Evidence map›Paper›PMID 39420485›Full record

ArticleJournal of paediatrics and child health2024

Pre-referral ultrasound for cryptorchidism: Still common, still not necessary.

Grace E Boyd, Bhaveshkumar Patel, Craig A McBride

Abstract read
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Article in Journal of paediatrics and child health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Grace E BoydDepartment of Paediatric Surgery, Queensland Children's Hospital, Brisbane, Queensland, Australia.ORCID 0000-0002-2107-4506
Bhaveshkumar PatelDepartment of Paediatric Surgery, Queensland Children's Hospital, Brisbane, Queensland, Australia.
Craig A McBrideDepartment of Paediatric Surgery, Queensland Children's Hospital, Brisbane, Queensland, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimEvidence-based guidelines do not recommend imaging in cryptorchidism, but anecdotally most referrals include an ultrasound report. We aimed to assess the frequency, utility and burden of imaging in children referred with presumptive disorders of testicular descent, and to assess trends over a 7-year period before and after local and international guidelines have been introduced.

methodsThis was a prospective cohort study of children referred to the Queensland Children's Hospital for anomalies of testicular descent between 2015-2017 and 2023-2024. Data were collected regarding demographics, referral details, imaging performed and surgical diagnosis.

resultsA total of 268 children were recruited. Ultrasound frequency has not significantly changed over time (72.8%, 2015-2017; 63.6% 2023-2024; P = 0.11). Currently, 17.6% of families are charged, and 31.9% need to take time off work, for the ultrasound. This is a significant increase from the 2015-2017 cohort. Parents report concern and anxiety, and find it traumatic for their child. Following review, the majority (65.7%) had physiologically normal testes, while 4.9% and 22.4% were diagnosed with bilateral or unilateral cryptorchidism, respectively, and 7.0% had other diagnoses. Ultrasound was concordant with the surgical diagnosis in 25.0% (2015-2017) and 30.7% (2023-2024). Ultrasound did not contribute to diagnosis nor management in any patient.

conclusionsDespite international and local guidelines, cryptorchid children continue to undergo ultrasound prior to referral. Such ultrasounds do not provide utility, or value for cost. We recommend avoiding their routine use for suspicion of testicular maldescent and working together to improve strategies for translating evidence-based guidelines into clinical practice.

Indexed as

CryptorchidismReferral and ConsultationUltrasonographyAdolescentChildChild, PreschoolCohort StudiesHumansInfantMaleProspective StudiesQueenslandUnnecessary Procedurescryptorchidismimagingreferral guidelineretractile testisultrasoundundescended testis

Identifiers

PMID39420485
PMCPMC11616252

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