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Systematic review and meta-analysis comparing outcomes following orchidopexy for cryptorchidism before or after

B S R Allin1,2, E Dumann3, D Fawkner-Corbett2

  • 1National Perinatal Epidemiology Unit University of Oxford Oxford UK.

BJS Open
|June 29, 2018
PubMed

Insights

Early orchidopexy (before 1 year) for cryptorchidism shows no difference in atrophy or complication rates compared to delayed surgery. However, early intervention may improve fertility potential, though data imprecision limits conclusions.

Area of Science:

  • Pediatric Surgery
  • Urology
  • Developmental Biology

Background:

  • Current guidelines recommend orchidopexy for cryptorchidism by 12 months of age.
  • Adherence to this guideline is not universal.
  • This study compares outcomes of early versus delayed orchidopexy.

Purpose of the Study:

  • To compare outcomes between orchidopexies performed before and after 1 year of age for cryptorchidism.
  • To evaluate testicular atrophy, fertility potential, and postoperative complications.
  • To assess the impact of surgical timing on testicular outcomes.

Main Methods:

  • Systematic review and meta-analysis of MEDLINE and Embase databases (searched September 2015).
  • Included studies compared early (<1 year) versus delayed (≥1 year) orchidopexy.
  • Exclusion criteria: >50% intra-abdominal testes or disorders of sexual differentiation.

Main Results:

  • No significant difference in testicular atrophy rates between early and delayed orchidopexy (912 testes).
  • Early orchidopexy was associated with greater testicular volume and more spermatogonia per tubule (382 testes).
  • No difference in postoperative complication rates was observed (426 testes).

Conclusions:

  • Orchidopexy timing (early vs. delayed) does not appear to affect atrophy or complication rates.
  • Early orchidopexy may offer better fertility potential.
  • Data imprecision limits the certainty of these findings.
Abstract

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