Related Experiment Video
Updated: Feb 9, 2026
The Participant-Reported Implementation Update and Score PRIUS: A Novel Method for Capturing Implementation-Related Data Over Time
Published on: February 19, 2021
Guideline implementation for the treatment of undescended testes: Still room for improvement
Verena Ellerkamp1, Andreas Schmid1, Gunnar Blumenstock2
1University Hospital Tuebingen, Department for Pediatric Surgery and Pediatric Urology, Germany.
Insights
Delayed surgery for undescended testis (UDT) is common, with most boys undergoing orchidopexy after age one. Delayed referral is the primary cause for this guideline non-conformity in UDT treatment.
Area of Science:
- Pediatric Surgery
- Urology
- Andrology
Background:
- Congenital undescended testis (UDT) management guidelines recommend early orchidopexy (OP) around age one.
- Previous studies may have underestimated delayed surgery due to not differentiating congenital from acquired UDT.
Purpose of the Study:
- To analyze the timing of orchidopexy in boys with congenital UDT.
- To identify reasons for delayed surgical intervention in UDT cases.
Main Methods:
- Retrospective analysis of orchidopexy data from 2009-2015 across eight pediatric surgery institutions.
- Differentiation between congenital and acquired UDT.
- Categorization of patients by age at surgery: <12 months, 12-24 months, >24 months.
- Detailed analysis of referral and surgery age, and intraoperative findings from one institution.
Main Results:
- Out of 4448 boys, 3270 had congenital UDT; 81% had surgery after age one, and 54.4% after age two.
- Hospitals showed higher rates of early operations than outpatient services; Germany had higher rates than Switzerland.
- For 694 detailed congenital cases, median referral age was 13 months and median surgery age was 15 months.
Conclusions:
- Delayed referral is the primary factor contributing to non-adherence to guidelines for timely UDT surgery.
- Current practices indicate a significant delay in surgical correction for congenital UDT.
Background:
Early orchidopexy (OP) around the age of 1 year is recommended in boys with congenital undescended testis (UDT) worldwide since decades. Former retrospectives studies did not distinguish congenital from acquired UDT with a consecutive negative bias concerning the age at surgery.
Methods:
In a retrospective analysis, data of all boys who underwent OP in eight pediatric surgery institutions from 2009 to 2015 were analyzed. Congenital or acquired UDT were differentiated. Patients were categorized into 3 groups of age at surgery: (1) <12 months, (2) 12-24 months, (3) >24 months. Data of one institution were analyzed in detail: exact age of first referral, exact age at surgery, intraoperative findings.
Results:
Out of 4448 boys, 3270 boys had congenital UDT. In 81% (2656 cases) surgery was performed beyond the age of 1 year, in 54.4% (1780) beyond the age of 2 years. chi-Square statistics showed a higher rate of early operations in hospitals compared to outpatient services and in Germany compared to Switzerland. In 694 congenital detailed cases, median age at referral was 13 months [range 0-196], median age at surgery was 15 months [range 0-202].
Conclusion:
Delayed referral is the main reason for guideline non-conform delayed surgery in UDT.
Type Of Study:
Clinical Research paper.
Level Of Evidence:
Level III: Treatment Study.
Related Concept Videos
01:15Nursing Implementation
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
01:30Guidelines for Nursing Documentation I
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.
01:23Guidelines for Sketching a Curve
01:26Guidelines for Nursing Documentation II
Timely documentation is crucial to ensure continuity of care for patients. Any delays in recording or reporting medical information can result in medical errors and even adverse patient outcomes. From medication administration to diagnostic test results, every detail must be accurately and promptly documented to provide the best possible care for patients.
01:06Legal Guidelines for Documentation