International Journal of
Reproductive Biomedicine
Sat, Dec 28, 2024
[Archive]
Volume 9, Issue 1 (7-2011)
IJRM 2011, 9(1): 0-0 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Shiryazdi S M, Modir A, Benrazavi S, Moosavi N, Kermani-Alghoraishi M, Ghahramani R. Causes of delay in proper treatment of patients with undescended testis. IJRM 2011; 9 (1)
URL: http://ijrm.ir/article-1-201-en.html
URL: http://ijrm.ir/article-1-201-en.html
Seyyed Mostafa Shiryazdi * 
1, Abbas Modir2 , Soheil Benrazavi2 , Nooshin Moosavi2 , Mohammad Kermani-Alghoraishi3 , Rahil Ghahramani3
1, Abbas Modir2 , Soheil Benrazavi2 , Nooshin Moosavi2 , Mohammad Kermani-Alghoraishi3 , Rahil Ghahramani3
1- Department of Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , smshiryazdi@ssu.ac.ir
2- Department of Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3- Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2- Department of Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3- Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Abstract: (3258 Views)
Background: Undescended testis (UDT) is the most common endocrine disorder in male children. Delayed diagnosis and treatment of UDT lead to complications such as infertility, malignancy and testis rotation.
Objective: The aim of this study was to evaluate the causes of delay in proper treatment of patients with undescended testis in our population.
Materials and Methods: An observational, descriptive, cross sectional study of 143 male patients, who applied to Shahid Sadoughi University Hospitals for orchiopexy operation was performed. The maximum recommended age for orchiopexy was 18 months.
Results: The mean age at referral was 5.34 years. Only 44 (30.8%) cases were operated on before the age of 18 months. The most common reasons of delay in treatment were absence of early diagnose (42.5%), parent's unawareness of surgery necessity and its complications associated (33.7%) and parent's disregard (23.5%). Only 19.6% of patients were diagnosed at born in the hospital. 49% of parents had the correct information for proper operation age and 40.6% of them had enough information about necessity of surgery and side effects of disease. Parent’s literacy, place of living and type of cryptorchidism had no significant relation with delay diagnosis (p> 0.05).
Conclusion: These results revealed that late diagnosis by physician and lack of insight of parents are the main reasons in delayed diagnosis and treatment of UDT. Therefore, education of parents and careful physical examination of the babies at birth and regular follow-up until 18 months can prevent the delay in diagnosis.
Objective: The aim of this study was to evaluate the causes of delay in proper treatment of patients with undescended testis in our population.
Materials and Methods: An observational, descriptive, cross sectional study of 143 male patients, who applied to Shahid Sadoughi University Hospitals for orchiopexy operation was performed. The maximum recommended age for orchiopexy was 18 months.
Results: The mean age at referral was 5.34 years. Only 44 (30.8%) cases were operated on before the age of 18 months. The most common reasons of delay in treatment were absence of early diagnose (42.5%), parent's unawareness of surgery necessity and its complications associated (33.7%) and parent's disregard (23.5%). Only 19.6% of patients were diagnosed at born in the hospital. 49% of parents had the correct information for proper operation age and 40.6% of them had enough information about necessity of surgery and side effects of disease. Parent’s literacy, place of living and type of cryptorchidism had no significant relation with delay diagnosis (p> 0.05).
Conclusion: These results revealed that late diagnosis by physician and lack of insight of parents are the main reasons in delayed diagnosis and treatment of UDT. Therefore, education of parents and careful physical examination of the babies at birth and regular follow-up until 18 months can prevent the delay in diagnosis.
Type of Study: Original Article |
References
1. Kolon TF, Patel RP, Huff DS. Cryptorchidism; diagnosis, treatment and long-term prognosis. Urol Clin N Am 2005; 31: 469-480. [DOI:10.1016/j.ucl.2004.04.009]
2. Barthold JS, Gonzales R. The Epidemiology of Congenital Cryptorchidism, Testicular Ascent and Orchiopexy. J Urol 2003; 170: 2396-401. [DOI:10.1097/01.ju.0000095793.04232.d8]
3. Virtanen HE, Toppari J. Epidemiology and pathogenesis of cryptorchidism. Hum Reprod Update 2008; 14: 49-58. [DOI:10.1093/humupd/dmm027]
4. Elert A, Jahn K, Heidenreich A, Hofmann R. The familial undescended testis. Klin Padiat 2003; 215: 40-45. [DOI:10.1055/s-2003-36894]
5. Cisek LJ, Peters CA, Atala A, Bauer SB, Diamond DA, Retik AB. Current findings in diagnostic laparoscopic evaluation of the nonpalpable testis. J Urol 1998; 160: 1145-1149. [DOI:10.1016/S0022-5347(01)62721-6]
6. Virtanen HE, Bierknes R, Cortes D, Jorgensen N, Rajpert-De Meyts E, Thorsson AV, et al. Cryptorchidism: classification, prevalence and long-term consequences. Acta Paediatr 2007; 96: 611-616 [DOI:10.1111/j.1651-2227.2007.00241.x]
7. Wang F, Roberts SM, Butfi loski EJ, Sobel ES. Acceleration of autoimmunity by organochlorine pesticides: a comparison of splenic B-cell effects of chlordecone and estradiol in (NZBxNZW) F1 mice. Toxicological Sciences 2007; 99: 141-152. [DOI:10.1093/toxsci/kfm137]
8. Docimo SG, Silver RI, Cromie W. The undescended testicle: diagnosis and management. Am Fam Physician 2000; 62: 2037-2044.
