title: Delayed referral despite appropriate knowledge in cryptorchidism as a cause of delayed orchidopexies in Austria.
abstract: OBJECTIVE
  Guidelines recommend early orchidopexy in cryptorchidism to decrease the risk of infertility and tumor formation. We aimed to asses if a delayed initial presentation for cryptorchidism was due to unawareness of these guidelines or for any other reasons.
  
  
  METHODS
  A short questionnaire exploring timing and referral habits when assessing children with cryptorchidism was sent by email to all registered pediatricians in Austria. Comparatively, a chart review of performed orchidopexies was performed at our institution.
  
  
  RESULTS
  Of 369 registered pediatricians, 102 (27.6%) returned valid questionnaires. The average maximum age at which pediatricians in Austria suggested treatment of cryptorchidism was the 21.2 (8.4 months standard deviation (SD)) month of life. Assessment of testicular descent was reported to be regularly performed until the 8.8 (3-18 years SD) year of life. In contrast, from 1997-2008, 730 boys were treated surgically for cryptorchidism at our department. The mean age at operation was 3.4 years (3.1 years SD).
  
  
  CONCLUSIONS
  The majority of pediatricians in Austria know the correct timing for treatment of cryptorchidism. Nevertheless, orchidopexies are still carried out to later than suggested by international guidelines. Further studies and analysis to evaluate the reasons for these suboptimal referring patterns coupled with further communication improvements between pediatricians and surgeons are needed.
authors.affiliation: Department of Pediatric Surgery, Medical University Vienna, Währinger Gürtel 18-20, Vienna, Austria. alexander.springer@meduniwien.ac.at
authors.forename: A
authors.initials: A
authors.lastname: Springer
authors.forename: C
authors.initials: C
authors.lastname: Huber
authors.forename: C A
authors.initials: CA
authors.lastname: Reck
authors.forename: D
authors.initials: D
authors.lastname: Fengler
authors.forename: E
authors.initials: E
authors.lastname: Horcher
mesh_terms: D000293:Adolescent; D001317:Austria; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000175:diagnosis* / Q000601:surgery*; D003625:Data Collection; D057210:Delayed Diagnosis / Q000009:adverse effects* / Q000523:psychology*; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D008297:Male; D056126:Orchiopexy; D010372:Pediatrics; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D011795:Surveys and Questionnaires