KNOWLEDGE AND ATTITUDES OF DOCTORS IN PRIMARY HEALTH CARE AND STUDENTS OF THE LAST YEAR OF MEDICINE REGARDING MODERN GUIDELINES IN THE TREATMENT OF UNDENSCENDED TESTICLES

Cilj istraživanja: Nepravodobno liječenje i nepravilno praćenje dječaka s nespuštenim testisima pridonosi većoj učestalosti muške neplodnosti i pojave malignih bolesti testisa. Važnu ulogu u postizanju zadovoljavajućih rezultata liječenja ima primarna zdravstvena skrb djece s redovitim probirom i upućivanjem djece s nespuštenim testisima prema dječjem kirurgu. Ovim istraživanjem željeli smo utvrditi informiranost liječnika primarne zdravstvene zaštite djece na području Splitsko-dalmatinske županije i studenata završne godine medicine Medicinskog fakulteta u Splitu o suvremenim smjernicama u liječenju nespuštenih testisa s obzirom na primjećen visoki prosjek dobi dječaka operiranih zbog problema nespuštenih testisa u KBC-u Split. Materijali i metode: Sastavljen je anketni upitnik i podijeljen liječnicima primarne zaštite djece po ambulantama domova zdravlja na području Splitsko-dalmatinske županije. Liječnici s lokalnih otoka i studenti anketni upitnik su rješavali online preko Google obrasca. U ovom presječnom anketnom istraživanju sudjelovalo je 99 ispitanika: 23 obiteljska liječnika, 18 pedijatara, 13 liječnika obiteljske medicine i 45 studenata. Rezultati: Suvremene smjernice poznaje 74% svih ispitanih liječnika i 37,8% studenata. Nije dokazana statistički značajna razlika u znanju i stavovima među liječnicima različitih specijalnosti. Dijete s nespuštenim testisima 42,6% ispitanih liječnika uputilo bi dječjem kirurgu u dobi od 6 mjeseci. Liječenje u prvoj godini života preporučuje 46,3% ispitanih liječnika. Retraktilne testise 55,6% ispitanih pedijatara prestalo bi pregledavati nakon 10. godine, a 44,4% njih smatra da orhidopeksija prevenira nastanak maligne bolesti testisa. Zaključak: Poznavanje smjernica u liječenju nespuštenih testisa liječnika primarne zdravstvene zaštite djece nije na zadovoljavajućoj razini. Potrebno je uložiti dodatne napore u podizanju svijesti o novim preporukama kako bi se informirali liječnici i roditelji s ciljem pružanja pravovaljane zdravstvene zaštite dječacima s problemom nespuštenih testisa.
Objectives: Untimely treatment and improper monitoring of boys with undescended testicles contributes to a higher incidence of male infertility and the occurrence of malignant testicular diseases. The primary health care of children with regular screening and referral of children with undescended testicles to a pediatric surgeon plays an important role in achieving satisfying treatment results. With this research we want to determine the level of knowledge about modern guidelines in the treatment of undescended testicles among primary care physicians in the Split-Dalmatia County and final year medical students of the University of Split School of Medicine. This study is made due to a high average age of boys operated on for undescended testicles in University Hospital of Split. Materials and methods: A questionnaire was compiled and distributed to primary care physicians in outpatient clinics in the Split-Dalmatia County. Doctors from local islands and students completed the survey questionnaire online via a Google form. Total 99 respondents participated in this cross-sectional survey: 23 family physicians, 18 pediatricians, 13 family physicians, and 45 medical students. Results: In total 74% of all testes doctors and 37,8% of students are informed about new guidelines. There was no statistically significant difference in knowledge and attitudes among physicians of different specialties. A child with undescended testicles 42.6% of the surveyed doctors would refer to a pediatric surgeon at the age of 6 months. Treatment in the first year of life is recommended by 46.3% of surveyed physicians. Retractile testicles 55.6% of surveyed pediatricians would stop examining after the age of 10, and 44.4% of them believe that orchidopexy prevents development of malignant testicular disease. Conclusion: Knowledge of guidelines in the treatment of undescended testicles by primary care physicians of children is not at a satisfactory level. Further efforts are needed to raise awareness of the new recommendations to inform physicians and parents with a common goal-to provide valid health care to boys with undescended testicles.