Timing of orchidopexy at a tertiary center in Saudi Arabia: reasons for late surgery

BACKGROUND: Orchidopexy should be performed during the first 18 months of life to decrease the risk of infertility and tumor formation. In our center, the timing of surgical correction varies depending on the availability of an operating room. OBJECTIVES: Evaluate whether orchidopexy performed for patients referred to our center is done within the recommended time period and to determine causes for delay. DESIGN: Retrospective descriptive study. SETTING: Pediatric urology department of a tertiary care center. SUBJECTS AND METHODS: We retrospectively reviewed the charts of patients charts who underwent orchidopexy at our center from 2000 to 2010. We assessed referral time and waiting list time, which were subdivided as follows: from referral to first visit and from first visit to surgery. We included patients younger than 14 years and excluded patients with comorbidities that affected the timing of referral and surgical treatment. MAIN OUTCOME MEASURES: Referral time period and waiting list time for surgical correction of patients presented with undescended testis. SAMPLE SIZE: 128 RESULTS: After exclusion of 32 patients because of comorbidities, we describe 128 who underwent surgery for cryptorchidism at our center. The median (interquartile range, minimum-maximum) for age at surgery was 46.7 months (24.4–83.4, 3.1–248.6]). The median (IQR) referral occurred at an age of 25.3 months (4.1–65.5). The median (IQR) waiting list time was 15.2 months (8.1–23.3). The median (IQR) waiting time from referral to the first visit was 4.1 months (1.0–8.2). The median waiting time from the first visit to surgery was 8.1 months (3.8–17.5). CONCLUSIONS: The age at the time of surgery at our center was far from ideal because of late referrals. A structured program offered by our National Health Service to educate referring physicians is necessary. Community health initiatives must emphasize prompt referral to reduce the impact of delayed surgery. LIMITATIONS: Lack of data on the type of referring physician (i.e., general practitioner, pediatrician, surgeon, urologist).