Recurrent undescended testes

Failure of primary orchiopexy for undescended testis is a relatively uncommon occurrence. Redo orchiopexy is a technically challenging procedure with a high rate of success. Prevention of recurrent undescended testis can be achieved with the application of the basic surgical principles of (1) extensive proximal cord mobilization, (2) careful inguinal dissection, and (3) secure intrascrotal gonadal fixation without tension. Secondary or redo orchiopexy requires an experienced pediatric subspecialty surgeon (pediatric or urologic), detailed anatomic knowledge, meticulous operative technique, magnification and delicate instrumentation, injury-free cord dissection, full proximal retroperitoneal cord mobilization, and tension-free intrascrotal fixation. En bloc cord dissection, cord transposition below the deep inferior epigastric vessels, and inguinal cordopexy are helpful adjuncts to reoperative orchiopexy. Successful correction of recurrent undescended testis should approach 95%.