Investigation of the Factors that Determine the Time for Correction of Cryptorchidism in Children

Introduction: Cryptorchidism is the most common congenital abnormality of the urogenital system and is cor- rected by the method of orchiopexy, in the first year of life. However, the recommended age for surgical repair is not consistently achieved internationally. To our knowledge the rate of adherence to these guidelines in recent years in Greece is unknown.

Aim: To investigate the trend of surgical timing and explore the factors that affect the surgical age for correction of cryptorchidism.

Material and Method: We enrolled all the children who had undergone surgical correction of cryptorchidism in any of the three public paediatric hospitals in Athens, from

01/ 07 /2017 to 31/3/2018. A questionnaire completed by parents, including socio-demographic data (age, race, marital status, educational level, etc.), as well as data on possible reasons for delaying surgery and intra opera- tive data was used. Informed consent and ethical approval was obtained accordingly. All tests of statistical sig- nificance were two-tailed and p-values <0.05 were considered statistically significant.

Results: In total data from 102 children that undergo surgical correction of cryptorchidism and fulfilled the study criteria were enrolled. The mean age of the children who underwent orchiopexy was 2,42±2,33 years. The interval from diagnosis to surgical correction of cryptorchidism was 17.1±29.8 months. The majority of parents that completed the questionnaire were women (N=70, 68,6%), with a monthly family income less than 1500 Euros (N=75, 73,6%) living in Athens (N=59, 57,9%). Only 23,5% (N=24) of study participants stated that the surgery was performed in the first year of life, although the majority of the parents (N=69, 67,6%) reported that they were aware of the possible complica- tions from delayed surgery and they were also informed by a physician (N=74, 72,5%). A logistic regression was preformed and several socio demographic factors were significantly associated with time to surgery. There was a clear trend for early surgical intervention and the majority of children are operated before the age of 24 months (N=67, 65,7%).

Conclusion: Our findings indicate that parents are not adequately informed and several socio demographic characteristics influence their decision. Public education is recommended in order to encourage treatment of cryptorchidism on optimal time.