Barriers to implementation of guidelines for the diagnosis and management of undescended testis.

Shawn C Smith,Hiep T Nguyen

doi:10.12688/f1000research.15532.1

Shawn C Smith, Hiep T Nguyen

Open Access

https://doi.org/10.12688/f1000research.15532.1

Copy DOI

Journal: F1000Research	Publication Date: Mar 25, 2019
Citations: 9	License type: CC BY 4.0

Affiliation: Banner Children's at Desert

Abstract

Cryptorchidism or undescended testis (UDT) is one of the most common genital disorders identified at birth. The gold standard for treatment in the US is to surgically bring the UDT into the scrotal sac. In 2014, the American Urologic Association (AUA) presented a guideline for evaluation and treatment of cryptorchidism. We reviewed some of the most recent domestic and international studies examining the results of implementing the AUA and similar guidelines for the diagnosis and management of UDT. In addition, we reviewed some of the more common barriers to the implementation of the AUA guidelines and offered recommendations on how to increase the rate of early detection of UDT, thereby increasing the rate of surgical correction at the appropriate age.

Highlights

Cryptorchidism or undescended testis (UDT) is one of the most common genital disorders identified at birth
One of the main goals was to outline for the non-surgeon provider how to correctly identify bilateral and unilateral undescended testicles, at what age and under what circumstances to refer a boy with suspected or identified undescended testicles, and at what age persistent UDT should be surgically brought to the scrotum
There was a decrease in median age of surgery from 38.8 months in the 1996–1998 group to 12.6 months in the 2014–2016 group. This decrease in the median age of referral and surgical correction was in line with the newest American Urologic Association (AUA) guidelines

Summary

Introduction

Cryptorchidism or undescended testis (UDT) is one of the most common genital disorders identified at birth. In a recently published German study of 5,547 boys with cryptorchidism seen at 16 hospitals nationwide between 2003 and 2016, the authors found that between 2003 and 2008 only 4% of all boys with UDT had surgical correction before the age of 1 year[10].

Results

Conclusion