Postoperative surveillance following orchiopexy: practice variations and recommendations

Introduction Orchiopexy is a common pediatric procedure for cryptorchidism, affecting 1–1.5% of one-year-old infants. Post-orchiopexy follow-up is essential to monitor testicular position and growth, yet there are no standardized guidelines regarding the frequency and duration of follow-up visits. Aim To assess follow-up patterns, adherence rates, and re-ascent incidence in children undergoing orchiopexy during a decade following the procedure. Methods A retrospective cohort study was conducted on pediatric patients who underwent orchiopexy between 2013 and 2014 at a tertiary center. Data on demographics, surgical details, post-operative follow-up adherence as documented until 31/12/2024, and outcomes were analyzed. Results Between 2013 and 2014, 158 children underwent orchiopexy due to undescended testis at our institution. Among them, adherence to long-term follow-up was low, with only 6.3% completing the recommended annually monitoring. Over the entire study period, 7 patients (4.4%) required reoperation due to recurrent undescended testis. The median time to re-ascent diagnosis was 22 months. Conclusion This study highlights the importance of structured follow-up in the first years post-orchiopexy to identify testicular re-ascent. It is recommended to prioritize adherence to this critical period. Beyond the first years, the necessity of annual follow-up visits should be reconsidered, based on risk stratification. Further research is needed to establish evidence-based protocols for post-operative surveillance.