Reasons for delayed orchiopexies in a Korean tertiary care hospital

Abstract

Introduction: Since the 1990s, it has been well known orchiopexies should be performed no later than 2 years of age. Nevertheless, studies from other countries report a substantial number of delayed orchiopexies. Based on the analysis of a tertiary care hospital database, we aimed to investigate the incidence of delayed orchiopexies performed in patients after 5 years of age, and to understand the causes of such delays and the possible consequences.

Methods: We retrospectively analyzed the surgical database of our institution between 2004 and 2012, and detected patients who underwent orchiopexy later than 5 years of age. Reasons for delayed orchiopexies were studied and the possible consequences of delayed orchiopexies were assessed with respect to surgical difficulty and testicular volume.

Results: We found 160 cases of delayed orchiopexies, which accounted for about 15% of all orchiopexies performed. Two major reasons for delay were related to the parents of the child

i.e. parental delay and parental request for the treatment of persistent retractile testis. Acquired cryptorchidism was found in 21 (13.1%) cases, mainly associated with hypospadias. Surgical difficulty, especially due to short testicular cord, was encountered in 48 cases (30.2%), and a comparison with age matched normative values showed substantially smaller testicular volume.

Conclusions: Despite well established guidelines for optimal age of surgery, 15% of orchiopexies were not performed at a proper time. Improved propagation of an optimal age limit is necessary for reducing the rate of delayed orchiopexies considering increases in surgical difficulty and potential testicular growth retardation.