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Practice variation and clinical confusion regarding undescended testes and retractile testes among primary care respondents: a multi-regional survey study in the United States

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Abstract

Purpose

Although previous studies have looked at referral patterns and indications for orchiopexy, this is the first attempt at quantifying the primary care provider knowledge base of cryptorchidism and its implications in a large multi-state setting in the United States.

Methods

Primary care providers (PCPs) (n = 3,000) were invited to complete a web-based survey regarding cryptorchidism. We evaluated: practice setting; training; knowledge of cryptorchidism; relationship to pediatric urologists and surgeons; understanding of the relationship between cryptorchidism, infertility and testis cancer.

Results

Seventeen percent (n = 453) of PCPs responded to the survey. Fifty-three percent indicated that they had minimal to no exposure to pediatric urology during training. Two-thirds refer patients with retractile testes to surgical specialists. Practice setting was associated with the type of information families received about the impact of UDT on fertility and malignancy with rural practices being more likely to counsel that unilateral UDT imparted a high risk of malignancy (RR 1.5; 95 % CI 1.2, 1.9) and bilateral UDT resulted in likely infertility (RR 2.1; 95 % CI 1.5, 2.8).

Conclusions

This study underscores the need for increased evidence-based recommendations, as well as improved training and education of PCPs in the US who deal with disorders of testicular descent.

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Authors and Affiliations

  1. Division of Pediatric Urology, Department of Urology, University of Washington, Seattle Children’s Hospital, 4800 Sand Point Way NE, Mail Stop W-7729, Seattle, WA, 98103, USA

    Margarett Shnorhavorian

  2. University of Texas Southwestern Medical Center, Dallas, TX, USA

    Micah A. Jacobs

  3. Department of Urology, Upstate Medical University, Syracuse, NY, USA

    Gillian Stearns

  4. Department of Urology, University of Vermont, Burlington, VT, USA

    Gerald Mingin

  5. The Hospital for Sick Children, Toronto, Ontario

    Martin A. Koyle

Authors
  1. Margarett Shnorhavorian
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  2. Micah A. Jacobs
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  3. Gillian Stearns
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  4. Gerald Mingin
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  5. Martin A. Koyle
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Corresponding author

Correspondence to Margarett Shnorhavorian.

Appendix: Cryptorchidism and Retractile Testes Survey

Appendix: Cryptorchidism and Retractile Testes Survey

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Shnorhavorian, M., Jacobs, M.A., Stearns, G. et al. Practice variation and clinical confusion regarding undescended testes and retractile testes among primary care respondents: a multi-regional survey study in the United States. Pediatr Surg Int 28, 635–639 (2012). https://doi.org/10.1007/s00383-012-3085-7

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  • DOI: https://doi.org/10.1007/s00383-012-3085-7

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