Orchidopexy for undescended testis-rate and predictors of re-ascent

Pediatr Surg Int. 2024 May 28;40(1):139. doi: 10.1007/s00383-024-05729-6.

Abstract

Purpose: This study aimed to investigate the rate of re-ascent requiring re-operation after primary orchidopexy and to investigate eventual differences between the inguinal and scrotal approach as well as other potential predictors for re-ascent.

Methods: A retrospective cohort study of children treated for undescended testis (UDT) with orchidopexy between 2018 and 2022 was conducted. The primary outcome was re-ascent requiring re-operation, and the secondary outcome was atrophy rate. Independent variables were age, underlying conditions, side, surgical approach, operation time, bilaterality, congenital/ascended UDT, presence of scrotal hypoplasia, presence of a patent processus vaginalis, division of external oblique, and suture of the testis. Univariate and logistic regression were used to evaluate differences between groups and risk for re-ascent.

Results: A total of 662 testes in 554 patients were included. Re-operation occurred in 6% (7% with inguinal approach, 3% with scrotal approach, p = 0.04). Re-operation was associated with younger age, congenital UDT, and inguinal approach, but neither of these variables remained significant in multivariate analyses. Atrophy occurred in one testis.

Conclusion: The rate of re-ascent was 6% and the atrophy rate was 0.15%. A larger study may find predictors for re-ascent but with very low absolute risk. The lower rate of re-ascent with the scrotal approach is probably due to selection bias.

Keywords: Follow-up; Orchidopexy; Re-ascent; Re-operation; UDT.

MeSH terms

  • Child
  • Child, Preschool
  • Cryptorchidism* / surgery
  • Humans
  • Infant
  • Male
  • Orchiopexy* / methods
  • Reoperation* / statistics & numerical data
  • Retrospective Studies
  • Scrotum / surgery
  • Testis / abnormalities
  • Testis / surgery
  • Treatment Outcome