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Variables Pediatric surgeons (n=77) Pediatric urologists (n=40) P-value How many cryptorchidisms do you manage per year? <25 18 (23.4) 4 (10.0) 0.02 25-50 28 (36.3) 9 (22.5) 50-100 21 (27.2) 23 (57.5) >100 10 (13.0) 4 (10.0) How many years in practice? <5 14 (18.2) 10 (25.0) 0.37 5-10 16 (20.8) 11 (27.5) >10 47 (61.0) 19 (47.5) Management Pediatric surgeons (n=77) Pediatric urologists (n=40) P-value What is your preferred age of orchidopexy? (months) 3- 6 4 (5.2.0) 0 <0.001 6-12 58 (75.3) 40 (100) >12 15 (19.5) 0 Do you routinely order ultrasounds for nonpalpable testes? Yes 28 (36.4) 7 (17.5) 0.05 Do you routinely order MRI for nonpalpable testes? Yes 3 (3.9) 0 0.55 Do you use hormonal therapy for cryptorchidism? No 64 (83.1) 37 (92.5) 0.01 If intra-abdominal testes 2 (2.6) 3 (7.5) If small bilateral testes 11 (14.3) 0 Management Pediatric surgeons (n=77) Pediatric urologists (n=40) P-value What is your preferred initial surgical approach to unilateral nonpalpable testes? Laparoscopic 74 (96.1) 38 (95.0) 0.74 Inguinal 2 (2.6) 2 (5) Examination under Ga if not palpable laparoscopic exploration 1 (1.3) 0 What is your preferred initial surgical approach for bilateral nonpalpable testes? Laparoscopic 77 (100) 40 (100) What is your preferred timing for bilateral nonpalpable undescended testes? Synchronous 50 (64.9) 32 (80) 0.09 Metachronous 27 (35.1) 8 (20) What is your preferred initial approach for intra-abdominal testes where the testis reaches the contralateral ring after mobilization? (When the intra-abdominal testes can be mobilized to the contralateral ring that means it have enough length to go down to the scrotum). Laparoscopic 1-stage orchidopexy 68 (88.3) 33 (82.5) 0.001 Staged laparoscopic testicular vessel elongation/Traction, followed by inguinal orchidopexy (Shehata Technique) 5 (6.5) 0 Laparoscopic 2-stage Fowler–Stephens orchidopexy 1 (1.3) 7 (17.5) Inguinal 1-stage orchidopexy 3 (3.9) 0 What is your preferred initial approach for intra-abdominal testes where the testis does not reach the contralateral internal ring after mobilization? Laparoscopic 1 stage orchidopexy 7 (9.1) 2 (5) <0.001 Laparoscopic 2-stage Fowler–Stephens orchidopexy 37 (48.1) 38 (95) Staged laparoscopic testicular vessel elongation/Traction, followed by inguinal orchidopexy (Shehata Technique) 33 (42.9) 0 Management Pediatric surgeons (n=77) Pediatric urologists (n=40) P-value What is your preferred approach for palpable undescended testes? Depends on the position of the testes 25 (32.5) 31 (77.5) <0.001 Inguinal, standard 2-incision orchidopexy 52 (67.5) 7 (17.5) Scrotal, single incision orchidopexy 0 2 (5.0) What is your preferred timing for bilateral palpable undescended testes? Synchronous 66 (85.7) 40 (100) 0.02 Metachronous 11 (14.3) 0 What kind of sutures do you use to fix the testes during the orchidopexy? I do not fix the testis. I pass it through a window in the scrotal septum 1 (1.3) 0 0.72 Vicryl 65 (84.4) 36 (90) Absorbable monofilament like Maxon 1 (1.3) 0 Polysorb 2 (2.6) 0 PDS 1 (1.3) 0 Prolene 2 (2.6) 4 (10.0) No fixation 1 (1.3) 0 Ethibond 2 (2.6) 0 No suture only good mobilization 1 (1.3) 0 No tension (absorbable) tension (non absorbable) 1 (1.3) 0 Management Pediatric surgeons (n=77) Pediatric urologists (n=40) P-value What do you do for an unsatisfactory testicular position after orchidopexy? Observe 40 (52.0) 6 (15.0) <0.001 Redo inguinal orchidopexy 37 (48.1) 34 (85.0) How you manage cryptorchidism in cerebral palsy children with severe disability Nothing 23 (29.9) 6 (15.0) 0.11 Orchidopexy 53 (68.8) 34 (85.0) Orchidectomy 1 (1.3) 0 How do you manage cryptorchidism in children with down syndrome? Nothing 3 (3.9) 0 0.55 Orchidopexy 74 (96.1) 40 (100) At what age will you do orchiectomy rather than orchidopexy for the undescended testes? (years) <10 6 (7.8) 0 0.01 10-15 8 (10.4) 13 (32.5) 15-20 24 (31.2) 11 (27.5) >20 39 (50.7) 16 (40.0)
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