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Consultants’ attitudes to the ideal age for orchidopexy

Consultants’ attitudes to the ideal age for orchidopexy
Consultants’ attitudes to the ideal age for orchidopexy
Aims: recent consensus statements recommend orchidopexy for undescended testis be performed between 6-12 months of age. We designed a survey to determine what age consultants believe is the optimal age for orchidopexy, as well as surveying other aspects of surgery for testicular maldescent.

Methods: anonymous survey of UK consultants (n=122) who participated in an international prospective audit of orchidopexy outcomes. Preferences and management strategies were compared between different groups of surgeons (specialist paediatric general surgeons, specialist paediatric urologists and general surgeons/urologists, with an interest in general surgery of childhood (but who mainly treat adult patients)).

Results: there were 105 responses (62 specialist paediatric surgeons, 30 specialist paediatric urologists and 13 general surgeons/urologists) from 25 centres; overall response rate was 86%. The median preferred age for orchidopexy was 10.5 months (range 3-24). This differed significantly between groups with a median of 12 months amongst specialist paediatric surgeons, 9 months amongst specialist paediatric urologists and 12 months amongst general surgeons/urologists (p=<0.001). Fifty-one consultants (49%) stated the optimal age to perform orchidopexy was 12 months or more.
Consultants cited concerns about the possible long-term effects of general anaesthesia at young age and higher atrophy rates in younger children as the main reasons for postponing orchidopexy until aged 12 months.

Conclusion: there remains no consensus amongst surgeons as to the optimal age for orchidopexy. Management practice of undescended testis varies across differing specialty of surgeon, particularly in regard to optimal age of surgery


182-188
Bradshaw, Catherine J.
9ee6b7c4-805f-452b-8d53-a0bb68318282
Skerritt, Clare
6df474cc-144e-4818-830a-0034b5822f9d
Rhodes, Hannah
1b76aa13-57fe-453b-8073-44fbf1cbf585
Woodward, Mark
b49071be-a4fa-4bb2-bef7-c4055e7211b2
Hall, Nigel
6919e8af-3890-42c1-98a7-c110791957cf
McCarthy, Liam
b1e1eb6c-134e-45c3-a482-56e146e7d44e
Paediatric Surgical Trainees Research Network
Bradshaw, Catherine J.
9ee6b7c4-805f-452b-8d53-a0bb68318282
Skerritt, Clare
6df474cc-144e-4818-830a-0034b5822f9d
Rhodes, Hannah
1b76aa13-57fe-453b-8073-44fbf1cbf585
Woodward, Mark
b49071be-a4fa-4bb2-bef7-c4055e7211b2
Hall, Nigel
6919e8af-3890-42c1-98a7-c110791957cf
McCarthy, Liam
b1e1eb6c-134e-45c3-a482-56e146e7d44e

Woodward, Mark, Hall, Nigel and McCarthy, Liam , Paediatric Surgical Trainees Research Network (2022) Consultants’ attitudes to the ideal age for orchidopexy. The Bulletin of the Royal College of Surgeons, 104 (4), 182-188. (doi:10.1308/rcsbull.2022.81).

Record type: Article

Abstract

Aims: recent consensus statements recommend orchidopexy for undescended testis be performed between 6-12 months of age. We designed a survey to determine what age consultants believe is the optimal age for orchidopexy, as well as surveying other aspects of surgery for testicular maldescent.

Methods: anonymous survey of UK consultants (n=122) who participated in an international prospective audit of orchidopexy outcomes. Preferences and management strategies were compared between different groups of surgeons (specialist paediatric general surgeons, specialist paediatric urologists and general surgeons/urologists, with an interest in general surgery of childhood (but who mainly treat adult patients)).

Results: there were 105 responses (62 specialist paediatric surgeons, 30 specialist paediatric urologists and 13 general surgeons/urologists) from 25 centres; overall response rate was 86%. The median preferred age for orchidopexy was 10.5 months (range 3-24). This differed significantly between groups with a median of 12 months amongst specialist paediatric surgeons, 9 months amongst specialist paediatric urologists and 12 months amongst general surgeons/urologists (p=<0.001). Fifty-one consultants (49%) stated the optimal age to perform orchidopexy was 12 months or more.
Consultants cited concerns about the possible long-term effects of general anaesthesia at young age and higher atrophy rates in younger children as the main reasons for postponing orchidopexy until aged 12 months.

Conclusion: there remains no consensus amongst surgeons as to the optimal age for orchidopexy. Management practice of undescended testis varies across differing specialty of surgeon, particularly in regard to optimal age of surgery


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Yet to reach a consensus. The Bulletin. Revisions_ (002) - Accepted Manuscript
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More information

Accepted/In Press date: 25 October 2021
e-pub ahead of print date: 1 June 2022
Additional Information: Originallly titled:Yet to reach a consensus? Consultants’ attitudes to the ideal age for orchidopexy

Identifiers

Local EPrints ID: 457719
URI: http://eprints.soton.ac.uk/id/eprint/457719
PURE UUID: ac5051fe-14e4-4b50-b354-a56c89e8ba3a
ORCID for Nigel Hall: ORCID iD orcid.org/0000-0001-8570-9374

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Date deposited: 16 Jun 2022 00:23
Last modified: 10 Aug 2022 01:43

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Contributors

Author: Catherine J. Bradshaw
Author: Clare Skerritt
Author: Hannah Rhodes
Author: Mark Woodward
Author: Nigel Hall ORCID iD
Author: Liam McCarthy
Corporate Author: Paediatric Surgical Trainees Research Network

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