Reasons for delayed orchiopexies in a korean tertiary care hospital.
OBJECTIVE
Since the 1990s, it has been well known that orchiopexies should be performed by no later than 2 years of age. Nevertheless, studies from other countries report a substantial number of delayed orchiopexies. On the basis of an analysis of a tertiary care hospital database, we aimed to investigate the incidence of delayed orchiopexies performed in patients after 5 years of age and to understand the causes of such delays and the possible consequences.


METHODS
We retrospectively analyzed the surgical database of Seoul National University Hospital between 2004 and 2012 and detected patients who underwent orchiopexy later than 5 years of age. Reasons for delayed orchiopexies were studied and the possible consequences of delayed orchiopexies were assessed with respect to surgical difficulty and testicular volume.


RESULTS
We found 160 cases of delayed orchiopexies, which accounted for about 15% of all orchiopexies performed. Two major reasons for delay were related to the parents of the child: parental delay and parental request for the treatment of persistent retractile testis. Acquired cryptorchidism was found in 21 cases (13.1%), mainly associated with hypospadias. Surgical difficulty, especially owing to a short testicular cord, was encountered in 48 cases (30.2%), and a comparison with age-matched normative values showed substantially smaller testicular volume.


CONCLUSIONS
Despite well-established guidelines for the optimal age of surgery, 15% of orchiopexies were not performed at a proper time. Improved propagation of an optimal age limit is necessary to reduce the rate of delayed orchiopexies considering increases in surgical difficulty and potential testicular growth retardation.
Department of Urology, Seoul National University, Seoul, Korea.
Hyunsoo
H
Ahn
Department of Urology, Seoul National University, Seoul, Korea.
Hahn Ey
HE
Lee
Department of Urology, Seoul National University, Seoul, Korea.
Kwanjin
K
Park
Armed Forces Capital Hospital, Seongnam, Korea.
Hwang
H
Choi
Cryptorchidism; Orchiopexy; Tertiary care centers