).ConclusionsPediatric referral is a risk factor for discordant CO diagnostics, and late age at referral brings a risk of delayed orchiopexy. It is necessary to enlighten pediatricians, who are mainly responsible for routine health checkups, in teaching CO diagnostic techniques to ensure early referral.

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“…El examen físico, es el pilar para el diagnóstico de (5) criptorquidia . La ecografía solamente debe ser pedida por el urólogo pediatra o el cirujano pediatra luego del examen (6) físico, ya que pocas veces es necesaria en manos entrenadas así mismo según ha sido demostrado por Kanaroglou, la correlación clínico-radiológica prequirúrgica es de 54% y cuando se solicita preoperatoriamente, retrasa en 3 meses la corrección quirúrgica de la patología, además del costo que (7) implica .…”

Section: Introductionunclassified

Características clínico-ecográficas pre y postquirúrgicas de niños intervenidos por criptorquidia en el Hospital Sabogal, Perú.

Alcántara¹,

Gamboa-Olivares²,

Ignacio-Cconchoy³

2022

Rev. Cuerpo Med. HNAAA

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Objetivo: Determinar las características clínico- ecográficas pre y postquirùrgicas de niños intervenidos por criptorquidia. Material y métodos: Estudio descriptivo y longitudinal, los datos recolectados de historias clínicas del Hospital Sabogal, las variables fueron edad del diagnóstico, tiempo de espera de orquidopexia, testículo afectado, ubicación del testículo y volumen testicular Resultados: Se incluyeron 34 niños menores de 14 años con criptorquidia, la edad del diagnóstico fue 44 meses y de la orquidopexia 49 meses. El tiempo de espera para la orquidopexia fue 4,72 meses, el testículo más afectado fue el derecho (58,82%). Se incluyeron 39 testículos, la ubicación primaria canalicular (71,79 %), la ubicación final escrotal (50,0%), la técnica operatoria fue inguinal (91,18%). El incremento de volumen testicular fue de 0,39 cm3, p = 0,0006, IC 95% (-0,62, -0,17). Conclusiones: La edad de la orquidopexia fue 49 meses y el volumen testicular aumentó en 0,39 cm3 después de la orquidopexia.

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Identifying and addressing training deficiencies in the examination of cryptorchidism—a quality improvement study

Cited by 6 publications

References 17 publications

Trends in treatment outcomes for retractile testis in Japanese boys: A single‐center study

Trends in treatment outcomes for retractile testis in Japanese boys: A single‐center study

Assessment of diagnostic accuracy for cryptorchidism and risk factors for delayed orchidopexy

Características clínico-ecográficas pre y postquirúrgicas de niños intervenidos por criptorquidia en el Hospital Sabogal, Perú.

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