Medical audit of community screening for undescended testes in Halton District.

OBJECTIVES

To evaluate the quality of screening in the community for undescended testis and to determine the percentage of boys referred for surgery before their second birthday.

DESIGN

Population-based retrospective study of hospital and community clinic records of boys resident in Halton Health District who underwent surgery for undescended testicle during 1987-89.

SETTING

Community Child Health Clinics. Medical Records Department of referral hospitals surrounding Halton district.

RESULTS

During 1987-89, 76 boys from Halton district underwent surgery for undescended testis in the neighbouring hospitals: 64 (84%) of these boys had attended at least one screening examination in the community clinics; 12 (16%) did not attend any. Among the 64 who attended 18 (28%) were not considered to have undescended testis. Of the 30 boys diagnosed to have undescended testis after school entry, six were diagnosed incidentally in hospital and 24 were detected by general practitioners and School Medical Service. The age range for surgical referral varied from six months to 12.5 years. The percentage of boys referred for surgery before their second birthday was only 13%.

CONCLUSION

Many cryptorchid boys were not picked up in community screening and many of these did not receive early surgery. This audit report suggested the following recommendations: (a) increased awareness of the condition amongst doctors and health visitors performing screening examination; (b) early surgical referral. These recommendations have been implemented in the district. Our further plan is to repeat the audit in three years to assess changes.