Reasons for Delayed Orchiopexies in a Korean Tertiary Care Hospital

Ahn, Hyunsoo; Lee, Hahn Ey; Park, Kwanjin; Choi, Hwang

doi:10.4111/kju.2014.55.1.69

Cited by 6 publications

(5 citation statements)

References 24 publications

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“… 7 Ahn et al, found that the reasons for delayed orchidopexy at a Korean tertiary care hospital were related to the parents of the child; parental requests for treatment of persistent retractile testis were delayed and approximately 15% of orchidopexy procedures were not performed at the proper time. 8 Similar results were observed in Austria; despite knowledge of the best timing for surgical treatment by pediatricians, orchidopexy was performed later than recommended. 9 In Saudi Arabia, it was observed that diagnosis and surgery of undescended testis are performed in a timely manner for only approximately half of the total patients treated.…”

Section: Discussionsupporting

confidence: 58%

Timing of orchidopexy at a tertiary center in Saudi Arabia: reasons for late surgery

Alhazmi

Junejo

Albeaiti

et al. 2018

Annals of Saudi Medicine

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BACKGROUNDOrchidopexy should be performed during the first 18 months of life to decrease the risk of infertility and tumor formation. In our center, the timing of surgical correction varies depending on the availability of an operating room.OBJECTIVESEvaluate whether orchidopexy performed for patients referred to our center is done within the recommended time period and to determine causes for delay.DESIGNRetrospective descriptive study.SETTINGPediatric urology department of a tertiary care center.SUBJECTS AND METHODSWe retrospectively reviewed the charts of patients charts who underwent orchidopexy at our center from 2000 to 2010. We assessed referral time and waiting list time, which were subdivided as follows: from referral to first visit and from first visit to surgery. We included patients younger than 14 years and excluded patients with comorbidities that affected the timing of referral and surgical treatment.MAIN OUTCOME MEASURESReferral time period and waiting list time for surgical correction of patients presented with undescended testis.SAMPLE SIZE128RESULTSAfter exclusion of 32 patients because of comorbidities, we describe 128 who underwent surgery for cryptorchidism at our center. The median (interquartile range, minimum-maximum) for age at surgery was 46.7 months (24.4–83.4, 3.1–248.6]). The median (IQR) referral occurred at an age of 25.3 months (4.1–65.5). The median (IQR) waiting list time was 15.2 months (8.1–23.3). The median (IQR) waiting time from referral to the first visit was 4.1 months (1.0–8.2). The median waiting time from the first visit to surgery was 8.1 months (3.8–17.5).CONCLUSIONSThe age at the time of surgery at our center was far from ideal because of late referrals. A structured program offered by our National Health Service to educate referring physicians is necessary. Community health initiatives must emphasize prompt referral to reduce the impact of delayed surgery.LIMITATIONSLack of data on the type of referring physician (i.e., general practitioner, pediatrician, surgeon, urologist).

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Section: Discussionsupporting

confidence: 58%

Timing of orchidopexy at a tertiary center in Saudi Arabia: reasons for late surgery

Alhazmi

Junejo

Albeaiti

et al. 2018

Annals of Saudi Medicine

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“…Semen specimens were collected by masturbation and the semen analyzed for sperm concentration and percent motility using computer-assisted semen analysis (SAIS Plus; Medical Supply, Seoul, Korea). The normal values used here were based on the World Health Organization 2010 reference limits [ 6 ]. Azoospermia was defined as an absence of sperm in the semen, and asthenozoospermia was defined as a ratio of motile sperm to all sperm of under 40%.…”

Section: Methodsmentioning

confidence: 99%

Clinical Characteristics and Treatment of Cryptorchidism in Adults: A Single Center Experience

