Send to

Choose Destination
Can J Surg. 2019 Mar 22;62(3):1-6. [Epub ahead of print]

Variability among Canadian pediatric surgeons and pediatric urologists in the management of cryptorchidism in boys before the publication of major guidelines: a retrospective review of a single tertiary centre

Author information

From the Faculty of Medicine, University of Toronto, Toronto, Ont. (Kim, Lee); the Division of Urology, The Hospital for Sick Children, Toronto, Ont. (Kim, Chua, Ming, Lee, Kesavan, Kahn, Lorenzo, Bagli, Farhat, Papanikolaou, Koyle); the School of Medicine, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland (Kesavan); the Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ont., (Langer); and the Department of Surgery, University of Toronto, Toronto, Ont. (Langer, Lorenzo, Bagli, Farhat, Papanikolaou, Koyle).


in English, French


Before 2014, there was a lack of recommendations on managing cryptorchidism, or undescended testis (UDT), from a large pediatric urological or surgical organization. We assessed the variability in management of UDT among pediatric urologists and pediatric surgeons at a single tertiary pediatric referral centre before publication of major guidelines.


We performed a retrospective review of the electronic records of patients who underwent primary unilateral or bilateral orchidopexy at our centre between January 2012 and January 2014.


A total of 488 patients (616 testes) were identified, of whom 405 (83.0%) and 83 (17.0%) were managed by pediatric urologists and pediatric surgeons, respectively. There was no difference in baseline characteristics, including age seen in clinic or at surgery, testis location/palpability and availability of preoperative ultrasonograms, of patients seen by the 2 groups. Pediatric surgeons ordered preoperative ultrasonography more often than pediatric urologists (25.3% v. 3.7%, p < 0.001). With palpable UDTs, although both groups used open approaches, pediatric urologists preferred a scrotal approach (56.9%), and pediatric surgeons approached most testes inguinally (98.8%). With nonpalpable UDTs, laparoscopic approaches were preferred by both groups; however, pediatric urologists used a 2-stage Fowler–Stephens approach more often than pediatric surgeons (48.4% v. 15.8%, p < 0.001).


There was wide variation in the management of primary UDT between pediatric urologists and pediatric surgeons before the publication of guidelines. The most prominent difference between the 2 groups was in the ordering of preoperative ultrasonography. Future assessment of change in practice patterns may elucidate whether guidelines are an effective tool for standardization of practice.

Supplemental Content

Full text links

Icon for The Canadian Medical Association Icon for PubMed Central
Loading ...
Support Center