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Factors related to the time to cryptorchidism surgery--a nationwide, population-based study in Taiwan
Yu-Fen Chen1, Wei-Yi Huang2, Kuo-How Huang3
1Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; National Health Insurance Dispute Mediation Committee, Department of Health, Executive Yuan, Taipei, Taiwan; Department of Nursing, Kang-Ning Junior College of Medical Care and Management, Taipei, Taiwan.
Insights
Most boys with cryptorchidism (undescended testes) in Taiwan undergo surgery after the recommended age of 12 months. Factors like physician age and patient diagnosis age influence surgical timing, highlighting a need for increased awareness.
Area of Science:
- Pediatric Surgery
- Urology
- Public Health
Background:
- Current guidelines advocate for cryptorchidism (undescended testes) surgery by 12 months of age.
- Cryptorchidism is a common congenital condition in male infants requiring timely surgical intervention.
Purpose of the Study:
- To investigate surgical timing trends for cryptorchidism in Taiwan.
- To identify factors associated with delayed time to surgery for cryptorchidism.
Main Methods:
- Utilized the National Health Insurance Research Database (Taiwan) from 1997-2007.
- Analyzed surgical timing in 547 boys under 18 diagnosed with cryptorchidism.
Main Results:
- 79.2% of boys underwent cryptorchidism surgery after the optimal age of 12 months.
- Physician's age at diagnosis, surgeon's age, patient's age at diagnosis, number of prior visits, and urbanization level were significant factors.
- Multivariate analysis identified key predictors for delayed surgical intervention.
Conclusions:
- A high proportion of cryptorchidism surgeries occur beyond the recommended timeframe.
- Physician and patient-related factors significantly impact the timing of cryptorchidism surgery.
- Enhanced parental and specialist education may promote earlier surgical intervention for cryptorchidism.
Background/Purpose:
Current guidelines recommend that the optimal timing for cryptorchidism surgery is by the age of 12 months. This study investigated the trend of surgical timing and examined the factors associated with time to surgery for cryptorchidism in Taiwan by using a nationwide, population-based database.
Methods:
The present study utilized the Longitudinal Health Insurance Database 2005, a subset of the National Health Insurance Research Database, which contains data on all paid medical benefit claims over the period 1997-2007 for a subset of 1 million beneficiaries randomly drawn from 22.72 million individuals enrolled in the National Health Insurance program in 2005. We analyzed the timing of surgery in boys younger than 18 years with diagnosis of cryptorchidism.
Results:
We identified 547 boys who underwent surgery under 18 years of age. Approximately 79.2% of study participants received surgery after the age of 12 months. A multivariate analysis showed that several factors were significantly associated with time to surgery: age of the physician making the diagnosis, age of the surgeon performing the surgery, age of the patient at the first diagnosis of cryptorchidism, and number of previous clinic visits with the diagnosis of cryptorchidism and urbanization level of the patient's residence.
Conclusion:
A surprisingly high rate (79.2%) of all study participants underwent surgery beyond the optimal timing. Certain doctor and patient factors were associated with time to cryptorchidism surgery. Improving the alertness and education of parents and specialists may lead to earlier surgeries.
