Abstract:
Background: Undescended testicles is a common condition in cerebral palsy, with a high incidence of ascending testicles. It is usually treated with orchidopexy, which is aimed to be performed early in life in order to minimise the impact on fertility and reduce cancer risk.
Aim: To assess whether there is a delay in the diagnosis and management of undescended testes in children with cerebral palsy, within NHS Grampian.
Method: A retrospective audit was conducted. The 13 patients included were identified by an electronic record review of 1061 patients with orchidopexy, as well as a database search for undescended testicles and cerebral palsy. Standards were set for assessing the documentation of testicular examination, delays in diagnosis of undescended testes as well as delays in surgery.
Results: Testicular exams were documented in 62% of patients during the neonatal exam period and 67% percent during the 6-8 weeks exam, however this was limited by records availability. None of the applicable patients had orchidopexy performed before 12 months however 50% did so by 18 months. Diagnosis of ascending testicles was potentially delayed in 44% of patients. In 44% of patients who were diagnosed after nine months, orchidopexy was performed within 3 months of diagnosis. Orchidopexy was performed before puberty in 86% of patients with ascending testicles.
Recommendation: To add testicular exams to the Community Child Health cerebral palsy annual review check-list, as well as implement a consistent and shared method of documentation for examination findings. Orchidopexy should be aimed to be done in a timely-manor. Parents and guardians should be made aware of the increased incidence/implications of undescended testicles. Further research needs to be Further research needs to be done on undescended testicles in cerebral palsy, as well as on ascending testicles.
