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Abstract：
OBJECTIVE: This study aimed to investigate the rate of re-ascent requiring re-operation after primary orchidopexy and to investigate eventual differences between the inguinal and scrotal approach as well as other potential predictors for re-ascent.
METHODS: A retrospective cohort study of children treated for undescended testis (UDT) with orchidopexy between 2018 and 2022 was conducted. The primary outcome was re-ascent requiring re-operation, and the secondary outcome was atrophy rate. Independent variables were age, underlying conditions, side, surgical approach, operation time, bilaterality, congenital/ascended UDT, presence of scrotal hypoplasia, presence of a patent processus vaginalis, division of external oblique, and suture of the testis. Univariate and logistic regression were used to evaluate differences between groups and risk for re-ascent.
RESULTS: A total of 662 testes in 554 patients were included. Re-operation occurred in 6% (7% with inguinal approach, 3% with scrotal approach, p = 0.04). Re-operation was associated with younger age, congenital UDT, and inguinal approach, but neither of these variables remained significant in multivariate analyses. Atrophy occurred in one testis.
CONCLUSIONS: The rate of re-ascent was 6% and the atrophy rate was 0.15%. A larger study may find predictors for re-ascent but with very low absolute risk. The lower rate of re-ascent with the scrotal approach is probably due to selection bias.
METHODS: A retrospective cohort study of children treated for undescended testis (UDT) with orchidopexy between 2018 and 2022 was conducted. The primary outcome was re-ascent requiring re-operation, and the secondary outcome was atrophy rate. Independent variables were age, underlying conditions, side, surgical approach, operation time, bilaterality, congenital/ascended UDT, presence of scrotal hypoplasia, presence of a patent processus vaginalis, division of external oblique, and suture of the testis. Univariate and logistic regression were used to evaluate differences between groups and risk for re-ascent.
RESULTS: A total of 662 testes in 554 patients were included. Re-operation occurred in 6% (7% with inguinal approach, 3% with scrotal approach, p = 0.04). Re-operation was associated with younger age, congenital UDT, and inguinal approach, but neither of these variables remained significant in multivariate analyses. Atrophy occurred in one testis.
CONCLUSIONS: The rate of re-ascent was 6% and the atrophy rate was 0.15%. A larger study may find predictors for re-ascent but with very low absolute risk. The lower rate of re-ascent with the scrotal approach is probably due to selection bias.
摘要：
目的：本研究旨在调查原发性睾丸固定术后需要再次手术的再上升率，并调查腹股沟和阴囊入路之间的最终差异以及其他潜在的再上升预测因素。
方法：进行了一项回顾性队列研究，研究对象为2018年至2022年期间接受睾丸隐伏症（UDT）治疗的儿童。主要结果是需要重新手术的重新上升，次要结果是萎缩率。独立变量是年龄，潜在条件，侧面,手术方法,操作时间,双边性，先天性/上升UDT，阴囊发育不全的存在，存在阴道突闭症，外斜的划分，和睾丸缝合。使用单变量和逻辑回归评估组间差异和再上升风险。
结果：共纳入554例患者的662个睾丸。6％（腹股沟入路7％，3%采用阴囊入路，p=0.04)。再次手术与年龄较小有关，先天性UDT,和腹股沟入路，但这两个变量在多变量分析中都不重要.萎缩发生在一个睾丸。
结论：再上升率为6%，萎缩率为0.15%。一项更大的研究可能会发现再上升的预测因素，但绝对风险非常低。阴囊法的再上升率较低可能是由于选择偏差。
方法：进行了一项回顾性队列研究，研究对象为2018年至2022年期间接受睾丸隐伏症（UDT）治疗的儿童。主要结果是需要重新手术的重新上升，次要结果是萎缩率。独立变量是年龄，潜在条件，侧面,手术方法,操作时间,双边性，先天性/上升UDT，阴囊发育不全的存在，存在阴道突闭症，外斜的划分，和睾丸缝合。使用单变量和逻辑回归评估组间差异和再上升风险。
结果：共纳入554例患者的662个睾丸。6％（腹股沟入路7％，3%采用阴囊入路，p=0.04)。再次手术与年龄较小有关，先天性UDT,和腹股沟入路，但这两个变量在多变量分析中都不重要.萎缩发生在一个睾丸。
结论：再上升率为6%，萎缩率为0.15%。一项更大的研究可能会发现再上升的预测因素，但绝对风险非常低。阴囊法的再上升率较低可能是由于选择偏差。
