Orchidopexy For Congenital And Acquired Undescended Testes - Long-Term Follow Up Needed

Introduction: Undescended 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.Methods: A 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.Results: A 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).Conclusion: Acquired 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.