Pd55-09 the Ball Is Out of Our Court: Does Modern Primary Care Literature Reflect the American Urological Association Cryptorchidism Guidelines?

You have accessJournal of UrologyPediatrics VI (PD55)1 May 2024PD55-09 THE BALL IS OUT OF OUR COURT: DOES MODERN PRIMARY CARE LITERATURE REFLECT THE AMERICAN UROLOGICAL ASSOCIATION CRYPTORCHIDISM GUIDELINES? Lauren M. Nesi and Kristina Suson Lauren M. NesiLauren M. Nesi and Kristina SusonKristina Suson View All Author Informationhttps://doi.org/10.1097/01.JU.0001008908.82706.9f.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In 2014, the American Urological Association (AUA) released guidelines concerning the management of undescended testicles. Two portions of the guidelines specifically target primary care (PC) providers: not performing imaging and referral by six months of age. There is no specific guideline offered by the American Academy of Pediatrics (AAP). We hypothesize that a paucity of modern PC literature mirrors the AUA recommendations. METHODS: A PubMed search for cryptorchidism was performed. All abstracts in the pediatrics, family medicine, and general practice literature were screened to include articles primarily about diagnosis, treatment and outcomes of UDT, including tumor and torsion. Articles about related topics, such as etiology, were excluded. Our primary outcomes were whether the manuscript referenced and made recommendations concerning age at referral, performance of ultrasound, and/or age at orchiopexy. Data points extracted included journal discipline, author specialty and country, and the above outcomes. We documented manuscript type and if the subject concerned diagnosis, management, outcome, tumor, or torsion. Descriptive statistics were performed. RESULTS: Of 2,375 publications, 125 (5.3%) were from PC literature. Of these, 44 met inclusion criteria, with 40 from pediatric literature, 3 from family medicine literature, and 1 from general practice literature from a total of 18 different countries. The three most commonly encountered first and senior author specialties included pediatric urology (37), pediatric surgery (25), and pediatrics (25). Of the articles, 15 (34%) reference whether to perform imaging, 17 (38%) reference age of referral to surgical specialist, and 32 (73%) reference age at which surgical intervention should ensue. Only 10 manuscripts (23%) reference all three criteria. Most articles (93%) recommend referral to a specialist at 6 months of age. Of the articles that make a recommendation for imaging, 32 (73%) recommend against it. A maximum ideal surgical age of 12 months was quoted most commonly (50%), followed by 18 months (33%). The highest maximum ages were at 144 and 24 months, with one article each making these recommendations. CONCLUSIONS: Since the release of the 2014 AUA guidelines, only 10 articles in the primary care literature outline the appropriate use of imaging, age at referral to a surgical specialist, and age at surgery. Collaboration between the AUA and AAP could facilitate the dissemination of information regarding the proper management of cryptorchidism by PC providers. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1153 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Lauren M. Nesi More articles by this author Kristina Suson More articles by this author Expand All Advertisement PDF downloadLoading ...