Cryptorchidism: the role of medical education in diagnosis

The hospital records in a community of 63,000 were reviewed for a five-year period (1978 to 1983) with regard to the diagnosis of cryptorchidism. There were 123 hospitalized patients with unilateral cryptorchidism and 17 patients with bilateral cryptorchidism. The diagnosis was made in 35 newborn infants from a total of 7,380 male births (neonatal incidence 0.48%). The mean age at time of orchiopexy was 7.56 years and only eight of 84 patients were less than 3 years of age at the time of surgery. Inappropriate surgery was done on occasion. A questionnaire mailed to 600 physicians in the region revealed that many were unaware of current recommendations regarding the timing of treatment for undescended testes. Missed diagnosis at birth and uninformed referring physicians appear to be major factors responsible for delayed diagnosis and treatment. Economic factors could not be implicated.