Orchidopexy trends in the paediatric population of Victoria, 1999-2006

PurposeIn recent times, much concern has been expressed in the media about male reproductive health. Undescended testis is a significant contributor to male infertility and testicular cancer. The recommended management is orchidopexy. Recent studies in the United Kingdom have shown a decline in orchidopexy rates in the paediatric population. An analysis of the orchidopexy rate in Victoria was therefore conducted to determine whether a similar trend existed and what factors may contribute toward this.MethodsData were extracted from hospital records using operation codes for orchidopexies for all patients between 0 and 18 years in the state of Victoria. Victorian population data were collected from the Australian Bureau of Statistics. Data were grouped into orchidopexy age groups 0 to 4, 5 to 9, and 10 to 18 and compared across calendar years using graphical and statistical analysis.Main ResultsOn average, the rate of operations on 0 to 4-year-old patients reduced by 2.1% each year over the period; the 95% confidence interval for the rate of reduction was 0.4% to 3.8% (P < 0.014). The rate of operations on 5 to 9-year-old patients reduced by 6.3% each year over the period; the 95% confidence interval for the rate of reduction was 3.7% to 8.8% (P < .005). The rate of operations on 10 to 14-year-old patients reduced by 5.7% each year over the period; the 95% confidence interval for the rate of reduction was 1.9% to 9.3% (P = .003).ConclusionIn the state of Victoria, there has been a true decline in the number of orchidopexy operations done in the paediatric population. This may represent a true decline in the incidence of disease, a failure of diagnosis, or a failure of management. Further investigation will therefore be required to determine the cause of current trends as the outcome may have significant consequences on male reproductive health.