Temporal trends in orchidopexy, Great Britain, 1992-1998.

TitleTemporal trends in orchidopexy, Great Britain, 1992-1998.
Publication TypeJournal Article
Year of Publication2003
AuthorsToledano MB, Hansell AL, Jarup L, Quinn M, Jick S, Elliott P
JournalEnviron Health Perspect
Date Published2003 Jan
KeywordsAdolescent, Age Distribution, Child, Child, Preschool, Cryptorchidism, Endocrine Glands, Great Britain, Hormones, Hospitalization, Humans, Infant, Infant, Newborn, Male, Prevalence, Risk Factors, Testicular Neoplasms, Time, Urologic Surgical Procedures, Male

Concern has been expressed in recent years about worsening male reproductive health, possibly mediated by increasing exposures to environmental endocrine-disrupting agents. Trends suggested large increases in cryptorchidism in Britain and the United States between the 1950s and 1980s, although published data on recent trends have been scarce. We examined numbers of orchidopexy procedures, as a marker for cryptorchidism, using routine hospital admission data for England, Wales, and Scotland for fiscal years 1992-1993 through 1998-1999. Annual trends in orchidopexy rates were analyzed by age, in-patient admission versus day case, and geographical region. Orchidopexy rates were also obtained from the General Practice Research Database (GPRD) for England to cross-validate the hospital admissions data. Orchidopexy rates for boys 0-14 years old fell by 33% (from 23.5 to 15.8 per 10,000 population) between 1992 and 1998, with the steepest decline (50%) in 5-9-year-olds. The decreasing trend for 0-14-year-olds was evident in every region in England, in Wales, and in Scotland. Rates remained stable for men 15 or more years old, at 0.7 per 10,000. There was a marked shift from in-patient to day-case procedures. Rates from the GPRD showed a similar downward trend to the hospital data. Our findings could represent either an underlying decrease in the frequency of undescended testis or a fairly dramatic improvement in the diagnosis of cryptorchidism--resulting in fewer orchidopexies performed for retractile testis--in Great Britain during the 1990s, or both. Either way, our findings do not support the postulate of a recent worsening of male reproductive health of the scale suggested by some recent commentators on the endocrine disruptor hypothesis.

Alternate JournalEnviron. Health Perspect.
PubMed ID12515691