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Undescended testis: Level of knowledge among potential referring health-care providers
Li Yan Lim1, Shireen A Nah2, Narasimhan K Lakshmi2
1Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Insights
Many healthcare providers lack awareness of undescended testis (UDT) guidelines, leading to delayed treatment. This study highlights knowledge gaps in UDT management among medical professionals, impacting timely orchidopexy for boys.
Area of Science:
- Pediatric Surgery
- Urology
- Medical Education
Background:
- Undescended testis (UDT) requires timely intervention, ideally before 1 year of age, to optimize outcomes.
- Studies indicate a significant delay in referral and surgical correction for UDT, often exceeding recommended timelines.
- Lack of awareness regarding established treatment guidelines is a suspected contributor to these delays.
Purpose of the Study:
- To assess the knowledge level of undescended testis (UDT) among healthcare professionals who are likely to refer patients for management.
- To identify potential barriers and knowledge deficits contributing to delayed diagnosis and treatment of UDT.
- To inform targeted educational interventions for healthcare providers regarding UDT management.
Main Methods:
- A survey was developed to evaluate knowledge of UDT clinical features and management protocols.
- Healthcare professionals and final-year medical students with pediatric patient contact were recruited using convenience sampling.
- Respondents' data were anonymized and categorized by specialty and level of experience.
Main Results:
- Out of 1179 individuals approached, 203 (17.2%) responded to the survey.
- A notable percentage of qualified doctors (24%) reported never having encountered a case of UDT.
- Significant knowledge gaps were observed, with 66% of doctors believing orchidopexy should occur after 1 year of age, and half ceasing examination for UDT after age 2.
Conclusions:
- Inexperience and outdated knowledge regarding undescended testis (UDT) contribute to delays in patient referral and treatment.
- Healthcare providers' cessation of UDT examination after age two indicates a lack of awareness of the ascending testis phenomenon.
- Community health initiatives and updated medical education are crucial to emphasize current guidelines for UDT management.
Aim:
Studies report that most boys with undescended testis(UDT) are referred and operated beyond the recommended age of 1 year, possibly due to lack of awareness of treatment guidelines. We investigate the level of knowledge of UDT among potential referring health-care providers.
Method:
We devised a survey on the clinical features and appropriate management of UDT. Using convenience sampling, we approached health-care professionals with regular contact with paediatric patients and final year medical students. Respondents were allowed to remain anonymous. They were categorised according to specialty and level of experience/training.
Results:
Of 1179 approached, 203 responded. Thirty-six (24%) of 149 qualified doctors had never seen a case of UDT. Median score was 6 (range 1-9). There was no significant difference in scores when comparing specialty. Mean scores decreased significantly in trend according to level of experience. When questioned regarding timings of referral and orchidopexy, 24% of qualified doctors would not refer until 9 months of age, and 66% thought orchidopexy should be done after 1 year old. Half would stop examining for UDT after 2 years old.
Conclusions:
Inexperience with UDT and outdated knowledge may contribute to delays in referral for UDT. Many would stop examining for UDT at 2 years old, placing undue reliance on accurate physical examination in early childhood and indicating lack of awareness of the ascending testis. Community health initiatives must emphasise recent changes in guidelines for management of UDT.
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