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[The surgical management of undescended testis between 6 and 12 months: A difficult message to convey]
J Rod1, J-B Marret1, C Dupont2
1Service de chirurgie pédiatrique, CHU de Caen, avenue Côte-de-Nacre, 14000 Caen, France; Université de Caen Basse-Normandie, UFR de médecine, 14000 Caen, France.
Insights
Early surgery for undescended testes (UT) in infants is recommended to reduce risks of infertility and cancer. Following educational initiatives, the percentage of infants operated on for UT between 6 and 12 months increased, though many still receive later treatment.
Area of Science:
- Pediatric Surgery
- Urology
- Congenital Malformations
Background:
- Undescended testis (UT) is the most common congenital genital malformation in male infants.
- Management aims to minimize risks of infertility and cancer, which increase with surgical delay.
- Learned societies recommend earlier intervention, typically between 6 and 12 months of age.
Purpose of the Study:
- To evaluate the impact of educational initiatives on the timing of surgery for congenital UT.
- To assess the implementation of early surgical intervention recommendations in Lower Normandy, France.
- To analyze the trend in the number of children operated for UT between 6 and 12 months post-intervention.
Main Methods:
- A retrospective evaluation of yearly percentages of children operated for UT between 6-12 months versus 12-24 months.
- Data collected from 2005 to 2014.
- Statistical comparison using the Chi-squared test for periods 2005-2008 and 2009-2012.
Main Results:
- The percentage of children operated on between 6 and 12 months increased from 13.7% (2005-2008) to 17.2% (2009-2014).
- From 2012 onwards, more children were operated on between 6-12 months than between 12-24 months.
- The proportion of children operated on after 2 years remained consistent throughout the study.
Conclusions:
- Educational efforts have led to a gradual increase in early surgical interventions for UT.
- Despite improvements, a significant number of children still undergo surgery for UT between 12 and 24 months or later.
- Further efforts may be needed to ensure adherence to optimal surgical timing for all UT cases.
Purpose:
The undescended testis (UT) is the most common congenital malformation of the genital apparatus in male infants. The main objective of the management of these patients is to reduce the risk of infertility and cancer. Since these risks increase with age of operation, learned societies have recommended earlier intervention. Following the publication in 2007 of the Nordic consensus that called for an intervention between 6 and 12 months of age, we issued this message to medical students in the Lower Normandy region of France. The aim of this study was to evaluate the implementation of this teaching through the evolution of the number of children operated between 6 and 12 months for a congenital UT in our center.
Material And Methods:
Between 2005 and 2014, we evaluated the yearly percentage of children operated for UT between 6 and 12 months compared to the percentage of children operated on between 12 and 24 months. A statistical study using the Chi(2) test was used to compare the 2005-2008 and 2009-2012 periods.
Results:
The percentage of children operated on between 6 and 12 months of age increased from 13.7 % between 2005 and 2008 to 17.2 % between 2009 and 2014. From 2012 on, the number of children operated on between 6 and 12 months was consistently higher than the number of children operated on between 12 and 24 months. The proportion of children operated beyond 2 years remained stable over the study period.
Conclusion:
Since we implemented teaching of early surgery for children with UT, we have observed a gradual increase in the number of children operated between 6 and 12 months of age. Nevertheless, there are still many children operated between 12 and 24 months and beyond.
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