The risk of failure after primary orchidopexy: an 18 year review.
OBJECTIVE
To review the primary orchidopexy failure rate and outcome of repeat orchidopexy in a tertiary paediatric surgical centre and identify risk factors.


METHODS
A prospectively collected and validated audits system was used to identify all boys having a repeat orchidopexy from August 1990 to December 2008 (18 years).


RESULTS
In total, 1538 boys underwent orchidopexy with 1886 testicles operated on. Of these 348 (22.6%) patients had bilateral cryptorchidism. A need for repeat orchidopexy was identified in 31 boys resulting in a primary failure rate of 1.6% over the 18 years. Unilateral orchidopexy as the primary operation had a 1.5% failure rate. The failure rate for bilateral cryptorchidism was 1.87% per testicle rising to 1.93% per testicle when the primary operation was synchronous bilateral orchidopexy. Orchidopexy failure occurred in 9 patients (1.97%) who were under 24 months, 15 (2.67%) who were between 24 and 72 months and 7 (0.8%) over 72 months at time of first operation.


CONCLUSION
Possible risk factors for primary orchidopexy failure are bilateral operation and older age at time of operation. Failure in achieving a satisfactory scrotal position (and testicular loss) following orchidopexy has been postulated as a potential surgical standard for revalidation of paediatric surgeons. This study adds important contemporary data to inform that process.
['McIntosh|L A|LA|', 'Scrimgeour|D|D|', 'Youngson|G G|GG|', 'Driver|C P|CP|']
D017677:Age Distribution D002648:Child D002675:Child, Preschool D003456:Cryptorchidism D006801:Humans D008297:Male D056126:Orchiopexy D011183:Postoperative Complications D012008:Recurrence D012086:Reoperation D012189:Retrospective Studies D012307:Risk Factors D013737:Testis D016896:Treatment Outcome
Orchidopexy cryptorchidism complication recurrence undescended testes