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Matouq, Alabdrabalnabi, Al Fareed, Alazzam, Al Ajrafi, and Al-Zahrani: Scrotal pathology evaluation among primary health care physicians

Introduction: Prompt evaluation of patients with scrotal complaint is recommended. Patients with testicular torsion need urgent medical attention. In contrast, neonate with congenital hydrocele has a benign course and needs reassessment within a year.

Objectives: To determine scrotal pathology assessment pattern among primary health care providers (PHCPs) in Eastern Province, Saudi Arabia.

Materials and methods: Cross-sectional study among 257 physicians using a questionnaire. The questionnaire consisted of two clinical scenarios, the first on acute scrotum and the second on congenital paediatric hydrocele. The chi-squared test was used to analyse categorical variable while the t-test was used for continuous variables. Logistic regression was used to assess factors affecting scrotal evaluation.

Results: Out of 257 questionnaires that were distributed, 170 were completed by PHCPs and analysed. The mean age of PHCPs was 34.7 years [standard deviation (SD) ± 9.8] and mean experience was 9.9 years (SD ± 10.2). Only 16 PHCPs (9.4%) stated that they do scrotal examination on a regular basis. Most PHCPs referred patients with acute scrotum to other specialists (49%) rather than to emergency services (32.9%). Thirty-eight PHCPs (22.3%) reported that they prefer to investigate either by laboratory or imaging modality before treating patients with acute scrotum. When asked about neonates with congenital hydrocele, most of the PHCPs (51.2%) reported that they tend to assure the parent and then reassess the patient after 1 year. However, a significant number of PHCPs (22.9%) stated that they recommended referral for surgical correction. Using logistic regression analysis, it was found that Saudi PHCPs tend to have more appropriate management than other nationalities (P ≤ 0.001).

Conclusions: Patients with scrotal complaints should have prompt and appropriate care. PHCPs tend to have significant delays in the care of patients with acute scrotum problems.

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