Surgical correction of the failed orchiopexy.

The reasons for failure of orchiopexy were investigated by reviewing the records of 350 boys with undescended testis. There were 36 boys (10 per cent) who had experienced failure of an initial surgical procedure. We found that the standard surgical techniques of local inguinal dissection, high ligation of a patent processus vaginalis, extensive retroperitoneal mobilization of the spermatic vessels and vas deferens, and/or creation of a dartos pouch were sufficient to correct these failures. Retroperitoneal dissections were required to correct the undescended testes in 58 per cent of the boys. Only 37 per cent of the boys could be treated satisfactorily by localized inguinal dissection. It appears that standard surgical techniques, especially aggressive retroperitoneal dissection, are adequate to correct even troublesome cases of undescended testis.