Advantage of early orchiopexy for undescended testis: Analysis of testicular growth percentage ratio in patients with unilateral undescended testicle

Abstract

This study reports the experience of our tertiary referral center and proposes a new indicator, the growth percentage ratio (GPR), for determining the optimal timing of surgical intervention. A retrospective review of boys who underwent orchiopexy for undescended testis from 2001 to 2013 was conducted. We analyzed testicular volumes in different age groups using the UDT to normally descended testis ratio and testicular GPR. A total of 134 boys with unilateral undescended testicle underwent regular ultrasonography follow-up examinations for more than a mean of 3.9 years. Forty-five (33.4%) of them underwent orchiopexy before the age of one year. Orchiopexy at this age resulted in a GPR (2.02 ± 0.40) that was significantly higher than the GPRs in the second (1 < age ≤ 2 years, 1.25 ± 0.13, p = 0.004) and third (age > 2 years, 1.24 ± 0.14 p = 0.008) age groups. The undescended testicle grew faster when orchiopexy was performed before one year of age. Orchiopexy performed within one year from birth significantly accelerates the growth of the UDT, as determined using the GPR, compared to other age groups. The present clinical evidence indicates that orchiopexy should be performed before one year of age.

Figure 1

Changes in age at orchiopexy in different time periods.

Figure 2

The undescended testis (UDT) to normally descended testis (NDT) ratio represents the relative size of the UDT. The p values represent results of comparison of the pre-operative and post-operative ratios.