Abstract

Objective: This study aimed to evaluate the age at presentation, timing of orchidopexy, and outcomes of early versus late surgical intervention among pediatric patients with undescended testicles (UDT) in the Qassim, Saudi Arabia.
Methods: A retrospective chart-review study was conducted at the Maternal and Children Hospital, Qassim, Saudi Arabia, including all pediatric patients aged 0-14 years diagnosed with UDT over the past 4 years (2021 2025). Medical records were reviewed to collect demographic data, testicular characteristics, surgical details, and postoperative outcomes. Early intervention was defined as orchidopexy performed at ≤18 months of age and late intervention as >18 months.
Results: A total of 170 patients were included. The mean age at presentation was 17.69 ± 0.65 months, while the mean age at surgery was 44.2 ± 38.47 months. The majority (94.7%) were Saudi nationals, and 62.9% had unilateral UDT, most commonly located in the inguinal canal (67.6%). Early surgical intervention was performed in 29.4% of cases. Late surgery was significantly associated with increased age at surgery (56.16 ± 38.81 vs. 12.31 ± 3.46 months, p < 0.001) and longer time to surgery (33.03 ± 41.46 vs. 9.17 ± 5.03 months, p < 0.001). Only 5.3% of patients developed postoperative complications, with small testis being the most common. A significant negative correlation was found between age at presentation and age at surgery (r = -0.074, p < 0.001).
Conclusion: Most patients underwent delayed surgical correction of UDT, despite international recommendations favoring early orchidopexy. Early surgical intervention was associated with fewer complications.

Key words: Undescended testis, cryptorchidism, orchidopexy, pediatric surgery, Saudi Arabia, early intervention, delayed surgery