A prediction model for risk factors of testicular atrophy after orchiopexy in children with undescended testis

作者：Zhilin Yang, Shoulin Li, Jianchun Yin, Jiming Bao, Hongwu Zeng, Wanhua Xu, Xuan Zhang, Zhihao Xing, Weiguang Zhao, Cundong Liu · 发表于：Translational Pediatrics · 年份：2021 · DOI：10.21037/tp-20-473 · 被引用次数：19 · 研究领域：Testicular diseases and treatments、Male Reproductive Health Studies、Sperm and Testicular Function

BACKGROUND: There have been limited studies with small sample sizes about risk factors of testicular atrophy. Thus, we aimed to investigate the risk factors for testicular atrophy after orchiopexy in male children with undescended testes and develop a prediction model based on clinical variables. METHODS: We performed a retrospective review of data on children who underwent orchiopexy for undescended testes from 2013 to 2017. The variables assessed included age, laterality, testicular location, preoperative testicular volume ratio, deferens and epididymis anomaly, hormonal treatment, comorbidities, type of surgical procedure, operating time, and complications as the outcome of testicular atrophy. A nomogram was constructed to predict the probability of testicular atrophy. We also validated our model based on a prospective cohort of patients who underwent orchiopexy from January 2018 to December 2018. RESULTS: A total of 1,608 patients undergoing orchiopexy were included in the training cohort. The median age was 2.8 years (range, 0.5-11.3 years). After follow-up for 12 to 18 months (median, 14 months), 228 (14.2%) cases of atrophic testes were recorded. The independent predictors of testicular atrophy were preoperative testicular volume ratio [odds ratio (OR) 0.001, P=0.001], testicular location (OR 1.903, P=0.001), deferens and epididymis anomaly (OR 6.470, P=0.001), and two-stage Fowler-Stephens orchiopexy (OR 2.613, P=0.04). Successful validation was achieved, and a receiv...