Adolescent testicular microlithiasis: A case-based, multinational survey of clinical management practices

Management of TM varies and a mix of surgeon and case factors significantly influences management strategies. This baseline understanding of the lack of systematic management suggests the need for the development of consensus guidelines and prospective study.Table. Analysis of the relationship between practitioner-specific factors and decisions about management of testicular microlithiasis.FactorUnivariateMultivariateOR95% CIp-valueOR95% CIp-valueAnalysis of respondents' initial management of TM (i.e. option selected more involved than solely counseling and self-examination)Region North America0.3080.155-0.6120.0010.2240.141-0.355<0.001 South America2.3080.712-7.4830.164Ref Europe1.5170.782-2.9460.218 Middle East2.3080.939-5.6690.068 AustralasiaRefTime in practice, years 02.5591.771-3.699<0.0011.9261.258-2.9480.003 1-50.7710.557-1.0670.117Ref 6-101.1140.819-1.5150.493 11-151.4621.040-2.0560.0291.4451.03-0.0280.033 16-201.2230.863-1.7320.258Ref >20RefPractice type Pediatric urology0.3750.294-0.477<0.0010.6790.527-0.8760.003 Pediatric and adult urology1.120.820-1.5290.475Ref Pediatric urology and pediatric surgeryRefVolume TM cases/year ≤52.2071.752-2.779<0.0011.8521.427-2.405<0.001 >5RefRefPattern Classic1.8511.506-2.276<0.0012.0161.604-2.536<0.001 LimitedRefRefOther risk factor (prior cryptorchidism) Yes2.0461.664-2.517<0.0012.3071.834-2.902<0.001 NoRefRefAnalysis of respondents' follow-up plan of TM (where follow-up involved a urologist ± additional diagnostic tests)Region North America0.7270.391-1.3540.315Ref South America1.5840.468-5.3570.459 Europe1.9291.036-3.5930.0381.8431.309-2.596<0.001 Middle East1.680.678-4.1650.263Ref AustralasiaRefTime in practice, years 00.8830.613-1.2730.506Ref 1-50.6980.531-0.9180.010.7210.557-0.9340.013 6-100.820.621-1.0830.162Ref 11-151.1310.814-1.5730.463 16-201.1630.836-1.6180.37 >20RefPractice type Pediatric urology0.3360.258-0.438<0.0010.5170.377-0.709<0.001 Pediatric and adult urology0.4610.327-0.65<0.0010.5890.406-0.8550.005 Pediatric urology and pediatric surgeryRefRefVolume TM cases/year ≤51.7841.469-2.166<0.0011.391.122-1.7240.003 >5RefRefPattern Classic1.9091.58-2.308<0.0011.9931.627-2.441<0.001 LimitedRefRefOther risk factor (prior cryptorchidism) Yes2.2581.864-2.735<0.0012.4792.021-3.041<0.001 NoRefRefTM, testicular microlithiasis.