title: The risk of failure after primary orchidopexy: an 18 year review.
abstract: OBJECTIVE
  To review the primary orchidopexy failure rate and outcome of repeat orchidopexy in a tertiary paediatric surgical centre and identify risk factors.
  
  
  METHODS
  A prospectively collected and validated audits system was used to identify all boys having a repeat orchidopexy from August 1990 to December 2008 (18 years).
  
  
  RESULTS
  In total, 1538 boys underwent orchidopexy with 1886 testicles operated on. Of these 348 (22.6%) patients had bilateral cryptorchidism. A need for repeat orchidopexy was identified in 31 boys resulting in a primary failure rate of 1.6% over the 18 years. Unilateral orchidopexy as the primary operation had a 1.5% failure rate. The failure rate for bilateral cryptorchidism was 1.87% per testicle rising to 1.93% per testicle when the primary operation was synchronous bilateral orchidopexy. Orchidopexy failure occurred in 9 patients (1.97%) who were under 24 months, 15 (2.67%) who were between 24 and 72 months and 7 (0.8%) over 72 months at time of first operation.
  
  
  CONCLUSIONS
  Possible risk factors for primary orchidopexy failure are bilateral operation and older age at time of operation. Failure in achieving a satisfactory scrotal position (and testicular loss) following orchidopexy has been postulated as a potential surgical standard for revalidation of paediatric surgeons. This study adds important contemporary data to inform that process.
authors.affiliation: Department of Surgical Paediatrics, Royal Aberdeen Children's Hospital, Westburn Road, Aberdeen AB25 2ZN, UK.
authors.forename: L A
authors.initials: LA
authors.lastname: McIntosh
authors.forename: D
authors.initials: D
authors.lastname: Scrimgeour
authors.forename: G G
authors.initials: GG
authors.lastname: Youngson
authors.forename: C P
authors.initials: CP
authors.lastname: Driver
mesh_terms: D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D056126:Orchiopexy / Q000009:adverse effects* / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D013737:Testis / Q000601:surgery; D016896:Treatment Outcome