Al-Anbar Medical Journal (Dec 2024)

Delayed Presentation of Cryptorchidism, What’s Behind?

  • Muhamed Fadhle,
  • Ali Al-Mayoof

DOI
https://doi.org/10.33091/amj.2024.148425.1648
Journal volume & issue
Vol. 20, no. 2
pp. 137 – 143

Abstract

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Background: Delayed presentation of cryptorchidism, or undescended testis (UDT), is still a common problem worldwide,  despite the clear recommendations of most international guidelines for early referral and correction at 6–12 months of life. Identifying the underlying causes of this delayed presentation is an important step in overcoming this problem.Objectives: To identify the causes and risk factors associated with delayed UDT presentation.Materials and Methods: A cross-sectional study was conducted  over 17 months, and included patients with UDT up to 14 years old age. Patients were divided into two groups according to their age at the time of presentation, early (≤ 1 year) and late (> 1-14  years) groups. The causes of delayed UDT presentation were identified in the late group. Both groups were compared regarding possible risk factors of delayed UDT presentation.Results: Of 204 cases with UDT, there were 121 (59.3%) patients presented beyond the recommended age of orchiopexy. The main causes of delayed presentation were parental ignorance and unawareness in 43 (35.5%) patients, false advice from medical and nonmedical personnel in 17 (14.1%) and 28 (23.1%) patients, respectively, the presence of another medical disease in 18 (14.9%) patients, and poverty in 15 (12.4%) patients. Patients in the late group had a significantly less urbanized level of residency (P-value = 0.036), a lower maternal education level (P-value = 0.012), less parent information about UDT (P-value = 0.013), more likely to be first-born boys in their families (P-value = 0.036), and to have another medical disease(s) (P-value = 0.049). We found insignificant differences between the two groups regarding family history of UDT (P-value = 0.300), paternal education level (P-value = 0.288), side (P-value = 0.759), and site (P-value = 0.073) of UDT.Conclusion: Delayed presentation of UDT was attributed mainly to the limited knowledge of the community and medical care providers about its management. Increasing public awareness about UDT and establishing effective measures for earlier detection and referral of patients with UDT are important initial steps to solving this problem in our society.

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