Prevalence of late orchidopexy is consistent with some undescended testes being acquired

Abstract

To diagnose the incidence of orchidopexy versus age over a 15-year period, a study was conducted of all patients discharged from a single institution for orchidopexy with reference to age during operation. The hypothesis drawn was that some boys have acquired UDT and therefore, will present late despite recommendations for early diagnosis and treatment. The study was conducted on patients from Royal Children's Hospital, Melbourne (1980-94). The results suggested that while the optimal age for management of congenital UDT has been lowered to one to two years of age by under-graduate education, the persistence of a significant number of older children undergoing surgery suggests that some UDT's are acquired. It also showed that the proportion of orchidopexies performed in infancy increased over the 15-year period while the proportion performed in late childhood remained constant.

Testicular descent and cryptorchidism: the state of the art in 2004

“…Our studies suggest that not only are they common [50] but also that they are caused by failure of postnatal elongation of the spermatic cord [51]. At birth, the spermatic cord is 4 to 5 cm in length, but by the 10th year, it is 8 to 10 cm; this doubling in length is inhibited if there is a residual fibrous remnant of the PV, which may be caused by deficient CGRP release from the GFN postnatally [52].…”

Previous testicular position in boys referred for an undescended testis: further explanation of the late orchidopexy enigma?

“…In recent years evidence has been accumulating that late orchidopexy might be accounted for by acquired UDT [19][20][21][22][23]; several studies found that 40-70% of those undergoing orchidopexy had previously descended testes [24]. In addition, most boys undergo surgery when much older than usually recommended.…”

Temporal trends in orchidopexy, Great Britain, 1992-1998.

“…The differences between orchidopexy and cryptorchidism rates might partly reflect either misdiagnosed cases of retractile testes (Chilvers et al 1984;Cooper and Little 1985;Snick 1984) or the possibility that cryptorchidism is acquired after birth (Donaldson et al 1996;Jackson and John Radcliffe Hospital Cryptorchidism Research Group 1988), for which various etiologies have been postulated (Atwell 1985;Clarnette et al 1997;Hutson and Goh 1993;Rabinowitz and Hulbert 1997). The cremaster reflex cannot retract the testes from the scrotum to the superficial inguinal pouch until about 6 months of age (Cortes 1998).…”