{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:45:48Z","timestamp":1787013948444,"version":"build-2736575974"},"reference-count":55,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,3,9]],"date-time":"2018-03-09T00:00:00Z","timestamp":1520553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the implementation of the current guideline and identify potential underlying causes for late surgery in children with undescended testis (UDT) in Germany. UDT is the most common surgical issue in paediatric urology and to avoid malignant degeneration and subfertility current guidelines recommend orchidopexy during the first year of life; however, this seems not to be implemented in practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>In all, 5\u00a0547 patients with cryptorchidism at 16 hospitals nationwide were studied regarding age at orchidopexy between 2003 and 2016. Multivariate analysis was performed to identify factors influencing timing of surgery. Additionally, a survey on knowledge of UDT management was conducted amongst physicians treating boys and final\u2010year medical students.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 2003 and 2008 only 4% of boys with UDT underwent surgery before the age of 1\u00a0year. After the guideline update from 2009, this figure was 5% from 2010 to 2012, and 8% from 2013 to 2016. The presence of a specialised department for paediatric surgery, as well as a high UDT case\u2010to\u2010year ratio positively influenced the timing of orchidopexy. The survey revealed discipline\u2010specific differences in the levels of knowledge about UDT management. One\u2010third of respondents did not know the guideline recommendations and 61% felt insufficiently informed. International comparisons revealed significant differences in the age at surgery of boys with UDT, with Germany and Great Britain ranging in the middle of the field.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Currently, only a small proportion of boys with UDT are operated upon during their first year of life. The level of knowledge in attending physicians remains in need of improvement. This should be actively addressed, i.e. by campaigns and educational programmes. Further studies are needed to investigate the underlying causes of late orchidopexy in UDT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.14171","type":"journal-article","created":{"date-parts":[[2018,2,16]],"date-time":"2018-02-16T10:16:55Z","timestamp":1518776215000},"page":"644-653","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Shortcomings in the management of undescended testis: guideline intention vs reality and the underlying causes \u2013 insights from the biggest German cohort"],"prefix":"10.1111","volume":"122","author":[{"given":"Philip","family":"Boehme","sequence":"first","affiliation":[{"name":"Witten\/Herdecke University Department of Paediatrics, Centre for Clinical and Translational Research (CCTR) Wuppertal University Hospital Wuppertal Germany"},{"name":"Cardiovascular Research Bayer Pharma AG Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berit","family":"Geis","sequence":"additional","affiliation":[{"name":"Institute of Medical Biometry and Epidemiology (IMBE) Faculty of Health Witten\/Herdecke University Witten Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Doerner","sequence":"additional","affiliation":[{"name":"Witten\/Herdecke University Department of Surgery, Centre for General and Visceral Surgery HELIOS University Hospital Wuppertal Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Wirth","sequence":"additional","affiliation":[{"name":"Witten\/Herdecke University Department of Paediatrics, Centre for Clinical and Translational Research (CCTR) Wuppertal University Hospital Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5826-6133","authenticated-orcid":false,"given":"Kai O.","family":"Hensel","sequence":"additional","affiliation":[{"name":"Witten\/Herdecke University Department of Paediatrics, Centre for Clinical and Translational Research (CCTR) Wuppertal University Hospital Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03345105"},{"key":"e_1_2_8_3_1","first-page":"647","article-title":"Undescended testis guideline \u2010 is it being implemented in practice?","volume":"111","author":"Hensel KO","year":"2014","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0003051"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000254061.90686.9f"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-305225"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2011.23"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000181055"},{"key":"e_1_2_8_9_1","first-page":"176","article-title":"Germ cell development in the postnatal testis: the key to prevent malignancy in cryptorchidism?","volume":"3","author":"Hutson JM","year":"2012","journal-title":"Front Endocrinol (Lausanne)"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.03.184"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s003830050239"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000106100.21225.d7"},{"key":"e_1_2_8_13_1","first-page":"649","article-title":"The timing of surgery for undescended testis \u2010 a retrospective multicenter analysis","volume":"111","author":"Hrivatakis G","year":"2014","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2016.59940"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067588"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(86)80389-X"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-013-3429-y"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.05.166"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2006.00159.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2014.05.005"},{"key":"e_1_2_8_21_1","unstructured":"Tekg\u00fclTS DoganHS HoebekePet\u00a0al.EAU guidelines on paediatric urology 2016. 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