Abstract
Objective
To identify risk factors associated with an inaccurate diagnosis, delayed referral,
and/or inappropriate ultrasound in consecutive referrals for an undescended testicle
(UDT).
Methods
This study was approved by the institutional review board. Data was prospectively
collected for all children referred to University of Oklahoma's pediatric urology
service from August 2019 to February 2020. The data was imported into SAS vs 9.4 for
analysis. We categorized the “quality” of referral by a point system using 3 factors
(no previous ultrasound, ≤18 months, correct location). An optimal referral had an
accurate testicular examination, was referred by 18 months of age, and no diagnostic
ultrasound.
Results
We collected 75 referrals. Thirty-nine (52.0%) had confirmed UDT, requiring surgery.
Twenty-seven (69.2%) had an accurate initial examination. Forty-one (54.7%) were outside
the optimal age. Thirty-four were considered low quality (0-1 qualities) and 41 were
high quality (2-3 qualities). Seven (9.3%) were optimal (3/3 qualities). Referrals
that needed intervention were statistically more likely to be higher quality.
Conclusion
Increased quality of UDT referrals directly correlated with the likelihood for treatment.
This study reveals a need for more education on UDT referral in the community. By
improving referring provider knowledge and skills, we can minimize unnecessary referrals.
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Article info
Publication history
Published online: August 17, 2021
Accepted:
August 1,
2021
Received:
June 12,
2021
Footnotes
Declarations of Interest: None.
Financial Disclosure: None.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
