Management of Recurrent Undescended Testis: An Observational Study

TL;DR

This study examines the management of recurrent undescended testis and highlights the importance of surgical technique and experience for successful outcomes.

Contribution

The study provides insights into the management and outcomes of redo orchiopexy for recurrent undescended testis.

Findings

Recurrent undescended testis occurred in 1.25% of orchiopexy cases over a 10-year period.

Testicular atrophy was observed in one patient, and five had smaller testes compared to the opposite side.

Successful outcomes depend on preserving vascular integrity and proper surgical technique.

Abstract

Introduction: Recurrent undescended testis (UDT) may result from the failure of the orchiopexy. Despite the high success rate of primary orchiopexy, complications may still occur. This study presents our experience of managing recurrent UDT.

Materials and methods: This retrospective observational study was conducted from January 2015 to January 2025. The hospital records of all patients presenting with recurrent UDT were reviewed and analyzed. Data were extracted from patient files, operative registers, and electronic medical records. The parameters assessed included demographic characteristics, details of prior orchiopexy, intraoperative findings during redo surgery, and postoperative outcomes on follow-up.

Results: During the 10-year study period, 558 orchiopexies were performed. Of these, seven (1.25%) were redo orchiopexies. Five of these were operated on elsewhere -three by pediatric surgeons and two by general surgeons. The mean age of the patients was 7.6 years. All patients had a testis in the inguinal canal. In follow-up, testicular atrophy was noted in one patient. The testicular size appeared to be smaller compared to the opposite testis in five patients.

Conclusion: Recurrent UDT, although uncommon, poses a significant surgical challenge. Identifying the etiological factors, if present, is imperative. Successful management depends on careful dissection, preservation of vascular integrity, and tension-free subdartos placement of the testis. The overall outcome appears to be good in the hands of experienced professionals.

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