Investig Clin Urol.  2017 Nov;58(6):468-473. 10.4111/icu.2017.58.6.468.

Circumcision-incision orchidopexy: A novel technique for palpable, low inguinal undescended testis

• Chua ME
• Silangcruz JMA
• Gomez O
• Dy JS
• Morales ML

• KMID: 2414776
• DOI: http://doi.org/10.4111/icu.2017.58.6.468

Abstract

Given that both orchidopexy and circumcision are commonly done in a single operative setting, we adopted a technique of combined orchidopexy and circumcision using a single circumcision incision. We applied this new technique to boys with palpable, low inguinal cryptorchidism. Here we describe a case series of 7 boys who underwent concurrent orchidopexy via the circumcision site. We present this novel technique and discuss our preliminary outcomes, including the anatomic basis and feasibility. The technique appears to be an alternative for concurrent circumcision and cryptorchid cases with palpable, low inguinal testes.

Keyword

Case reports; Cryptorchidism; Male circumcision; Orchidopexy; Reconstructive surgical procedures

MeSH Terms

Circumcision, Male
Cryptorchidism*
Female
Male
Orchiopexy*
Reconstructive Surgical Procedures
Testis

Figure

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  Fig. 1 (A) Double-incision circumcision mucosal-sparing approach. (B) Partial degloving of the penis on the side of the undescended testis. Dissection was made via the plane of the Dartos layer down to the penile base.

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  Fig. 2 (A) Small retractors were gently placed into the peno-inguinal space. (B) The palpable testicle was extracted distally and the gubernaculum was grabbed with the mosquito clamp.

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  Fig. 3 (A) After lengthening of the spermatic cord, the hernia sac was separated from the cord, transected, and suture ligated as proximally as possible. (B) The Dartos pouch was made via the circumcision site by use of a mosquito clamp.

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  Fig. 4 (A) The inner surface of the developed Dartos pouch was grasped by using an Allis clamp. (B) Testicular fixation was done with a figure 8 suture to the inner surface of the everted Dartos pouch.

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  Fig. 5 (A) The testicle was placed into the Dartos pouch as the inner surface of the scrotum was inverted. (B) Completion of the circumcision closure by use of Chromic 4-0 interrupted sutures.

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  Fig. 6 Follow-up condition at 1 to 3 months.

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