Transscrotal orchidopexy: orchidopexy revised (original) (raw)
Related papers
Transscrotal orchidopexy for palpable cryptorchid testis: follow-up and outcomes
La Pediatria medica e chirurgica : Medical and surgical pediatrics, 2018
We retrospectively reviewed the results of transscrotal orchidopexy in the surgical management of palpable testis. From January 2014 to June 2017, 130 male children with a total of 140 palpable undescended testes (UDT) underwent transscrotal orchidopexy. The charts were retrospectively reviewed for demographic data, preoperative position and mobility of the testis, patency of the peritoneal vaginal duct (PVD), and post-operative complications. The resting position of the testis and its traction towards the scrotum were assessed before surgery and under anaesthesia. The mean age of the patients was 4.6 years. The position of the testis assessed at surgery was in most cases at the external inguinal ring (62.8%), at the neck of the scrotum (15.7%), in the inguinal canal (12.8%), or in an ectopic position (8,5%). A PVD was found in 66 testes (47.1%). Two surgical cases required an inguinal incision. In each patient, the postoperative course was unremarkable. The testicle at 1-year follo...
20 years of transcrotal orchidopexy for undescended testis: Results and outcomes
Journal of Pediatric Urology, 2010
Background: The role of the transcrotal approach to the undescended testis remains controversial despite its increasing popularity. The authors update their previous published series and review the literature on this subject, aiming to delineate the value of this technique. Methods: The authors performed a retrospective review of the transcrotal primary orchidopexy carried out to treat palpable undescended testis at Royal Manchester Children's Hospital between 1993 and 2005. A structured review of literature published since the proposal of this technique was also performed. Results: 122 procedures were included. The transcrotal approach was successfully completed in 119 (97.5%). Additional groin incision was needed in three (2.5%) to further mobilize the spermatic cord. No immediate complications were recorded and 8.4% required a reoperative procedure. On review of the literature, a total of 16 articles were discovered spanning 1695 transcrotal procedures, including the previously published authors' experience. On combining the data, the transcrotal approach required an additional groin incision in 4.4% of cases, 1.6% experienced immediate and/or early complications, and the overall recurrence rate was 2.0%. Conclusions: Transcrotal orchidopexy for the treatment of palpable undescended testes is a safe procedure with a long-term success rate comparable to the two-incision approach.
Orchidopexy for undescended testis in England: is it evidence based?
Journal of Pediatric Surgery, 2008
Background: Current evidence-based recommendations are that orchidopexy for undescended testis should be performed before 18 months of age. We examined hospital episode statistics data for all orchidopexies performed in England over a 9-year period to see how well this guideline was implemented in current practice and examine trends. Methods: Hospital episode statistics data were extracted from 1997 to 2005. Boys with both an Office of Population, Census and Surveys Fourth Revision code for orchidopexy and an International Classification of Diseases, 10th Revision code for undescended testis were included. Results: Four thousand ninety-four (±21) orchidopexies were performed annually. Between 1997 and 2005, the proportion of boys who were younger than 2 years at the time of orchidopexy increased from 15.8% to 28.5% (P b .005, χ 2 test). When adjusted for age and population, there was a secondary peak of incidence at 8 to 10 years. Overall, 46.0% of procedures were performed by paediatric surgeons, 32.1% by general surgeons, and 21.2% by urologists. Over the 9-year study period, an increasing proportion of orchidopexies were performed by paediatric surgeons (P b .001, χ 2). Conclusions: Only 1 in 5 boys is operated on at an "evidence-based" age. The trend has been for more boys to receive surgery at an appropriate age, although the level remains unacceptably low. The reasons are likely to be multifactorial but may partly be explained by secondary testicular ascent.
Pediatric Surgery International, 2006
In this present study we aimed to discuss the surgical efficacy of single stage Fowler-Stephens orchidopexy (FSO) technique, with an emphasis on its practical and logical application that may be kept in mind during a standard orchidopexy procedure. Twenty-two children have undergone a single stage FSO procedure for nonpalpable testes during the last 9 years in our department. Surgical procedure was initiated with a standard inguinal oblique incision keeping in mind that depending on the position and the anatomic features of the testes a FSO method might be needed. While an excellent result was defined as a testis with good scrotal position, size and adequate blood flow on Doppler sonogram, acceptable result was a palpably normal sized testis in a high scrotal position with adequate blood supply and lastly an unacceptable result was the atrophy of the testis with compromised blood supply. During regular follow-up visits although some cases revealed testicular atrophy; long-term examination (12 months) did show that majority of the testes maintained their normal position and tissue consistency (21/24, 87.5%). Due to the necessity of surgical approach either in the evaluation or the treatment of nonpalpable testes in most cases along with the unsatisfactory data of the time consuming and invasive radiological proce-dures; we believe that a classical orchidopexy approach together with further single stage FSO will be a rational and satisfactory algorithm in the majority of such cases.
Orchidopexy for undescended testis among Saudi children: is it conducted at the optimal age?
2010
Current evidence-based studies indicate the need to perform orchidopexy for undescended testicles early in life, between the ages of 6 and 12 months. Despite this evidence, we observed a significant delay in the actual age that such a procedure is performed in Saudi Arabia. Therefore, we retrospectively examined all of our patients who received an orchidopexy, identified their age at the procedure, and, if the procedure was performed after 12 months of age, noted the reason for the delay. We found that the mean age at orchidopexy in our cohort was approximately four and half years old, indicating the need for greater awareness of the recommended time frame for this procedure among health providers and parents of patients.
Testicular atrophy after attempted pediatric orchidopexy for true undescended testis
Journal of Pediatric Surgery, 2014
Background/Purpose: A normal testis in the scrotum is the most important outcome of the attempted pediatric orchidopexy for a true undescended testis. The reports of post-orchidopexy testicular atrophy in the literature have ranged from non-existent to unclear. Our purpose in this study was to estimate the incidence of and associated risk factors for post-orchidopexy testicular atrophy. Methods: We performed a retrospective review of data from children who had an attempted orchidopexy for a true undescended testis from 1969 to 2003 inclusive. REB approval 1000011987. Results: There were 1400 attempted orchidopexies involving common (low) type (n = 1135), ectopic type (n = 174), and high type testes (n = 91). There were a total of 111/1400 (8%) atrophic testes, mostly rightsided. 66/111 (59%) were MADE atrophic, and 45 (41%) were FOUND atrophic. Of the 1135 common type, 56 (5%) were MADE atrophic. In the ectopic and high types, the incidence of post-operative testicular atrophy was 1% and 9%, respectively. The most significant risk factors associated with testes MADE atrophic were high testicle, vas problems, and pre-operative torsion. Conclusions: In this series, the incidence of post-operative testicular atrophy that was MADE was 5% in the common (low) type and 9% in the high type. These numbers and the above risk factors should be quoted to the caregiver during pre-operative informed consent.
Circumcision-incision orchidopexy: A novel technique for palpable, low inguinal undescended testis
Investigative and Clinical Urology
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.