The ascending testis

This study relates the timing and incidence of orchidopexy to possible ascent of the testis. During 1985, 341 patients underwent surgery for undescended testes at the Royal Children's Hospital, Melbourne. In 85 (25%), surgery was performed before 2 years of age. The number of children managed surgically over the age of 2 years is high (75%) despite our surgical policy to perform orchidopexy at 2 years of age. Statistical analysis shows a bimodal distribution for age at the time of surgery for undescended testis, with 16% of the orchidopexy population in the older age group. It also demonstrates that the overall orchidopexy rate of 2.6% is three times the expected incidence of undescended testes at 1 year of age. Possible explanations for these observations include: (1) the diagnosis and referral of undescended testis is being made late; (2) surgery is being performed on retractile testes; or (3) some later presenting undescended testes are acquired, the so-called ascending testes.