Misuse of ultrasound for palpable undescended testis by XXXX : A prospective study.

@entity1 @entity298 @entity1062
INTRODUCTION: Although previous evidence has shown that ultrasound is unreliable to diagnose undescended testis, many @entity298 ( @entity298 ) continue to misuse it. We assessed the performance of ultrasound as a diagnostic tool for palpable undescended testis, as well as the diagnostic agreement between @entity298 and pediatric urologists. METHODS: We performed a prospective observational cohort study between 2011 and 2013 for consecutive @entity1 referred with a diagnosis of undescended testis to our tertiary pediatric hospital. @entity1 referred without an ultrasound and those with non-palpable @entity1062 were excluded. Data on referring diagnosis, pediatric urology examination and ultrasound reports were analyzed. RESULTS: Our study consisted of 339 @entity1 . Of these, @entity1 without an ultrasound (n = 132) and those with non-palpable @entity1062 (n = 38) were excluded. In the end, there were 169 pateints in this study. Ultrasound was performed in 50% of referred @entity1 showing 256 undescended testis. The mean age at time of referral was 45 months. When ultrasound was compared to physical examination by the pediatric urologist, agreement was only 34%. The performance of ultrasound for palpable undescended testis was: sensitivity = 100%; specificity = 16%; positive predictive value = 34%; negative predictive value = 100%; positive likelihood ratio = 1.2; and negative likelihood ratio = 0. Diagnosis of undescended testis by @entity298 was confirmed by physical examination in 30% of cases, with 70% re-diagnosed with normal or retractile @entity1062 . CONCLUSION: Ultrasound performed poorly to assess for palpable undescended testis in @entity1 and should not be used. Although the study has important limitations, there is an increasing need for education and evidence-based guidelines for @entity298 in the management of undescended testis.