9. Capello SA, Georgi LJ Jr, Kogan BA. Orchiopexy practice patterns in New York State from 1984 to 2002. J Urol 2006; 176: 1180-1183. [DOI:10.1016/j.juro.2006.04.052]
10. Upadhyay V, Kothari M, Manoharan M. The referral pattern for undescended testes in Auckland. NZ Med J 2001; 114: 310-311.
11. Lamah M, McCaughey ES, Finlay FO, Burge DM. The ascending testis: Is late orchidopexy due to failure of screening or late ascent? Paediatr Surg Int 2002; 17: 421-423. [DOI:10.1007/s003830000535]
12. Hack WW, Meijer RW, VanDer VLM, Bos SD, De Kok ME. Previous testicular position in boys referred for an undescended testis; further explanation of the late orchiopexy enigma? BJU 2003; 92: 293-296. [DOI:10.1046/j.1464-410X.2003.04317.x]
13. Thayyil S, Shenoy M, Agrawal K. Delayed orchiopexy: failure of screening or ascending testis. Arch Dis Child 2004; 89: 890. [DOI:10.1136/adc.2003.045070]
14. Brown JJ, Wacogne I, Fleckney S, Jones L, Ni Bhrolchain C. Achieving early surgery for undescended testes: quality improvement through a multifaceted approach to guideline implementation. Child Care Health Dev 2005; 31: 97- 102. [DOI:10.1111/j.1365-2214.2005.00490.x]
15. Timing of elective surgery on the genitalia of male children with particular reference to the risks, benefits, and psychological effects of surgery and anesthesia. American Academy of Pediatrics. Pediatrics 1996; 97: 590-594.
16. United Kingdom Testicular Cancer Study Group. Aetiology of testicular cancer: Association with congenital abnormalities, age at puberty, infertility, and exercise. Br Med J 2008; 308: 1393-1399.
17. Cortes D, Kjellberg EM, Breddam M, Thorup J. The true incidence of cryptorchidism in Denmark. J Urol 2008; 179: 314-318. [DOI:10.1016/j.juro.2007.08.158]
18. Hadziselimovic F, Huff D. Gonadal differentiation-Normal and abnormal testicular development. Adv Exp Med Biol 2002; 511: 15- 21. [DOI:10.1007/978-1-4615-0621-8_2]
19. Huff DS, Fenig DM, Canning DA, Carr MG, Zderic SA, Snyder HM. Abnormal germ cell development in cryptorchidism. Horm Res 2001; 55: 11-17. [DOI:10.1159/000049957]
20. Guven A, Kogan BA. Undescended testis in older boys: further evidence that ascending testes are common. J Pediatr Surg 2008; 43: 1700-1704. [DOI:10.1016/j.jpedsurg.2008.03.029]
21. Davey RB. Undescended testes: early versus late maldescent. Pediatr Surg Int 1997; 12: 165-167. [DOI:10.1007/BF01349990]
22. Cendron M, Huff DS, Keating MA, Snyder HM 3rd, Duckett JW. Anatomical, morphological and volumetric analysis: a review of 759 cases of testicular maldescent. J Urol 1993; 149: 570-573. [DOI:10.1016/S0022-5347(17)36151-7]
23. Seddon JM, Savory L, Scott-Conner C. Cryptorchidism: the role of medical education in diagnosis. South Med J 1985; 78: 1201-1204. [DOI:10.1097/00007611-198510000-00015]
24. A Sarmah. Late diagnosis of cryptorchidism: a failure of medical screening? Arch Dis Child 1992; 67: 728–730 [DOI:10.1136/adc.67.6.728]
25. Raghavendran M, Mandhani A, Kumar A, Chaudary H, Srivastava A, Bhandari M, Dubey D, Kapoor R. Adult cryptorchidism: Unrevealing the cryptic facts. Indian Journal of Surgery 2004; 66: 160-163.
26. Steckler RE, Zaontz MR, Skoog SJ, Rushton HG Jr. Cryptorchidism, pediatricians, and family practitioners: patterns of practice and referral. J Pediatr 1995; 127: 948-951. [DOI:10.1016/S0022-3476(95)70034-X]
27. Sinha CK, Vinay S, Kulkarni R, Nour S. Delayed diagnosis for undescended testes. Indian Pediatr 2008; 45: 503-504.
28. Rabinowitz R, Hulbert WC Jr. Late presentation of cryptorchidism: the etiology of testicular re-ascent. J Urol 1997; 157: 1892-1894. [DOI:10.1016/S0022-5347(01)64895-X]
29. Gyawali B, Bhattacharyya S, Reid JA. Medical audit of community screening for undescended testes in Halton District. Public Health 1993; 107: 343-347. [DOI:10.1016/S0033-3506(05)80126-X]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
