title: Failed orchiopexy.
abstract: BACKGROUND
  Failure after orchiopexy or cryptorchidism after inguinal surgery are not so rarely encountered conditions. Reoperative orchiopexies are technically demanding procedures. In our study, we aimed to examine the causes of failures and outcomes of reorchiopexies.
  
  
  METHODS
  Between 1993 and 2003, a total of 28 children who underwent reoperative orchiopexy were included into the study. Undescended testes was detected as unilateral in 24 and bilateral in 4 cases. The mean age of patients at the time of second operation was 6.8 years. The mean period of time between the first and the second operations was 3.2 (1-13 years) years.
  
  
  RESULTS
  The first operations were orchiopexies in all patients. After the first operations, 15 testes were found to be localized at the high scrotal position, 8 at the level of the external ring and 9 within the inguinal canal. Overall, reorchiopexies were performed on 32 testes in 28 patients. During the second operation, patent processus vaginalis was detected in 11 (34.4%), and unsuccessful hernia repair in 9 (28.1%) cases. After reorchiopexies, two testes with preoperative inguinal location could only be brought to high scrotal position and in another case orchiectomy was performed to an atrophic testis. Overall, after a mean follow-up period of 3.8 (1-7 years) years following the second operations, 29 (93.5%) testes were scrotal without evidence of atrophy.
  
  
  CONCLUSIONS
  In our series, inadequate repair of inguinal hernia or patent processus vaginalis, as noted in 62.5% of the cases, was determined as an important factor leading to failure after surgical treatment of undescended testis. Adequate dissection and correction of inguinal hernia increase the success rate after orchiopexies.
authors.affiliation: Division of Pediatric Urology, Department of Urology, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Turkey. ziylan@doruk.net.tr
authors.forename: Orhan
authors.initials: O
authors.lastname: Ziylan
authors.forename: Tayfun
authors.initials: T
authors.lastname: Oktar
authors.forename: Esat
authors.initials: E
authors.lastname: Korgali
authors.forename: Ismet
authors.initials: I
authors.lastname: Nane
authors.forename: Haluk
authors.initials: H
authors.lastname: Ander
mesh_terms: D002648:Child; D003456:Cryptorchidism / Q000601:surgery*; D006801:Humans; D008297:Male; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure; D013521:Urologic Surgical Procedures, Male / Q000379:methods