Surgery for Undescended Testes Often Occurs After Age 2

Though orchidopexy is recommended by age 1, fewer than half of patients have surgery by age 2

MONDAY, Aug. 23 (HealthDay News) -- Clinical guidelines recommend orchidopexy by age 1 for treatment of congenital undescended testes, but a substantial number of boys do not undergo the surgery even by age 2, according to research published online Aug. 23 in Pediatrics.

Paul J. Kokorowski, M.D., of the Children's Hospital Boston, and colleagues evaluated data on 28,204 children who underwent orchidopexy at Pediatric Health Information System hospitals between 1999 and 2008 to investigate trends in surgical timing and possible factors that may be associated with age at surgery.

The researchers found that only 5,031 (18 percent) had surgery by age 1, and only 12,165 (43 percent) had surgery by age 2. These figures were stable over time (P = .32). Factors associated with patients' age at the time of orchidopexy included race and insurance status. The factor most predictive of timing was the hospital where the patient was treated.

"Only 43 percent had surgery by 2 years of age, which suggests that either significant numbers of boys with congenital cryptorchidism do not undergo surgery in a timely fashion or late-onset testicular ectopy is more common than generally recognized. Factors associated with the timing of orchidopexy include patient race, insurance status, and the hospital in which surgery is performed," the authors write.

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