How electronically available referral guidelines for primary medical practitioners can improve the timeliness of orchidopexy

AIM: This study determined whether easily used guidelines and an electronic referral process could decrease the age of referral of suspected undescended testes (UDT). An online resource for primary medical practitioners was introduced for which the UDT guideline advises referral to paediatric surgery for testes not sitting spontaneously in the scrotum at three-months corrected age. METHOD: Data were collected prospectively for boys referred with UDT over a seven-year period (2012-2018), during which time agreed GP guidelines on the Community HealthPathways website for referral were introduced. Trends in the age at referral and age at orchidopexy were analysed. RESULTS: Complete data were obtained for 212 boys. Referral before age six months increased from 13% to 61%, and before 12 months from 48% to 78%. Orchidopexy by 12 months increased from 16% to 39%, and by 18 months from 48% to 74%, during the same period. Median age at orchidopexy for this 2012-2018 cohort was 21.6 months compared with 31.1 months from 1997-2007. DISCUSSION: These data demonstrate earlier referral of boys with UDT and earlier orchidopexy corresponded to the introduction of the GP Community HealthPathways website. A similar resource available in other regions or countries also might be expected to reduce the age of referral of suspected UDT from primary care providers.