Imaging use and cryptorchidism: determinants of practice patterns

Area of Science:

• Pediatric Surgery
• Diagnostic Imaging
• Urology

Background:

• Undescended testes (cryptorchidism) require accurate preoperative evaluation.
• Diagnostic imaging is often employed, but its utility and influencing factors are not fully understood.

Purpose of the Study:

• To determine the rate of diagnostic imaging use in the preoperative evaluation of boys with cryptorchidism.
• To identify factors influencing pediatricians' decisions to order imaging.

Main Methods:

• A national cross-sectional survey of randomly sampled pediatricians was conducted.
• The survey assessed imaging use, practice characteristics, and influencing factors.
• Multivariate logistic regression identified factors associated with imaging use.

Main Results:

• 34% of surveyed pediatricians reported usually or always ordering imaging for cryptorchidism.
• Ultrasound was the predominant imaging modality (96.4%).
• Less experienced (<20 years in practice) and non-academic practitioners were more likely to order imaging.

Conclusions:

• Ultrasound is widely used for preoperative cryptorchidism evaluation, particularly for nonpalpable testes.
• The diagnostic performance of ultrasound in this context is suboptimal.
• Strategies to decrease unnecessary imaging for cryptorchidism should be developed.