Retrospective Analysis of the Timing of Orchiopexy, the Reason for the Delay and Testicular Atrophy in Cryptorchidism in Our Department

Abstract

Purpose: Guidelines recommend early orchiopexy up to 18 months of age in the United States and up to 2 years in Japan in patients with cryptorchidism. However, this strategy might not be widely adopted in Japan. We report a retrospective analysis of the timing of orchiopexy, the reason for the delay and testicular atrophy in our department to clarify the current status.
Methods: From April 2008 to March 2014, we reviewed the medical records of patients who underwent orchiopexy in our department in terms of the timing of surgery, the reason for the delay and testicular atrophy. Testicular atrophy is defined as a more than 20% volume loss as determined by ultrasonography or apparent clinical findings. Reoperated patients, those with Pradder-Willi syndrome or Charge syndrome, or patients with retractile testis were excluded.
Results: A total of 109 patients underwent orchiopexy. The mean age at surgery was 2 years and 3 months (median: 1 year and 7 months). Testicular atrophy was confirmed in 15 of 76 patients who underwent orchiopexy under 2 years of age and in 15 of 33 patients who underwent orchiopexy at the age of 2 years or older. There was a greater risk of testicular atrophy in patients older than 2 years (p = 0.01).
Conclusions: Many orchiopexy procedures are still carried out at later dates than suggested by guidelines. Communication should be improved not only during medical checkups, but also between pediatricians, urologists and pediatric surgeons as well as for the education of the general public.