Age at referral for undescended testes: has anything changed in a decade?

Undescended testis (UDT) affects 1-6% of males and is one of the most common disorders in paediatric surgery.Updated consensus guidelines now recommend surgical management of UDT by 18 months. We compare the age at referral and subsequent timing of orchiopexy with data published from 1996-1998 at our institution, prior to the advent of updated guidelines.

A retrospective review of all patients undergoing an orchiopexy for UDT from 2014 to 2016 was conducted. The age at time of first referral, first outpatient review and age at date of surgery were recorded. Calculations were made for time between referral and clinic visit (T-1) and between clinic visit and surgery (T-2). Data are reported as median (range).

In the 2014-2016 group (n=216), the median age at time of referral was 5.3 (range 0-182) months. Following referral, children were seen in the clinic at a median interval 1.84 (T-1: range 0.16-17) months. The median interval between the clinic visit and operation was 2.95 (T-2: range 0-30.7) months. The median age at time of surgery was 12.6 (range 4.6-191.3) months. Compared to the data from 1996-1998 (n=325), there was a drop in the median ages both at time of referral (23 months vs 5.3) and at time of operation (38.8 months vs 12.6). In this cohort, 66% (n=143) of boys had surgery before eighteen months of age. The median times between referral and clinic visit (T-1: 1.7 months vs 1.84) and between clinic and operation (T-2: 3.3 months vs 2.95) were essentially unchanged.

Our second snapshot in time (2014-2016) shows improvements in median age at referral (under six months) and age at time of operation (at 12.6 months) when compared to the older snapshot (1996-1998). These timings are more in keeping with recommendations for orchiopexy.