Factors affecting the outcome of orchiopexy for undescended testis

Orchiopexy was performed on 135 testes in 121 patients aged up to 15 (median 6) years who had no previous inguinal surgery or hormonal treatment. Hypoplasia at the time of orchiopexy (34/135) was significantly less common when the testis was in or peripheral to the superficial inguinal ring than when it was intracanalicular. The position did not influence the outcome of surgery or the risk of postoperative hypoplasia (9 cases). At follow-up 87% of the testes were in the scrotum. Reoperation was required for four of nine which were anchored to the femoral skin or with suture through testis and scrotal wall. Tension on the spermatic cord significantly increased the failure risk. Simultaneous herniotomy was associated with 15%, and dissection only (including excision of the vaginal process remnant) with 6% orchiopexy failure. Retroperitoneal dissection to avoid tension on the cord significantly reduced the failure rate without increasing the risk of postoperative hypoplasia. Orchiopexy performed with optimal technique by experienced surgeons is a safe and effective alternative to hormonal treatment.