How important is the surgeon's experience in the success of orchiopexy? 15 years’ experience of a tertiary center

Abstract

Objective: Cryptorchidism is one of the most common congenital anomalies in pediatric urology. Orchiopexy operation is performed to prevent testicular damage caused by cryptorchidism. However, orchiopexy is an operation that requires experience. Although re-orchiopexies are technically demanding procedures, often a secondary intervention may be required. Therefore, we examined the causes and outcomes of orchiopexy cases who had secondary intervention in our institute under a single investigator. Method: Orchiopexy surgeries, performed by pediatric urologists in a tertiary hospital, between 2005 and 2020 were retrospectively reviewed. The cases which were required a secondary orchiopexy are included in the study. Perioperative findings, time of the primary surgery, and success rates were evaluated. Results: Secondary orchiopexy was applied to 88 cases. Primary surgery was performed in 66 (75%) of these patients in the tertiary hospital by pediatric urologists, and in the remaining 22 (25%) patients in a state hospital by general urologists. It was observed that hernia repair was performed at significantly higher rates in patients whose first operation was performed by a pediatric urologist (79% vs. 32%, p<0.001). Conclusion: According to the results of our study, inadequate hernia repair may be associated with the need for secondary orchiopexy. Also, we can say that pediatric urologists are more experienced in undescended testis and therefore the results of the first surgery are more satisfactory.

Keywords

• undescended testis
• orchiopexy
• surgical failure
• experience

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