Jeong

Lee

2014

World J Mens Health

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PurposeWe evaluated the clinical and therapeutic characteristics of adult cryptorchidism, which have been difficult to establish, given the small number of patients presenting to outpatient clinics.Materials and MethodsA retrospective study of 20 adult patients with cryptorchid testis was performed. We analyzed their palpation of testis, location, surgical method, marital status, number of children, histologic findings, and semen analysis.ResultsIn 17 cases with unilateral cryptorchidism, the mean age at surgery was 31.1±12.5 years. Fourteen patients had a palpable, small cryptorchid testis. The location of the testis, as verified, was inguinal in 14, prepubic in 2, and intra-abdominal in 1, respectively. We performed orchiopexy in 14 out of 15 patients who sought to have this procedure. Four among 6 married patients had children. Testis biopsy was performed in 12 patients, and all showed abnormal histologic findings. Three among 4 patients, performed semen analysis, showed abnormal findings. In three cases of bilateral cryptorchidism, the mean age at surgery was 35.7±12.5 years. All of these patients had palpated cryptorchid testes in the inguinal area and sought to have a bilateral orchiopexy. Two patients have been married but had no children. All showed abnormal findings in both testis biopsy and semen analysis. No testicular neoplasm was detected during the duration of follow-up.ConclusionsMost adult patients with cryptorchidism preferred orchiopexy to orchiectomy. However, most of patients showed abnormal histology of the testis and semen analysis. Therefore, orchiopexy with regular scrotal examination may be considered a suitable treatment options for adult cryptorchidism.

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“…The impact of the rate of secondary ascended testis on the timing of orchidopexy could not be analyzed in our data as administrative claims data do not provide clinical information. In a study from Korea, acquired cryptorchidism was seen as a reason for orchidopexy after the age of 5 years in 13% of the cases [40]. A study from Denmark reported ascensus testis accounting for 58% of all cases of undescended testis at the age of 18 months and 69% after the age of 36 months [3].…”

Section: Strength and Limitationsmentioning

confidence: 99%

Are we still too late? Timing of orchidopexy

Schmedding

Wasen²,

Lippert³

2023

Eur J Pediatr

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An undescended testis is the most common genitourinary disease in boys. The German guidelines, first published in 2009, proposed the timing of orchidopexy to be before 12 months of age. The aim of the study was to analyze the implementation of these guidelines 10 years after publication. The national cumulative statistics of hospital admissions, provided by the Institute for the Remuneration System in Hospitals (InEK), and the statistics concerning procedures performed in private pediatric surgical practices of the professional association of pediatric surgeons (BNKD) regarding the time of surgeries for the year 2019 were analyzed. Data from InEK included all German hospital admissions. Data from BNKD included data from 48 private pediatric surgical practices. The hospitals treated 6476 inpatients with undescended testis, and 3255 patients were operated in private practices. Regarding the age at treatment, 15% of the hospital patients and 5% of the private practice patients were younger than 1 year and fulfilled the guideline recommendations. Forty percent of the hospital patients and 29% of the private practice patients were 1 or 2 years of age. All other patients were 3 years of age or older at the time of orchidopexy. Conclusions: The rate of orchidopexy within the first 12 months of life is remarkably low even 10 years after the publication of the guidelines. Awareness of the existing guideline must be increased for both referring pediatric and general practitioners. What is Known:• In Germany, orchidopexy is performed by pediatric surgeons and urologists either in hospital settings or in private practices.• Most international guidelines set the age for surgical treatment of undescended testis between 12 and 18 months of age. The German guidelines, published in 2009, sets the time-limit at one year of age. Until five years after publication of the German guidelines, the number of patients treated before the first year of life was low; studies show an orchidopexy ratebetween 8% and 19% during this time. What is New:• This study the first to cover all administered hospital patients in Germany and a large group of patients treated in private practices. It contains the largest group of German patients with undescended testis.• Although almost all children participate in the routine check-up at the age of seven months, which includes investigation for undescended testis, adherence to the orchidopexy guidelines is still low. Only 15% of the hospital patients and 5% of the patients in private practice were treated before their first birthdays.

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Reasons for Delayed Orchiopexies in a Korean Tertiary Care Hospital

Cited by 6 publications

References 24 publications

Timing of orchidopexy at a tertiary center in Saudi Arabia: reasons for late surgery

Timing of orchidopexy at a tertiary center in Saudi Arabia: reasons for late surgery

Clinical Characteristics and Treatment of Cryptorchidism in Adults: A Single Center Experience

Are we still too late? Timing of orchidopexy

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