Surveillance of testicular microlithiasis?: Results of an UK based national questionnaire survey
1 Specialist Registrar in Urology, University Hospital Aintree, Liverpool, L9 7AL, UK
2 SHO in Urology, Royal Liverpool University Hospital, Prescot Road, Liverpool, UK
3 Consultant Urologist, Royal Liverpool University Hospital, Prescot Road, Liverpool, UK
4 17, Milfield, Neston, Cheshire, CH64 3TF, UK
BMC Urology 2006, 6:8 doi:10.1186/1471-2490-6-8Published: 15 March 2006
The association of testicular microlithiasis with testicular tumour and the need for follow-up remain largely unclear.
We conducted a national questionnaire survey involving consultant BAUS members (BAUS is the official national organisation (like the AUA in USA) of the practising urologists in the UK and Ireland), to provide a snapshot of current attitudes towards investigation and surveillance of patients with testicular microlithiasis.
Of the 464 questionnaires sent to the BAUS membership, 263(57%) were returned. 251 returns (12 were incomplete) were analysed, of whom 173(69%) do and 78(31%) do not follow-up testicular microlithiasis. Of the 173 who do follow-up, 119(69%) follow-up all patients while 54(31%) follow-up only a selected group of patients. 172 of 173 use ultra sound scan while 27(16%) check tumour makers. 10(6%) arrange ultrasound scan every six months, 151(88%) annually while 10(6%) at longer intervals. 66(38%) intend to follow-up these patients for life while, 80(47%) until 55 years of age and 26(15%) for up to 5 years. 173(68.9%) believe testicular microlithiasis is associated with CIS in < 1%, 53(21%) think it is between 1&10% while 7(3%) believe it is > 10%. 109(43%) believe those patients who develop a tumour, will have survival benefit with follow-up while 142(57%) do not. Interestingly, 66(38%) who follow-up these patients do not think there is a survival benefit.
There is significant variability in how patients with testicular microlithiasis are followed-up. However a majority of consultant urologists nationally, believe surveillance of this patient group confers no survival benefit. There is a clear need to clarify this issue in order to recommend a coherent surveillance policy.