An assessment of different surgical approaches among different specialties for undescended testicle cases in the postpubertal era: A survey study

Objectives: This study aims to evaluate different surgical approaches for postpubertal undescended testicle in the branches of pediatric surgery, urology, and pediatric urology and to identify the most optimal approach for the treatment of this special age group. Materials and methods: Between March 2024 and April 2024, a 15-question survey was developed using Google Forms and sent via e-mail and text messages to pediatric surgery, urology, and pediatric urology specialists in Türkiye. A total of 119 surgeons who agreed to participate in the study were included. Results: Of the 119 surgeons, 58 (48.7%) were pediatric surgeons, 40 (33.6%) were urologists, and 21 (17.6%) were pediatric urologists. In the study, 61.8% of the participants in the pediatric urology group had more than 10 years of specialized experience, compared to 60.4% and 57.5% of the respondents in the pediatric surgery and urology groups, respectively, who had 10 years or less (p=0.030). While pediatric surgeons and pediatric urologists strongly preferred diagnostic laparoscopy for the diagnosis of non-palpable testicles, 25% of urologists preferred magnetic resonance imaging (p=0.015). While approaching a patient presenting with a non-palpable unilateral undescended testicles, urologists and pediatric urologists preferred orchiectomy, if they found the testicles during laparoscopic exploration, while pediatric surgeons preferred orchidopexy with testicular biopsy (p=0.002). Conclusion: Although there are similar approaches to postpubertal undescended testicle scenarios among the three specialties, there are certain differences in the diagnosis and treatment of non-palpable undescended testicles. It seems that urologists can make more aggressive decisions regarding the treatment of postpubertal non-palpable undescended testicle, whereas pediatric surgeons tend to make more aggressive decisions regarding the diagnosis of the condition. Pediatric urologists who are also pediatric surgeons or urologists are likely to follow the guidelines more closely for the management of postpubertal undescended testicle.