Orchidopexy for undescended testis—rate and predictors of re-ascent
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In brief
In brief
Retrospective study of 662 testes found 6% re-ascent rate after orchidopexy, with lower rates using scrotal versus inguinal approach (3% vs 7%). Atrophy was rare (0.15%), and no independent predictors for re-ascent were identified in multivariate analysis, suggesting selection bias influences surgical approach outcomes.
- Re-ascent requiring re-operation after orchidopexy occurs in 6% of cases, with testicular atrophy being rare (0.15%).
- Scrotal approach showed lower re-ascent rate (3%) vs inguinal approach (7%), though likely due to patient selection bias.
- Younger age, congenital UDT, and inguinal approach were associated with re-operation, but none remained significant predictors.
- With absolute re-ascent risk being very low, larger studies needed to identify reliable predictors for surgical planning.
Written by the GCMD Library team from the article.
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.