Many unnecessary referrals about testicular retention from BVC

Approximately 2% of all boys in Sweden require surgery because one or both testicles have not migrated into the scrotum. Without surgery, fertility deteriorates later in life. The risk of testicular cancer also increases.

It’s an important condition that needs to be revealed, says Martin Salo, MD, a pediatric surgeon and assistant professor at Skene University Hospital.

At the same time, a study by Martin Salo among others showed that many referrals for suspected testicular retention show a normal testicular condition.

Researchers reviewed journal data with all referrals with a ‘retentio testis’ question that came to the Clinic for Pediatric and Adolescent Surgery at Skåne University Hospital in Lund during 2019 and 2020.

Of the 740 males referred, 378, more than 50 percent, were judged to have a normal testicular condition. 235 referrals (32 per cent) resulted in surgery and 127 (17 per cent) required further follow-up.

The greater risk of ‘unnecessary’ referral was if the referral came from the health care center, compared to whether it was issued at a health center, pediatric clinic, or surgery and urology clinic. According to Martin Salo, one explanation could be that in the BVC they see a lot of children and that the doctor has time to go through the whole body.

– I am very humbled by the fact that this can be difficult when you have a lot of patients and you have to check a lot in a short time. Then the testicle is only a small part of the examination, and if you don’t feel it right away, you may prefer to go back rather than take the risk.

However, researchers believe that more education and training in examining boys’ testicles, particularly in BVC, could likely reduce the number of referrals that lead to no action. The increased accuracy can also benefit boys and their families, who avoid unnecessary trips and unnecessary checks.

A lot of parents are worried, too.

Even care like this would benefit from increased accuracy, says Martin Salo.

– It has a lot to do with priorities and with long queues at both receptions and operations, and that’s something that could be improved. With many “unnecessary” referrals, it can mean that others who will need to come early have to wait longer.

The study, which was presented at the ongoing Surgeons Week, was conducted by researchers in the Department of Clinical Sciences, Department of Pediatrics, at Lund University and the Clinic for Pediatric and Adolescent Surgery at Skene University Hospital.

Lakartidningen.se 2022-08-26