Orchidopexy trends in the paediatric population of Victoria, 1999-2006.

PURPOSE: In recent times, much concern has been expressed in the media about male reproductive health. Undescended testis is a significant contributor to male infertility and testicular cancer. The recommended management is orchidopexy. Recent studies in the United Kingdom have shown a decline in orchidopexy rates in the paediatric population. An analysis of the orchidopexy rate in Victoria was therefore conducted to determine whether a similar trend existed and what factors may contribute toward this. METHODS: Data were extracted from hospital records using operation codes for orchidopexies for all patients between 0 and 18 years in the state of Victoria. Victorian population data were collected from the Australian Bureau of Statistics. Data were grouped into orchidopexy age groups 0 to 4, 5 to 9, and 10 to 18 and compared across calendar years using graphical and statistical analysis. MAIN RESULTS: On average, the rate of operations on 0 to 4-year-old patients reduced by 2.1% each year over the period; the 95% confidence interval for the rate of reduction was 0.4% to 3.8% (P < 0.014). The rate of operations on 5 to 9-year-old patients reduced by 6.3% each year over the period; the 95% confidence interval for the rate of reduction was 3.7% to 8.8% (P < .005). The rate of operations on 10 to 14-year-old patients reduced by 5.7% each year over the period; the 95% confidence interval for the rate of reduction was 1.9% to 9.3% (P = .003). CONCLUSION: In the state of Victoria, there has been a true decline in the number of orchidopexy operations done in the paediatric population. This may represent a true decline in the incidence of disease, a failure of diagnosis, or a failure of management. Further investigation will therefore be required to determine the cause of current trends as the outcome may have significant consequences on male reproductive health.

Update on congenital versus acquired undescended testes: incidence, diagnosis and management.

Congenital and acquired undescended testes are two distinct entities. Current management is surgery in the first 6-12 months of life for congenital undescended testes. Current management of acquired undescended testes is surgery at the time of diagnosis. Accurate diagnoses and expedient management are imperative in this condition to minimize the long-term sequelae of infertility and testicular cancer.