Evidence map›Paper›PMID 41396320›Full record

SynthesisPediatric surgery international2025

Timing of orchidopexy and effect on surrogate outcomes for fertility: a systematic review and meta-analysis.

Sanchit Kaushal, K Liam Varvaris, Adree Khondker, Sabrina Balkaran, Ihtisham Ahmad, Yerin Lee, Justin Y H Chan, Keith Jarvi, Rodrigo Romao, Michael E Chua and 1 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Sanchit Kaushal *Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
K Liam Varvaris *Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Adree KhondkerDivision of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Sabrina BalkaranTemerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Ihtisham AhmadTemerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Yerin LeeTemerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Justin Y H ChanDivision of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Keith JarviDivision of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Rodrigo RomaoDivision of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Michael E ChuaDivision of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Armando J LorenzoDivision of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada. armando.lorenzo@sickkids.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCryptorchidism is a common congenital abnormality affecting male infants and is associated with impaired germ cell maturation and infertility. Current guidelines recommend orchidopexy between 6 and 18 months of age to optimize fertility-related outcomes; however, the real-world feasibility of early surgery is limited, and the benefits of earlier intervention remain uncertain. This study aimed to evaluate whether orchidopexy before 12 months reduces testicular atrophy and postoperative complications compared with surgery after 12 months.

methodsA systematic literature search of five databases was conducted following PRISMA guidelines. Studies comparing early (< 12 months) versus late orchidopexy in boys with cryptorchidism were included, based on thresholds within the available data. The primary outcome was testicular atrophy; secondary outcomes included postoperative complications and fertility-related markers. Random-effects meta-analyses were performed with outcomes reported as odds ratios (OR) and 95% confidence intervals (CI). Certainty of evidence was assessed using the GRADE framework.

resultsSixteen studies were included. Meta-analysis of 1855 testes from five studies showed no significant difference in testicular atrophy between orchidopexy before 12 months (OR 1.05, 95% CI 0.49–2.23; I² = 0%). Pooled analysis of 757 testes across three studies showed no significant difference in postoperative complication rates (OR 1.15, 95% CI 0.44–2.99; I² = 36%). The overall quality of evidence was rated low for both outcomes.

conclusionAvailable data of low quality suggest that orchidopexy before 12 months does not significantly reduce testicular atrophy or postoperative complications compared with later surgery.

Indexed as

CryptorchidismFertilityOrchiopexyAtrophyHumansInfantMalePostoperative ComplicationsTestisTime FactorsTreatment OutcomeCryptorchidismFertilityOrchidopexyPediatric urologyTesticular atrophyUndescended testes

Identifiers

PMID41396320

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.