JPED Journal

Abstract

Objectives: To determine patient characteristics and clinical outcomes during and after orchiopexy in syndromic children with either developmental delay, genetic syndromes, or congenital anomalies compared to age matched controls. Study Design: This is a retrospective cohort study of patients ≤ 18 years old who underwent orchiopexy at UCSF Benioff Children’s Hospitals between 2012-2020 and were identified as syndromic patients with either developmental delay, molecular testing-confirmed genetic syndromes or known congenital anomalies, compared to an age-matched non syndromic control group. Intra-operative covariates including procedure staging, surgical approach, undescended testes location, estimated blood loss, intra-operative complication occurrence, orchiopexy laterality and post-operative covariates including complication occurrence were gathered through electronic chart review. Differences in continuous and categorical variables were assessed using Mann-Whitney and Chi-squared tests, respectively. Results: Our study yielded 825 total patients undergoing orchiopexy, of which 16% were defined as syndromic. 67 patients had developmental delay, 38 patients had a defined genetic syndrome, and 25 patients had an associated congenital anomaly. These patients were compared to 60 age matched non-syndromic control patients undergoing orchiopexy. Patients with unspecified developmental delay more often underwent bilateral orchiopexy compared to the control group (43% v. 23%, p=0.02). Patients with a genetic syndrome were less likely to have a single stage procedure (92% v. 100%, p=0.03) and more likely to undergo bilateral orchiopexy (45% v. 23%, p=0.03) compared to the control group. There were no differences in rate of bilateral orchiopexy and single stage procedures between patients with a congenital anomaly and the control group. There was no difference in intraoperative or post-operative complications or clinical outcomes between the three syndromic groups and control group. Conclusions: Clinical outcomes were no different between patients with syndromes undergoing orchiopexy compared to non-syndromic children. Patients with non-specific developmental delay or a genetic syndrome more often had bilateral orchiopexies. Patients with a genetic syndrome were also less likely to have a single stage procedure. Orchiopexy in syndromic patients undergoing orchiopexy is safe with comparable outcomes to non-syndromic patients.

Keywords: Orchiopexy; Testis; Syndromic; Outcomes; Pediatrics