Management of undescended testis may be improved with educational updates for referring providers

Abstract

Objective: A large proportion of boys referred for undescended testis (UDT) is not managed optimally prior to the referral, with the majority seen at >1 year of age and many having unnecessary ultrasound (US). Our objective was to assess the magnitude of these problems in our area and to determine if unnecessary US decreased following interventions to educate referring providers (RPs).

Materials and methods: A chart review was done on new patients referred for UDT from January 2010 to June 2012. Data collection included age on date of pediatric urology office visit, whether or not RPs obtained an US, and whether the pediatric urology examination revealed an UDT or retractile testis. Several educational updates for RPs were provided and the proportion having US was tracked during the study period.

Results: Of 363 boys referred for UDT, only 17% (62) were seen at <1 year of age, and 62% (227) had retractile testis. US had been obtained in 24% (87/363). There was a statistically significant decrease in the proportion of patients having had an unnecessary US following the last update (p < 0.01).

Conclusions: Delayed urology consultation and unnecessary US for UDT are common in our area. A brief focused educational update was effective in decreasing US in our area.

Keywords: Retractile testis; Ultrasound; Undescended testis.