Determinants of redo orchiopexy success and association with testicular morphological changes

This study evaluates the growth potential of the affected testis and its influencing factors in patients undergoing redo orchiopexy (RO).

Between 2014 and 2024, 53 patients (4.6 %) with 57 testes who underwent RO among 1130 inguinal orchiopexies were analyzed retrospectively. Changes in testicular volume (TV), testicular growth percentage (TGP), and testicular atrophy index (TAI) after failed orchiopexy (FO) and redo orchiopexy were assessed using Doppler ultrasonography. Age, testis location, laterality, surgical approach, fixation, and the interval between operations were obtained from patient data.

The mean age at FO and RO was 3.18 years and 5.08 years, respectively. The mean interval between FO and RO was 22.8 months(range 6-117 months). Among 39 unilateral undescended testes, TAI increased in 22(56 %) and regressed in 4(10 %) after FO. Following RO, TAI decreased by over 10 % in 21 cases(53 %), while an increase was observed in 11(28 %). Mean TAI values were 30.9 at baseline, 41.65 after FO, and 27.47 after RO(p = 0.068, p = 0.625). Older age at surgery correlated with TAI increase (p = 0.011). In 57 testes, mean TGP significantly increased from 29.8 to 134.68 after RO(p = 0.02). Early RO(≤1 year, n = 29) showed a higher TGP(169 %) compared to late RO(>1 year, n = 23,%101), though the difference was not statistically significant(p = 0.224).

Testicular asymmetry increases less in patients undergoing surgery at a younger age. Redo orchiopexy within the first year helps restore the growth potential of the affected testis more effectively, mitigating the adverse effects of failed orchiopexy.