title: A 22-year retrospective study: educational update and new referral pattern of age at orchidopexy.
abstract: OBJECTIVE
  To determine the current age at orchidopexy in China and whether changing targets have altered practice, as research suggesting progressive deterioration in an undescended testis (UDT) has led to the reduction in the target age for orchidopexy to 6-12 months but it is still unknown whether changing targets have altered practice.
  
  
  METHODS
  The demographics of orchidopexies performed in the Children's Hospital of Chongqing Medical University between 1993 and 2014 were reviewed. A survey of the general publics' awareness of UDT and survey of primary healthcare practitioners' current opinion on age at orchidopexy and referral patterns were performed.
  
  
  RESULTS
  In all, 3784 orchidopexies were performed over 22 years. The median age at orchidopexy fell between 1993 and 2014. There was an initial drop in the median age for orchidopexy between 2000 and 2010 (36 months) compared with 1993 and 2000 (48 months) (P < 0.05); however, beyond the corresponding target age (<18 months). The age for orchidopexy between 2010 and 2014 was also beyond the corresponding target age (6-9 months). The survey of the general public showed that 0.98% had knowledge of UDT and none of them knew about the target age for orchidopexy in the survey of 5393 cases. In all, 63.46% of them were told about the UDT by healthcare practitioners at the 1-4 months postnatal baby check. Furthermore, only 2% of the healthcare practitioners knew the recommended age for orchidopexy was 6-9 months and only 14.3% of them would directly make a surgical referral to paediatric surgery specifically at this point.
  
  
  CONCLUSIONS
  The recommended orchidopexy age is not being achieved and we recognise the national need to address this. The approach should include the right cognition of cryptorchidism among the general public and earlier primary care referral directly from the routine postnatal baby check to a specialist centre prepared to undertake surgery in this age group.
authors.affiliation: Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002, China International Science and Technology Cooperation base of Child's Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.|Department of Pediatric Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Wei
authors.affiliation: Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002, China International Science and Technology Cooperation base of Child's Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.|Department of Pediatric Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Sheng-de
authors.initials: SD
authors.lastname: Wu
authors.affiliation: Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002, China International Science and Technology Cooperation base of Child's Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.|Department of Pediatric Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Yang-Cai
authors.initials: YC
authors.lastname: Wang
authors.affiliation: Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002, China International Science and Technology Cooperation base of Child's Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.|Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Lin
authors.affiliation: Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002, China International Science and Technology Cooperation base of Child's Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.|Department of Pathology, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Da-Wei
authors.initials: DW
authors.lastname: He
authors.affiliation: Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002, China International Science and Technology Cooperation base of Child's Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.|Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Xu-Liang
authors.initials: XL
authors.lastname: Li
authors.affiliation: Department of Pediatric Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.|Department of Pathology, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Jun-Hong
authors.initials: JH
authors.lastname: Liu
authors.affiliation: Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002, China International Science and Technology Cooperation base of Child's Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Liu
authors.affiliation: Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002, China International Science and Technology Cooperation base of Child's Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.|Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Hua
authors.affiliation: Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002, China International Science and Technology Cooperation base of Child's Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.|Department of Pathology, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Lu
authors.affiliation: Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002, China International Science and Technology Cooperation base of Child's Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.|Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: De-Ying
authors.initials: DY
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Wen
authors.affiliation: Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002, China International Science and Technology Cooperation base of Child's Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.|Department of Pediatric Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.|Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China.|Department of Pathology, Children's Hospital of Chongqing Medical University, Chongqing, China.
authors.forename: Guang-Hui
authors.initials: GH
authors.lastname: Wei
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002681:China; D003456:Cryptorchidism / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D056126:Orchiopexy / Q000592:standards* / Q000639:trends*; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000639:trends; D012017:Referral and Consultation / Q000639:trends; D012189:Retrospective Studies; D013997:Time Factors; D014572:Urology
keywords: China; children; cryptorchidism; orchidopexy