Orchiopexy Practice Patterns in New York State From 1984 to 2002

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Abstract
Cryptorchidism is the most common genital anomaly identified at birth, and endocrine disrupters in the environment may be causing an increase in this entity. To determine whether the rate of surgery for undescended testes is increasing, we evaluated all documented orchiopexies performed in New York State during a 19-year period. We used the New York State Statewide Planning and Research Cooperative System database to identify all orchiopexies performed between 1984 and 2002. Orchiopexies performed for torsion were excluded. A total of 36,484 boys were included in the study, of whom 26,575 were outpatients and 9,909 were inpatients. The overall rate of orchiopexy in our population (number of orchiopexies performed divided by number of live births during the study period) was 1.39%, and remained fairly constant throughout the study. Most orchiopexies were performed on an inpatient basis early in the study (92% in 1984) but by 2002 only 3% of repairs were done in inpatients. Early in the study (1984 to 1988) only 20% of orchiopexies were performed in patients younger than 2 years. However, between 1999 and 2002, 37.8% of orchiopexies were done before age 2. Orchiopexy is being performed at an earlier age today than 2 decades ago. However, the majority of orchiopexies are not performed until after the recommended patient age of 2 years. The rate of orchiopexy is substantially higher than the accepted rate of 0.8% to 1.1%. Delayed referral to a surgeon, repair of retractile testicles and truly ascending testicles may account for these findings.