Timing of Orchidopexy for Undescended Testis in Israel: A Quality of Care Study.

Autor:	Hidas G; Pediatric Urology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Ben Chaim J; Pediatric Urology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Udassin R; Department of Pediatric Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Graeb M; Pediatric Urology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Gofrit ON; Department of Urology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Zisk-Rony RY; School of Nursing, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Pode D; Department of Urology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Duvdevani M; Departments of Urology and Pediatric Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Yutkin V; Department of Urology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Neheman A; Pediatric Urology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Fruman A; Department of Pediatric Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Arbel D; Department of Pediatric Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Kopuler V; Department of Pediatric Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Armon Y; Department of Pediatric Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel., Landau EH; Pediatric Urology Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Jazyk:	angličtina
Zdroj:	The Israel Medical Association journal : IMAJ [Isr Med Assoc J] 2016 Nov; Vol. 18 (11), pp. 697-700.
Abstrakt:	Background: Strong evidence suggests that in order to prevent irreversible testicular damage surgical correction (orchidopexy) for undescended testis (UDT) should be performed before the age of 1 year. Objectives: To evaluate whether orchidopexy is delayed in our medical system, and if so, to explore the pattern of referral for orchidopexy as a possible contributing factor in such delays. Methods: We conducted a retrospective chart review of all children who underwent orchidopexy for UDT between 2003 and 2013 in our institution. We collected data on the age at surgery and the child's health insurance plan. We also surveyed pediatricians from around the country regarding their pattern of UDT patient referral to a pediatric urologist or surgeon for surgical correction. Results: A total of 813 children underwent orchidopexy in our institute during the study period. The median age at surgery was 1.49 years (range 0.5-13). Only 11% of the children underwent surgery under the age of 1 year, and 53% between the ages of 1 and 2 years. These findings were consistent throughout the years, with no difference between the four health insurance plans. Sixty-three pediatricians who participated in the survey reported that they referred children to surgery at a median age of 1 year (range 0.5-3 years). Conclusions: Our results demonstrate delayed orchidopexy in our medical system. There is a need to improve awareness for early specialist consultation in order to facilitate earlier surgery and better care.
Databáze:	MEDLINE
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