Our Summary

The study examines why there are delays in performing a certain surgery (orchidopexy or OP) for boys born with undescended testes (UDT). This condition should ideally be treated by the age of 18 months to avoid damage to the sperm-producing cells and reduce the risk of testicular cancer. However, the study found that the surgery often gets delayed.

The researchers looked at the medical records of over 4,000 newborn boys who underwent this surgery in Ontario between 2006 and 2012. They found that the median age at which the surgery was performed was 24 months, six months later than the recommended age.

The most significant risk factor for this delay was the age at which the child first saw a surgeon. If the first consultation was delayed beyond 12 months, the risk of delayed surgery increased dramatically. Other factors contributing to the delay included hospitalization in an ICU, having an associated condition called hypospadias, the hospital performing a higher volume of these surgeries, the baby having more healthcare visits in their first year, and the surgeon being older.

The researchers suggest that if doctors refer babies with UDT for surgical consultation earlier (ideally before six months), it could help ensure the surgery is performed on time. However, they also note that their study might have some limitations due to potential errors or missing information in the databases they used.

FAQs

  1. What is the ideal age to treat undescended testes (UDT) in boys?
  2. What were the main factors contributing to the delay in performing the surgery for undescended testes?
  3. How could the delay in surgery for undescended testes be reduced according to the researchers?

Doctor’s Tip

A doctor might advise a patient that early consultation with a surgeon is crucial for timely undescended testicle surgery. It is recommended to seek a consultation before the child reaches six months of age to reduce the risk of delays in treatment. Additionally, parents should be proactive in scheduling appointments and following up with healthcare providers to ensure the surgery is performed at the appropriate time.

Suitable For

Patients who are typically recommended undescended testicle surgery are newborn boys with undescended testes (UDT) who have not undergone spontaneous descent of the testicle by the age of 18 months. These patients are at risk for potential complications such as damage to sperm-producing cells and an increased risk of testicular cancer if the surgery is delayed.

Other factors that may influence the recommendation for surgery include hospitalization in an ICU, the presence of associated conditions such as hypospadias, the hospital’s volume of surgeries for UDT, the number of healthcare visits in the baby’s first year, and the age of the surgeon. Patients who have these risk factors may be recommended for earlier surgical intervention to prevent complications associated with delayed surgery.

Timeline

In summary, before undescended testicle surgery, a patient may experience delays in receiving the surgery due to factors such as late referral to a surgeon, hospitalizations, associated conditions, and healthcare visits. After the surgery, the patient can expect improved outcomes in terms of fertility and reduced risk of testicular cancer. By addressing the factors leading to delays in surgery, healthcare providers can ensure timely treatment for boys with undescended testes.

What to Ask Your Doctor

Some questions a patient should ask their doctor about undescended testicle surgery include:

  1. What are the risks and benefits of undergoing orchidopexy surgery for my child’s undescended testicle?
  2. At what age is it recommended to perform the surgery for optimal outcomes?
  3. What factors can contribute to delays in performing the surgery, and how can we avoid them?
  4. What is the success rate of this surgery in terms of correcting the undescended testicle and preventing future complications?
  5. Are there any alternative treatments or options for managing undescended testicles?
  6. What is the recovery process like for my child after the surgery?
  7. Are there any potential long-term effects or complications associated with undescended testicle surgery?
  8. How often will my child need follow-up appointments or monitoring after the surgery?
  9. What should I expect in terms of pain management and care for my child post-surgery?
  10. Are there any lifestyle changes or precautions my child should take after undergoing orchidopexy surgery?

Reference

Authors: Dave S, Clark J, Chan EP, Richard L, Liu K, Wang PZ, Shariff S, Welk B. Journal: J Pediatr Urol. 2022 Oct;18(5):695.e1-695.e7. doi: 10.1016/j.jpurol.2022.07.017. Epub 2022 Jul 30. PMID: 35970738