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. Key words: cryptorchidism, endocrine,
orchidopexy, routine health data, temporal trends, testes