Bilateral orchidopexies: synchronous or metachronous? Survey of BAPS and BAPU members and single-centre comparison.
Child, Preschool
Cryptorchidism
/ surgery
Humans
Infant
Infant, Newborn
Male
Orchiopexy
/ adverse effects
Pediatrics
Practice Patterns, Physicians'
/ statistics & numerical data
Retrospective Studies
Societies, Medical
Specialties, Surgical
Surveys and Questionnaires
Time Factors
United Kingdom
Urology
Cryptorchidism
Testicular atrophy
Undescended testes
Undescended testis
Journal
Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
21
10
2018
accepted:
30
10
2018
pubmed:
12
12
2018
medline:
5
4
2019
entrez:
12
12
2018
Statut:
ppublish
Résumé
Approximately 20% of undescended testes (UDT) are bilateral. It is unclear whether bilateral orchidopexy (BO) should be undertaken synchronously (SBO) or metachronously (MBO). Our aim was to investigate current UK practice and the complications of SBO vs MBO. Following approval of BAPS and BAPU ethics committee, a survey was circulated to UK consultant pediatric surgeons and urologists regarding practice. A departmental retrospective review was additionally carried out for patients undergoing BO between 2005 and 2017. Forty-three consultant surgeons from 20 centres completed the survey. Overall, SBO was preferred by 70% for bilateral palpable UDT versus 30% for bilateral impalpable UDT. When one side was palpable and the other impalpable, 70% preferred SBO. Pediatric urologists were significantly more likely to undertake SBO than pediatric general surgeons. One hundred eighty-eight patients (376 testicular units) were identified who had undergone BO with a median follow up of 9 months. 144/188 (76.6%) underwent SBO, while 44 had MBO. There was no statistical difference in the complication rate between the two groups (7.6% in SBO vs 9.1% in MBO; p = 0.66). The majority of the responding UK consultants, in particular pediatric urologists, favor SBO. This potentially offers a reduction in cost, more rapid completion of treatment, and is not associated with additional complications by comparison to MBO. We recommend SBO to be standard practice for bilateral UDT whenever possible. Level III, Retrospective Comparative Study.
Sections du résumé
BACKGROUND/AIM
OBJECTIVE
Approximately 20% of undescended testes (UDT) are bilateral. It is unclear whether bilateral orchidopexy (BO) should be undertaken synchronously (SBO) or metachronously (MBO). Our aim was to investigate current UK practice and the complications of SBO vs MBO.
MATERIALS & METHODS
METHODS
Following approval of BAPS and BAPU ethics committee, a survey was circulated to UK consultant pediatric surgeons and urologists regarding practice. A departmental retrospective review was additionally carried out for patients undergoing BO between 2005 and 2017.
RESULTS
RESULTS
Forty-three consultant surgeons from 20 centres completed the survey. Overall, SBO was preferred by 70% for bilateral palpable UDT versus 30% for bilateral impalpable UDT. When one side was palpable and the other impalpable, 70% preferred SBO. Pediatric urologists were significantly more likely to undertake SBO than pediatric general surgeons. One hundred eighty-eight patients (376 testicular units) were identified who had undergone BO with a median follow up of 9 months. 144/188 (76.6%) underwent SBO, while 44 had MBO. There was no statistical difference in the complication rate between the two groups (7.6% in SBO vs 9.1% in MBO; p = 0.66).
CONCLUSIONS
CONCLUSIONS
The majority of the responding UK consultants, in particular pediatric urologists, favor SBO. This potentially offers a reduction in cost, more rapid completion of treatment, and is not associated with additional complications by comparison to MBO. We recommend SBO to be standard practice for bilateral UDT whenever possible.
LEVEL OF EVIDENCE
METHODS
Level III, Retrospective Comparative Study.
Identifiants
pubmed: 30528205
pii: S0022-3468(18)30748-6
doi: 10.1016/j.jpedsurg.2018.10.088
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
310-312Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.