Does bilateral undescended testis have worst testicular function than unilateral cases? A meta-analysis of adult orchidopexy patients.

INTRODUCTION

Cryptorchidism, or undescended testis (UDT), is a congenital anomaly linked to an increased risk of infertility. The laterality of UDT, whether unilateral or bilateral, may influence post-orchidopexy outcomes. This meta-analysis compares testicular function and azoospermia rates between patients with bilateral and unilateral UDT post-orchiopexy.

MATERIALS AND

METHODS

A comprehensive literature search was performed using PubMed, ScienceDirect, and Google Scholar databases up to March 2025. Statistical analyses were conducted using Review Manager (RevMan).

RESULTS

Ten eligible studies were included in the analysis, comprising 563 bilateral UDT post-orchidopexy and 1259 unilateral UDT post-orchidopexy cases. Populations post bilateral orchidopexy have significantly higher FSH level (MD: 3.77 UI/L [95% CI: 1.65 - 5.89]), significantly higher LH level (MD: 1.27 UI/L [95% CI: 0.27 - 2.26]), lower inhibin B level (MD: -44.86 pg/mL [95% CI: -69.58 - -20.15]), and higher frequency of azoospermia (OR 2.3 [95% CI: 1.57 - 3.37]) compared to unilateral UDT post orchidopexy.

CONCLUSIONS

Bilateral UDT post-orchidopexy exhibits poorer testicular function with significantly higher FSH and LH levels, reduced inhibin B levels, and a greater incidence of azoospermia compared to unilateral UDT post-orchidopexy.