Effectiveness of child health surveillance in lowering age of referral and surgery for undescended testis

Abstract

ABSTRACTObjective To ascertain the effectiveness of the child health Surveillance (CHS) in terms of referral age and time of surgery for undescended testis (UDT).Design, Setting and Participants Retrospective study of 106 children aged 1–15 years from Trafford, Greater Manchester (UK) who underwent orchidopexy between 1 December 1993 and 31 December 1998. Cases identified from a NW Regional Database and from hospital information departments.Main variables studied Age at referral and surgery, source of referral, pattern of referral to six different hospitals, time span between referral and surgery.Main outcome measures Referral to appropriate surgeon at key ages of 12 and 24 months of age (standards 90 and 95%, respectively). Orchidopexy performed by 24 months and 60 months of age (standards 75 and 95%, respectively).Results Overall, 20% were referred by the age of 12 months and 35% by the age of 24 months. Subsequently, 20% underwent surgery by the age of 24 months and 66% by 60 months.Conclusions Neither of the achievement standards was fulfilled. Although referral for UDT has improved, the timing of referrals and surgery is still unacceptably delayed.Implications for practice Active measures are recommended to improve the education and awareness of the health visitors, GPs and the parents that early referral and surgery for children with UDT is essential.