📃 Paper Title: Timing of orchidopexy and its relationship to postoperative testicular atrophy: results from the ORCHESTRA study
🧍 Author: Paediatric Surgical Trainees Research Network (PSTRN)
🕒 Year: 2021
📚 Journal: BJS Open
🌎 Country: United Kingdom
ㅤContext to the study:
Can you tell me about a study that assessed the risk of post-operative complications from early orchidopexy versus orchidopexy on older boys?
ㅤ✅ Take-home message of study:
No increased risk of post-operative testicular atrophy, reoperation rates and anaesthetic complications with early orchidopexy <1 year of age compared to orchidopexy on older boys.
Higher wound infection rate in boys that underwent early orchidopexy <1 year of age compared to older boys aged >1 year.
Further research remains needed to illustrate non-inferiority of early orchidopexy to orchidopexy in older boys aged over 1 year.
ㅤ Multicentre, international trainee-led prospective audit of practice
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Study participants:
Study Size:
417 patients from 28 centres over a 3 month period
Inclusion criteria:
<16 years old males
Orchidopexy performed for unilateral, palpable undescended testis
Exclusion criteria:
Patients who required laparoscopy to determine testicular position
Boys who had a known endocrine or genetic condition that could affect testicular growth
Patients who underwent orchidopexy following ipsilateral inguinal hernia repair
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Key study outcomes:
Primary outcome:
Postoperative testicular atrophy.
Secondary outcomes:
Data on post-operative wound infections, reoperations, and unplanned hospital stays related to anaesthetic events.
Testicular atrophy was measured in comparison with the contralateral, normally descended testis and estimated by the surgeon at the time of surgery and again at follow-up.
No significant difference in postoperative testicular atrophy (at least 6-months post-op) in early orchidopexy (n=1/37, 3.0%) vs orchidopexy in older boys (n=9/294, 3.1%) (p=0.999)
Significantly higher rates of surgical site infections in early orchidopexy vs orchidopexy on older boys (p=0.025)
No significant difference in reoperation rates and anaesthetic complications for early orchidopexy vs orchidopexy on older boys (p>0.05)
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Study Limitations:
Relatively small sample size of the early orchidopexy group (n=37, 11.5%)
Loss of follow-up of 20% of patients
Testicular volume was assessed clinically by the surgical team; potential for observer bias and interrater variability
There is a lack of consensus regarding what constitutes testicular atrophy
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