Highly Complete Follow-Up Data Are Necessary to Ascertain the Actual Complication Rate in Orchidopexy for Undescended Testes

Abstract

Objective: This study aimed to assess orchidopexy outcomes in a tertiary pediatric urology center. Methods: A retrospective review of orchidopexies at our institution initially showed a 20% follow-up loss. To ensure more reliable outcomes, patients and parents were actively contacted and encouraged to attend follow-up visits 6 months post-surgery, reducing follow-up loss and enhancing the accuracy of our data. Results: Two hundred eleven patients with 254 testicular units were included, with only five patients lost to follow-up due to relocation, yielding a follow-up rate of 98%. The median follow-up time was 7 months. Of 206 inguinal orchidopexies, three were atrophied, and three had an inguinal position. Among 25 patients who underwent a (staged) laparoscopic procedure for abdominal testis, four were found to be atrophied. Of the 18 redo orchidopexies, one testis atrophied. One patient suffered a severe complication, Fournier's gangrene, due to streptococcus infection with uneventful healing after multiple surgeries. Conclusions: In a tertiary setting with a high follow-up percentage and orchidopexy performed or supervised by a fellowship-trained pediatric urologist, the success rate of standard orchidopexy was 97%, for redo orchidopexy 94%, and for laparoscopic (staged) procedures 80%. The reported outcomes can be used in more accurate patient/parental counseling in daily clinical practice and guidelines.