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How Effective was the 2014 AUA Cryptorchidism Guideline? A Multi-Institutional Evaluation
Journal article   Peer reviewed

How Effective was the 2014 AUA Cryptorchidism Guideline? A Multi-Institutional Evaluation

Hillary Weiner, Julie R Solomon, Robert Thinnes, Benjamin Pinsky, Charles Ferreri, Marquise Singleterry, Amanda Bahamonde, Sami Awadh, Jacqueline Tran, Alethea G Paradis, …
Urology practice, Vol.10(6), pp.605-610
11/2023
DOI: 10.1097/UPJ.0000000000000437
PMID: 37498314

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Abstract

PURPOSE In 2014, the American Urological Association (AUA) published guidelines regarding the evaluation of cryptorchidism. This multi-institutional study aims to determine if these guidelines reduced the age of referral and the utilization of ultrasound in boys with cryptorchidism. We hypothesize that delayed referral continues, and utilization of ultrasound remains unchanged. MATERIALS AND METHODS A retrospective review of boys referred for the evaluation of cryptorchidism was performed at 4 academic institutions, collecting data for 1 year prior (2013) and 2 non-consecutive years following guideline creation (2015 and 2019). Across these time frames, we compared median ages at evaluation and surgery and rates of patient comorbidities, orchiopexy, and pre-evaluation ultrasound. RESULTS A total of 3,293 patients were included. The median age at initial pediatric urology evaluation in all cohorts was 39 months (interquartile range: 14-92 months). Following publication of the AUA guidelines, there was no difference (P = .08) in the median age at first evaluation by a pediatric urologist between 2013 and 2015 and an increase (P = .03) between 2013 and 2019. Overall, 21.2% of patients received an ultrasound evaluation prior to referral, with no significant difference between 2013 and 2015 (P = .9) or 2019 (P = .5) cohorts. CONCLUSIONS Our data suggest that, despite publication of the AUA Guidelines on evaluation and treatment of cryptorchidism, there has been no reduction in the age of urologic evaluation or the utilization of imaging in boys with undescended testis. Finding alternative avenues to disseminate these evidence-based recommendations to referring providers and exploring barriers to guideline adherence is necessary to improve care for patients with cryptorchidism.

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