Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

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15:37 - 15:40
S18-2 (PP)
TESTICULAR ATROPHY AND CATCH-UP GROWTH RATES FOLLOWING PAEDIATRIC
PRIMARY ORCHIDOPEXY: A PROSPECTIVE STUDY
Jonathan DURELL1, Navroop JOHAL1, David BURGE2, Robert WHEELER1, Lara KITTERINGHAM3, Michael STANTON3,
Mervyn GRIFFITHS3, Henrik STEINBRECHER3, Pat MALONE3 and Stephen GRIFFIN3
1) Southampton General Hospital, Department of Paediatric Surgery and Urology, Southampton, UNITED KINGDOM - 2)
Southampton General Hospital, Department of Paediatric Surgery and Urology, Southampton, UNITED KINGDOM - 3)
Department of Paediatric Surgery and Urology, Southampton General Hospital, Southampton, UNITED KINGDOM
PURPOSE
To prospectively assess testicular atrophy and catch-up growth rates following primary orchidopexy of undescended
testicles in a paediatric population.
MATERIAL AND METHODS
A prospective database from August 2008 to December 2012 was established registering age at operation, classification
of the undescended testicle, length of follow-up, and subjective comparison of intra-operative and post-operative
testicular volumes as compared to the contralateral testicle. Testicular atrophy was defined as more than 50% loss of
testicular volume or a post-operative testicular volume less than 25% of the volume of the contralateral testicle.
Patients were excluded for incomplete data and follow up less than six months.
RESULTS
From 366 entries into the database, data regarding 234 patients met the inclusion criteria. All secondary acquired cases
underwent a previous ipsilateral hernia repair. Overall, testicular atrophy occurred in 2.6% of cases, whereas catch-up
growth was experienced in 20.1%. The following table includes atrophy rates and quartile catch-up growth rates with
respect to the classification of the undescended testicle.
Classification of
undescended testicle
Age at operation in
years (median)
Length of follow up
in months (median)
Atrophy
Rate
Increase in
growth
(0-25%)
Increase in
growth
(25-50%)
Increase in
growth
(50-75%)
Overall 2.2 6.9 2.6% 16.7% 3.0% 0.4%
Congenital 1.8 7.1 2.6% 15.0% 2.6% 0.4%
Primary Acquired 8.7 6.5 0% 1.3% 0.4% -
Secondary Acquired 4.5 6.4 0% 0.4% - -
CONCLUSIONS
This study represents one of the larger collections of prospective assessments of outcomes following primary
orchidopexy in a paediatric population. Although there is a 2.6% risk of undergoing testicular atrophy, we report
greater than 20% of cases with testicular catch-up growth. We acknowledge that subjectively assessing testicular
volume is not ideal. However, this data can help during counselling for orchidopexy and may prompt further studies
using more robust means of volume calculation.