TITLE:
Determinants of Primary Orchiopexy Failure in Children: A 5-Year Retrospective Cohort from a Kenyan Tertiary Hospital
AUTHORS:
Joseph Musamia Tabalya, Shreya Gyanesh Srivastava
KEYWORDS:
Cryptorchidism, Orchiopexy, Surgical Outcomes, Re-Ascent, Testicular Atrophy, Kenya
JOURNAL NAME:
Yangtze Medicine,
Vol.10 No.4,
October
26,
2026
ABSTRACT: Background: Cryptorchidism is a common congenital condition, and orchiopexy is the standard treatment for persistent undescended testis. This study assessed primary orchiopexy failure and associated factors at a Kenyan county referral hospital. Methods: We conducted a retrospective cohort study at Kiambu Level 5 Hospital, Kenya, covering January 2018 to December 2022. The study included 78 children undergoing 90 primary orchiopexies. Failure was defined as re-ascent, testicular atrophy, or repeat orchiopexy. Generalized estimating equations were used to account for clustering of testes within children. Results: Median age at surgery was 4.5 years (IQR 2.5 - 7.0), and 12/90 procedures (13.3%) met the failure definition. Failures comprised re-ascent (7/12, 58.3%), atrophy (3/12, 25.0%), and repeat orchiopexy (2/12, 16.7%). In the multivariable model, bilateral cryptorchidism (OR 2.1, 95% CI 1.1 - 4.0; p = 0.032), high inguinal position (OR 2.9, 95% CI 1.3 - 6.5; p = 0.008), and intra-abdominal position (OR 4.1, 95% CI 1.7 - 9.9; p = 0.002) were associated with failure. Conclusion: Primary orchiopexy failure occurred in 13.3% of procedures. Bilateral disease and higher testicular position were associated with increased odds of failure. Earlier referral and careful operative planning for high-positioned testes warrant attention.