Objective To investigate the risk factors of testicular atrophy after laparoscopic orchiopexy in children and to construct a predictive model. Methods A retrospective analysis was conducted on the clinical data of children diagnosed with cryptorchidism and treated with laparoscopic orchiopexy in our department from June 2021 to December 2023. Patients were divided into an atrophy group (Group A, n = 36 testes) and a non-atrophy group (Group B, n = 149 testes) based on postoperative outcomes. The clinical data of the two groups were compared, including age, surgical side, weight, premature birth, preoperative testicular position, operative time, epididymal-vas deferens anomalies, patency of the processus vaginalis, postoperative complications (incision infection, hematoma, etc.), spermatic cord development, preoperative color Doppler flow imaging (CDFI), preoperative testicular volume ratio and postoperative testicular fixation position. Univariate analysis followed by multivariate logistic regression was performed to identify independent risk factors for postoperative testicular atrophy and construct a corresponding predictive model. The discriminative performance, calibration, and reliability of the model were evaluated using receiver operating characteristic (ROC) curve, calibration curve, and Bootstrap internal validation. Results A total of 152 patients (involving 185 testes) were enrolled in this study, including 36 testes in group A and 149 testes in group B. The incidence of postoperative testicular atrophy was 19.5%. Univariate analysis showed that there were significant differences between the two groups in epididymal-vas deferens anomalies, spermatic cord development, preoperative testicular position and preoperative testicular volume ratio (P < 0.05). There were no significant differences in age, surgical side, weight, premature birth, operative time, patency of the processus vaginalis, postoperative complications, preoperative color Doppler flow imaging (CDFI) and postoperative testicular fixation position (P > 0.05). Multivariate analysis showed epididymal-vas deferens anomalies (OR = 11.841, 95% CI: 4.149–33.79), intra-abdominal testis (OR = 20.522, 95% CI: 4.2–100.282) and a low preoperative testicular volume ratio (OR = 0.007, 95% CI: 0.000–0.11) were independent risk factors for testicular atrophy after laparoscopic orchiopexy (P < 0.05). Conclusions Epididymal-vas deferens anomalies, intra-abdominal testis and a low preoperative testicular volume ratio were independent risk factors for testicular atrophy after laparoscopic orchiopexy, and the predictive model based on these three factors had high predictive value.

Risk factors and a predictive model for testicular atrophy after laparoscopic orchiopexy in children

期刊论文
发表日期：

2026年3月5日

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Yuchen Liu,
Luping Li,
Yingzhong Fan

摘要

Objective

To investigate the risk factors of testicular atrophy after laparoscopic orchiopexy in children and to construct a predictive model.

Methods

A retrospective analysis was conducted on the clinical data of children diagnosed with cryptorchidism and treated with laparoscopic orchiopexy in our department from June 2021 to December 2023. Patients were divided into an atrophy group (Group A, n = 36 testes) and a non-atrophy group (Group B, n = 149 testes) based on postoperative outcomes. The clinical data of the two groups were compared, including age, surgical side, weight, premature birth, preoperative testicular position, operative time, epididymal-vas deferens anomalies, patency of the processus vaginalis, postoperative complications (incision infection, hematoma, etc.), spermatic cord development, preoperative color Doppler flow imaging (CDFI), preoperative testicular volume ratio and postoperative testicular fixation position. Univariate analysis followed by multivariate logistic regression was performed to identify independent risk factors for postoperative testicular atrophy and construct a corresponding predictive model. The discriminative performance, calibration, and reliability of the model were evaluated using receiver operating characteristic (ROC) curve, calibration curve, and Bootstrap internal validation.

Results

A total of 152 patients (involving 185 testes) were enrolled in this study, including 36 testes in group A and 149 testes in group B. The incidence of postoperative testicular atrophy was 19.5%. Univariate analysis showed that there were significant differences between the two groups in epididymal-vas deferens anomalies, spermatic cord development, preoperative testicular position and preoperative testicular volume ratio (P < 0.05). There were no significant differences in age, surgical side, weight, premature birth, operative time, patency of the processus vaginalis, postoperative complications, preoperative color Doppler flow imaging (CDFI) and postoperative testicular fixation position (P > 0.05). Multivariate analysis showed epididymal-vas deferens anomalies (OR = 11.841, 95% CI: 4.149–33.79), intra-abdominal testis (OR = 20.522, 95% CI: 4.2–100.282) and a low preoperative testicular volume ratio (OR = 0.007, 95% CI: 0.000–0.11) were independent risk factors for testicular atrophy after laparoscopic orchiopexy (P < 0.05).

Conclusions

Epididymal-vas deferens anomalies, intra-abdominal testis and a low preoperative testicular volume ratio were independent risk factors for testicular atrophy after laparoscopic orchiopexy, and the predictive model based on these three factors had high predictive value.