Surveillance of testicular microlithiasis? Results of an UK based national questionnaire survey.
BACKGROUND
The association of testicular microlithiasis with testicular tumour and the need for follow-up remain largely unclear.


METHODS
We conducted a national questionnaire survey involving consultant BAUS members (BAUS is the official national organisation (like the AUA in USA) of the practising urologists in the UK and Ireland), to provide a snapshot of current attitudes towards investigation and surveillance of patients with testicular microlithiasis.


RESULTS
Of the 464 questionnaires sent to the BAUS membership, 263(57%) were returned. 251 returns (12 were incomplete) were analysed, of whom 173(69%) do and 78(31%) do not follow-up testicular microlithiasis. Of the 173 who do follow-up, 119(69%) follow-up all patients while 54(31%) follow-up only a selected group of patients. 172 of 173 use ultra sound scan while 27(16%) check tumour makers. 10(6%) arrange ultrasound scan every six months, 151(88%) annually while 10(6%) at longer intervals. 66(38%) intend to follow-up these patients for life while, 80(47%) until 55 years of age and 26(15%) for up to 5 years. 173(68.9%) believe testicular microlithiasis is associated with CIS in < 1%, 53(21%) think it is between 1&10% while 7(3%) believe it is > 10%. 109(43%) believe those patients who develop a tumour, will have survival benefit with follow-up while 142(57%) do not. Interestingly, 66(38%) who follow-up these patients do not think there is a survival benefit.


CONCLUSIONS
There is significant variability in how patients with testicular microlithiasis are followed-up. However a majority of consultant urologists nationally, believe surveillance of this patient group confers no survival benefit. There is a clear need to clarify this issue in order to recommend a coherent surveillance policy.
Specialist Registrar in Urology, University Hospital Aintree, Liverpool, L9 7AL, UK. chintuappu@aol.com.
Subramanian
S
Ravichandran
Richard
R
Smith
Philip A
PA
Cornford
Mark V P
MV
Fordham
D002137:Calculi / Q000150:complications*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D013733:Testicular Diseases / Q000150:complications*; D006113:United Kingdom