Orchidopexy for palpable undescended testis: Is one cut not enough?

Document Type : Original Article

Authors

1 Paediatric Surgery, Bristol Royal Hospital for Children, Bristol, GBR

2 Paediatric Surgery Department, Royal Aberdeen Children’s Hospital, Aberdeen, GBR

3 Paediatric Surgery, Faculty of Medicine, Ain Shams University, Egypt

Abstract

Introduction: Undescended testes (UDTs), is a prevalent congenital abnormality in male newborns, affecting
1.0–4.6% of full-term boys and showing a higher incidence in preterm boys. This condition poses a well-established
independent risk for infertility, testicular cancer, testicular torsion, and other related diseases. Early correction of
undescended testes is crucial to prevent subsequent testicular degeneration. The traditional two-incision inguinal
orchidopexy remains the preferred method for correcting cryptorchidism. Alternatively, scrotal orchidopexy uses a
single incision to deliver the testis, divide the gubernaculum if needed, mobilize the cord, and dissect the vas and
vessels to the proper length, then fixates the testicle in the scrotum.
Aim of work: Our primary objective was to compare the outcomes of these two approaches, specifically looking
at recurrence and atrophy rates, with a particular emphasis on operative time.
Patients and methods: Over a five-year period from October 2018 to October 2023, we conducted a retrospective
analysis of our surgical practices, focusing on the frequency of using Scrotal Orchidopexy (SO) versus Inguinal
Orchidopexy (IO).
Results: 261 patients were included. We looked into 306 performed orchidopexies. 37were operated upon
by scrotal incision, while 309 had surgery with the traditional 2 incision orchidopexy. There were 45 bilateral
procedures, with 39 performed inguinally and 6 through the scrotal approach. 1 case (2.7%) of testicular recurrent
ascent observed in the scrotal incision group, whereas there were 5 cases (1.8%) of recurrent ascent in the inguinal
approach group, all of which required redo inguinal orchidopexy. Median operative time for scrotal orchidopexy was
37 minutes, while for inguinal orchidopexy it was 48 minutes. No atrophy was seen in both groups.
Conclusion: the scrotal approach is safe and effective to use and offer some merits including shorter operative
time among other variables.

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Ain Shams Journal of Surgery
Volume 18, Issue 1
January 2025
Pages 32-35

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