Adv Pediatr Surg.  2019 Jun;25(1):14-19. 10.13029/aps.2019.25.1.14.

A Comparative Study of Single Scrotal Incision Orchiopexy of Children with Palpable Low-Lying Undescended Testis with Traditional Inguinal Method

Affiliations
  • 1Department of General Surgery, Imam Reza hospital, Tabriz University of Medical Sciences, Tabriz, Iran. semoosavit@gmail.com
  • 2Department of Anesthesia, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Abstract

PURPOSE
Undescended testis (UDT) is a developmental defect in which one or both testicles do not arrive in the scrotum. Its prevalence at birth and one year after is 2%-4% and less than 1%, respectively. Currently, surgery is recommended to treat congenital cryptorchidism in order to prevent testicular degeneration. Classic method is performed via incision in inguinal and scrotum and the new method is done via incision in scrotum. METHOD: Sixty male participants with 65 UDT undergoing surgery were randomly assigned to scrotal incision (n=31) and classic inguinal incision methods (n=34). Patients were followed for 6 months and testicular atrophy, infection, recurrence, and duration of surgery were compared between two groups.
RESULTS
Scrotal incision compared to classic incision method had significantly lower duration of surgery (19.06±2.96 minutes vs. 30±10.42 minutes; p=0.002) and recurrence during follow-up (0 vs. 5 cases; p=0.026). There was only one surgical site infection in the scrotal incision method. There were hematoma and post-operative swelling in 13.3% of cases after scrotal incision method.
CONCLUSION
Scrotal incision is an alternative method for the UDT with lower duration of surgery, lower recurrence rate, and better cosmetic results.

Keyword

Orchiopexy; Scrotal incision; Undescended testis

MeSH Terms

Atrophy
Child*
Cryptorchidism*
Follow-Up Studies
Hematoma
Humans
Male
Methods*
Orchiopexy*
Parturition
Prevalence
Recurrence
Scrotum
Surgical Wound Infection
Testis

Reference

1. Schneck FX, Bellinger MF. Abnormalities of the testis and scrotum and their surgical management. In : Walsh PC, Retik AB, Vaughan ED, Wein AJ, editors. Campbell's urology. 8th ed. Philadelphia (PA): W.B. Saunders;2002. p. 2353–2370.
2. Barthold JS, González R. The epidemiology of congenital cryptorchidism, testicular ascent and orchiopexy. J Urol. 2003; 170:2396–2401.
Article
3. Brucker-Davis F, Pointis G, Chevallier D, Fenichel P. Update on cryptorchidism: endocrine, environmental and therapeutic aspects. J Endocrinol Invest. 2003; 26:575–587.
Article
4. Koivusalo A, Taskinen S, Rintala RJ. Cryptorchidism in boys with congenital abdominal wall defects. Pediatr Surg Int. 1998; 13:143–145.
Article
5. Aslan Abadi S, Kazemi Rashed F. Study of prevalence of hidden testis in the children under one year in city of Tabriz with study diagnostic role of the social workers in referral system. Med J Tabriz Univ Med Sci. 2006; 28:25–28.
6. Abe T, Aoyama K, Gotoh T, Akiyama T, Iwamura Y, Kumori K. Cranial attachment of the gubernaculum associated with undescended testes. J Pediatr Surg. 1996; 31:652–655.
Article
7. Esposito C, De Lucia A, Palmieri A, Centonze A, Damiano R, Savanelli A, et al. Comparison of five different hormonal treatment protocols for children with cryptorchidism. Scand J Urol Nephrol. 2003; 37:246–249.
Article
8. Ameh EA, Mbibu HN. Management of undescended testes in children in Zaria, Nigeria. East Afr Med J. 2000; 77:485–487.
Article
9. Ritzén EM. Undescended testes: a consensus on management. Eur J Endocrinol. 2008; 159:Suppl 1. S87–S90.
Article
10. Na SW, Kim SO, Hwang EC, Oh KJ, Jeong SI, Kang TW, et al. Single scrotal incision orchiopexy for children with palpable low-lying undescended testis: early outcome of a prospective randomized controlled study. Korean J Urol. 2011; 52:637–641.
Article
11. Karaman I, Karaman A, Erdoğan D, Çavuşoğlu YH. The transscrotal approach for recurrent and iatrogenic undescended testes. Eur J Pediatr Surg. 2010; 20:267–269.
Article
12. Dayanç M, Kibar Y, Tahmaz L, Yildirim I, Peker AF. Scrotal incision orchiopexy for undescended testis. Urology. 2004; 64:1216–1218.
Article
13. Zouari M, Dhaou MB, Jallouli M, Mhiri R. Single scrotal-incision orchidopexy for palpable undescended testis in children. Arab J Urol. 2015; 13:112–115.
Article
14. Bianchi A, Squire BR. Transscrotal orchidopexy: orchidopexy revised. Pediatr Surg Int. 1989; 4:189–192.
Article
15. Thong M, Lim C, Fatimah H. Undescended testes: incidence in 1,002 consecutive male infants and outcome at 1 year of age. Pediatr Surg Int. 1998; 13:37–41.
Article
16. Koyle MA, Walsh R, Caruso A, Wilson E. Scrotal (Bianchi) approach to patent processus vaginalis in children. Tech Urol. 1999; 5:95–99.
17. Bassel YS, Scherz HC, Kirsch AJ. Scrotal incision orchiopexy for undescended testes with or without a patent processus vaginalis. J Urol. 2007; 177:1516–1518.
Article
18. Russinko PJ, Siddiq FM, Tackett LD, Caldamone AA. Prescrotal orchiopexy: an alternative surgical approach for the palpable undescended testis. J Urol. 2003; 170:2436–2438.
Article
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