Age at orchiopexy for undescended testis in the United States

Purpose: Undescended testis (UDT) is the most common congenital anomaly of the male genitalia. The American Urological Association guidelines recommend orchiopexy by age 18 months to ameliorate the risk of subfertility. The study aim was to assess adherence to these guidelines on a national level. Methods: We retrospectively reviewed both the State Ambulatory Surgery Database (SASD) in 2012 and the Pediatric Health Information System (PHIS) for 2015. All patients aged 18 years or less with a diagnosis of UDT who underwent orchiopexy were included. Demographic data including age at repair as well as surgical subspecialty and payer status were extracted. Results: Analysis of the 2012 SASD for New Jersey, Florida, and Maryland yielded 1654 patients. The majority were white, 791 (48.3%), with a median age at repair of 4 years (IQR 1–8). Most patients, 1048 (64%), had orchiopexy later than age 2. A total of 844 males were identified from the PHIS database. Of these, 63% were white. The median age at repair was 5 years (IQR 1–9). There were 577 (68%) patients older than 2 years at orchiopexy. Conclusion: Almost 70% of boys with undescended testes in the United States are undergoing orchiopexy at least 6 months later than the recommended age. Type of study: Retrospective. Level of evidence: III.