Background: Endocrine disrupters in the environment may be increasing the rate of cryptorchidism. We sought to determine whether the rate of orchiopexy has increased in New York State over the past 2 decades.
Methods: We used the New York Statewide Planning and Research Cooperative System database to obtain information on all in- and out-patient orchiopexies performed from 1984 to 2002. Patients were included only if they had a diagnosis of undescended or retractile testis and the data were indexed to live male births.
Results: A total of 32,988 boys were included in the study: 24,395 outpatients and 8,593 inpatients. The overall “incidence” of orchiopexy in our population (number of orchiopexies divided by number of births) was 1.26% and has remained fairly constant throughout the study.
Most orchiopexies were performed on an inpatient basis early in the study (93% in 1984), but the number of inpatient procedures decreased rapidly during the study period such that in 2002, only 3% of repairs were done on an inpatient basis.
There has been a substantial shift in the age at which orchiopexies are performed (Figure). Early in the study (1984 to 1988), only 17% of orchiopexies were performed on patients under 2 years of age. However, in 1999 to 2002, 37.5% were done before age 2. Of note, however, in 1999 to 2002, over 62% of orchiopexies were performed in patients age 2 or above.
Conclusions: The rate of orchiopexy has not increased over the past 19 years, but is substantially higher than the accepted prevalence of 0.8%. This suggests that many children with retractile testes are undergoing orchiopexy. Furthermore, while the age at orchiopexy has shown a downward trend in the past 19 years, the age at orchiopexy remains considerably higher than recommended, indicating that boys may not be referred to a pediatric urologist as early as is currently recommended.

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