Predictors of delayed consultation in undescended testis patients at a Rwandan referral hospital

INTRODUCTION: Delayed management of undescended testes (UDT) is associated with an increased risk of malignancy and impaired fertility. To identify causes of delayed consultation of patients with UDT at a Rwandan referral hospital METHODS: This was a retrospective study of patients with delayed...

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Main Authors: A. Bonane, A. Nshimiyimana, I. Nzeyimana, A. Nyirimodoka, E. Muhawenimana, T. Hategekimana, J. Richard
Format: Article
Language:English
Published: Rwanda Biomedical Centre (RBC)/Rwanda Health Communication Center 2022-12-01
Series:Rwanda Medical Journal
Subjects:
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author A. Bonane
A. Nshimiyimana
I. Nzeyimana
A. Nyirimodoka
E. Muhawenimana
T. Hategekimana
J. Richard
author_facet A. Bonane
A. Nshimiyimana
I. Nzeyimana
A. Nyirimodoka
E. Muhawenimana
T. Hategekimana
J. Richard
author_sort A. Bonane
collection DOAJ
description INTRODUCTION: Delayed management of undescended testes (UDT) is associated with an increased risk of malignancy and impaired fertility. To identify causes of delayed consultation of patients with UDT at a Rwandan referral hospital METHODS: This was a retrospective study of patients with delayed UDT presentations from 2012 to 2016. A delayed UDT presentation was defined as any patient presenting with UDT at >1 year of age. RESULTS: There were 44 cases of delayed UDT presentations. Most patients (n = 35, 79.5%) were born at a hospital; the rest (n = 9, 20.5%) were born at home. The patient’s parent with higher education in the family was considered. Most of the patients’ parents (n = 29, 65.9%) had a primary education, 6 (13.6%) had a secondary education (high school graduate), 1 (2.3%) had a university education, and 8 (18.2%) never went to school. The reported reasons for delays as they appear in the patient chart were 16 (36.4%) patients due to ignorance, 12 (27.3%) due to poor physical examination at birth, 7 (15.9%) due to poor guidance, 4 (9.0%) due to poverty and 5 (11.4%) due to long appointments. There were no overlapping reasons for delay reported. Patients born at home were more likely to identify ignorance as a reason for the delay (p = 0.007). Of the 16 patients who reported a delay due to ignorance, 12 of their parents had primary education, and 3 had no education. Most (n = 34, 77.3%) patients were fertile in adulthood, but 9 (20.4%) presented with infertility and 1 (2.3%) presented with testicular torsion. CONCLUSION: A number of reasons are responsible for delayed consultation in patients with UDT, including ignorance, poor physical examination, poor guidance, and poverty. Most of the causes are preventable. The urgent need for awareness of UDT and collaboration between physicians is paramount for early consult and management.
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spelling doaj.art-18b35e32740841209bd44645e09ebb222023-01-15T15:35:21ZengRwanda Biomedical Centre (RBC)/Rwanda Health Communication CenterRwanda Medical Journal2410-86262022-12-017947884https://dx.doi.org/10.4314/rmj.v79i4.8Predictors of delayed consultation in undescended testis patients at a Rwandan referral hospitalA. Bonane0A. Nshimiyimana1I. Nzeyimana2A. Nyirimodoka3 E. Muhawenimana4T. Hategekimana5J. Richard6Department of Surgery, University of Rwanda; Department of Surgery, University Teaching Hospital of KigaliDepartment of Surgery, University of RwandaDepartment of Surgery, University Teaching Hospital of ButareDepartment of Surgery, University of RwandaDepartment of Surgery, University Teaching Hospital of KigaliDepartment of Surgery, University Teaching Hospital of KigaliDepartment of Surgery, University of Rwanda; Department of Surgery, University Teaching Hospital of Kigali; Department of Surgery, University of MinnesotaINTRODUCTION: Delayed management of undescended testes (UDT) is associated with an increased risk of malignancy and impaired fertility. To identify causes of delayed consultation of patients with UDT at a Rwandan referral hospital METHODS: This was a retrospective study of patients with delayed UDT presentations from 2012 to 2016. A delayed UDT presentation was defined as any patient presenting with UDT at >1 year of age. RESULTS: There were 44 cases of delayed UDT presentations. Most patients (n = 35, 79.5%) were born at a hospital; the rest (n = 9, 20.5%) were born at home. The patient’s parent with higher education in the family was considered. Most of the patients’ parents (n = 29, 65.9%) had a primary education, 6 (13.6%) had a secondary education (high school graduate), 1 (2.3%) had a university education, and 8 (18.2%) never went to school. The reported reasons for delays as they appear in the patient chart were 16 (36.4%) patients due to ignorance, 12 (27.3%) due to poor physical examination at birth, 7 (15.9%) due to poor guidance, 4 (9.0%) due to poverty and 5 (11.4%) due to long appointments. There were no overlapping reasons for delay reported. Patients born at home were more likely to identify ignorance as a reason for the delay (p = 0.007). Of the 16 patients who reported a delay due to ignorance, 12 of their parents had primary education, and 3 had no education. Most (n = 34, 77.3%) patients were fertile in adulthood, but 9 (20.4%) presented with infertility and 1 (2.3%) presented with testicular torsion. CONCLUSION: A number of reasons are responsible for delayed consultation in patients with UDT, including ignorance, poor physical examination, poor guidance, and poverty. Most of the causes are preventable. The urgent need for awareness of UDT and collaboration between physicians is paramount for early consult and management.cryptorchidismrwandaretrospective studiesreferral consultation
spellingShingle A. Bonane
A. Nshimiyimana
I. Nzeyimana
A. Nyirimodoka
E. Muhawenimana
T. Hategekimana
J. Richard
Predictors of delayed consultation in undescended testis patients at a Rwandan referral hospital
Rwanda Medical Journal
cryptorchidism
rwanda
retrospective studies
referral consultation
title Predictors of delayed consultation in undescended testis patients at a Rwandan referral hospital
title_full Predictors of delayed consultation in undescended testis patients at a Rwandan referral hospital
title_fullStr Predictors of delayed consultation in undescended testis patients at a Rwandan referral hospital
title_full_unstemmed Predictors of delayed consultation in undescended testis patients at a Rwandan referral hospital
title_short Predictors of delayed consultation in undescended testis patients at a Rwandan referral hospital
title_sort predictors of delayed consultation in undescended testis patients at a rwandan referral hospital
topic cryptorchidism
rwanda
retrospective studies
referral consultation
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