The role of physical assessment in primary health care in the early detection of pediatric undescended testis in Saudi Arabia

Background: The early detection of undescended testis is the key to minimizing infertility and malignancy risks associated with this condition. Thorough routine physical examination during scheduled visits for vaccines during the first year of a child's life can lead to early detection and referral to a surgeon for evaluation and surgical intervention in a timely manner. We aimed to investigate the role of physical examinations in primary health care for the discovery of undescended testis. Methods: Anonymous structured interviews were conducted in the waiting areas of a hospital and primary health-care center. Parents were asked about their perceptions of undescended testis and their experience during primary health-care visits for routine vaccinations. A descriptive analysis was carried out, and the percentage of boys who underwent genital examinations in a primary health-care setting was determined. Results: We interviewed a total of 352 parents, most of whom did not have a child with undescended testis (n = 322, 91%). Only 25 (7%) reported that a formal clinical genital examination was done at every primary health-care visit, whereas 50 (14%) indicated that their boy had been examined only once among their many vaccination visits. However, 160 (46%) parents stated that their primary health-care provider did not examine their boys' genitalia during any of these visits. Conclusion: Late detection of undescended testis could result from failure to adhere to the recommended genital clinical examinations of boys during immunization visits for infants among primary health-care providers.