title: Reduction in the number of orchidopexies for cryptorchidism after recognition of acquired undescended testis and implementation of expectative policy.
abstract: BACKGROUND
  Since the mid-1990s, acquired undescended testis has gradually been recognised as a separate entity for which the efficacy of prepubertal surgery has not been univocally been demonstrated. Therefore, in our hospital, orchidopexy was no longer routinely performed for acquired undescended testis.
  
  
  OBJECTIVE
  To investigate the effect of expectative policy in our hospital on the number of orchidopexies.
  
  
  METHODS
  Two 5-year periods were compared. Period A (1991-1995), in which undescended testis was treated surgically, and period B (2000-2004), in which prepubertal orchidopexy in our hospital was no longer performed for acquired undescended testis. In addition, a comparison was made between the percentage reduction in hospital and national figures.
  
  
  RESULTS
  In period B, the number of orchidopexies in our hospital was reduced by 61.8% (from 387 to 148), mainly in the age group >6 years. Nationally, during the same period, the number of orchidopexies decreased only by 2.4% (from 18 024 to 17 591).
  
  
  CONCLUSIONS
  The results of this study confirm that recognition of acquired undescended testis is crucial for reducing the high number of (late) orchidopexies.
authors.affiliation: Department of Paediatrics, Medical Centre Alkmaar, Alkmaar, The Netherlands.
authors.forename: W W M
authors.initials: WW
authors.lastname: Hack
authors.forename: L M
authors.initials: LM
authors.lastname: van der Voort-Doedens
authors.forename: K
authors.initials: K
authors.lastname: Sijstermans
authors.forename: R W
authors.initials: RW
authors.lastname: Meijer
authors.forename: F H
authors.initials: FH
authors.lastname: Pierik
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D013737:Testis / Q000601:surgery*; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000706:statistics & numerical data