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Purpose: Description of the demographic profile of patients with cryptorchidism who present to the Klerksdorp/Tshepong (K/T) Complex Hospital. The aim of this study is to examine the referral and surgical age and outcome of patients with cryptorchidism and compare them with results worldwide. Educational programmes that target general practitioners, paediatricians and parents are recommended to raise awareness of the importance of the early diagnosis and timed surgical management of undescended testes (UDT).
Methods: This retrospective study was done by reviewing hospital records of all cases of patients with UDT who underwent orchidopexy at the K/T Complex Hospital in the north-western part of South Africa between 1 June 2016 and 31 May 2021.
Selection criteria: All patients diagnosed with cryptorchidism who underwent orchidopexy at K/T Complex Hospital. Patients were divided into two groups, depending on age at the time of surgery: a) before/at 24 months (Group 1), and b) after 24 months (Group 2).
Results: Of the 196 patients with UDT who underwent surgery at K/T Complex Hospital, 77.6% had unilateral disease vs 22.4% with bilateral disease; 73.1% had a right UDT vs 26.9% with left UDT; and 82.6% of patients had their testes located in the inguinal location (9.7% of patients had ectopic testes and 7.7% of patients had abdominal testes). Postoperative complications were reported in 6.1% of cases. Very importantly, up to 93.4% of patients with UDT presented after the recommended age of intervention. Statistically, analysis revealed that the age at referral was a significant risk factor affecting the time of surgery. The rate of orchidectomy was 10.6% affecting patients in late presentation, i.e. those above 13 years due to testicular atrophy/torsion.
Conclusion: Data showed almost all patients with UDT (93.4%) managed at K/T Complex Hospital urology service in the study period were beyond the age recommended by international guidelines. Also, delayed patient presentation led to increased risk of orchidectomy.