Orchidopexy for congenital and acquired undescended testes ‐ Long‐term follow up needed

Abstract

AbstractIntroductionUndescended testis (UDT) is the most common urological anomaly in boys with orchidopexy as the standard of treatment. However, characteristics of UDT and long‐term outcomes after orchidopexy had not been reported in our locality. This study aimed to review the late surgical outcomes of these patients in our centre.MethodsA retrospective review was performed on patients under 16 years old with orchidopexy done for UDT from 2005 to 2010. Patient demographics, UDT characteristics, pre‐operative imaging, peri‐operative complications and any late testicular ascent or atrophy were documented. Only those with 1‐year follow up after operation were included for long‐term outcome analysis.ResultsA total of 331 testes in 290 boys were included; 244 (73.7%) testes were congenital while 43 (13%) were acquired UDT. Of the 43 acquired UDT, 28 (65.1%) had been followed up by us for retractile testis and had significantly earlier orchidopexy than those who had not (6 vs 9.6 years; P = .04). More patients with acquired UDT had hypospadias (20%) compared with 2.3% in those with congenital UDT (P < .001). The median follow up time was 8 years (1‐13 years) and the overall success rate of orchidopexy was 93.8% (271/289). The median time to detect any late complication was 17.5 months (3‐46 months).ConclusionAcquired UDT accounted for at least 13% of orchidopexies in our centre. Patients after orchidopexy should have a minimum follow up time of 4 years in order to detect any late failures. Early referral of retractile testes to a specialised paediatric surgical centre for regular follow up is recommended for earlier detection of acquired UDT. Boys with a history of hypospadias and retractile testes had higher risk of acquired UDT.