Korean J Urol.  2009 Nov;50(11):1133-1137.

A Comparison between Single Scrotal Incision Orchiopexy and the Inguinal Approach in Patients with Palpable Undescended Testes Distal to the External Inguinal Ring

• Lee HR
• Lee YS
• Kim HS
• Lee JY
• Kim JC
• Koh JS

Abstract

PURPOSE
Single scrotal incision orchiopexy is emerging as an alternative to the traditional inguinal approach. The purpose of this study was to compare the operative time, success rates, and complications of single scrotal incision orchiopexy with the traditional inguinal approach.
MATERIALS AND METHODS
We reviewed the charts of patients with palpable undescended testes treated with a single scrotal incision or inguinal orchiopexy from April 2004 to April 2008. The position of the testis was confirmed under general anesthesia before any incision. Retractile and ectopic testes were excluded. We compared preoperative and postoperative testicular position, operative time, prevalence of patent processus vaginalis, and complications between the two groups.
RESULTS
There were 43 patients who had palpable undescended testes below the external inguinal ring. A total of 57 orchiopexies were performed in 43 patients by either the single scrotal approach (group 1; n=25, mean age 3.12+/-1.99 years) or the inguinal approach (group 2; n=32, mean age 2.56+/-1.92 years). The average operative times for groups 1 and 2 were 39.76+/-7.66 and 53.31+/-6.33 minutes, respectively (p<0.05). Only 1 patient required conversion to an inguinal incision because of inappropriate mobilization. The complication rates were similar between the two groups. Testicular atrophy, hernia, or hydrocele formation did not occur during the follow-up period (4-41 months).
CONCLUSIONS
Single scrotal incision orchiopexy is an effective procedure in selected patients regardless of patency of the processus vaginalis. It has the advantages of a shorter operative time and a more cosmetically appealing result compared with the inguinal two-incision approach.

Keyword

Testis; Cryptorchidism

MeSH Terms

Anesthesia, General
Atrophy
Cryptorchidism
Follow-Up Studies
Hernia
Humans
Inguinal Canal
Male
Operative Time
Orchiopexy
Prevalence
Testis

Figure

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  Fig. 1 Operative procedure of single scrotal incision. (A) Examination of undescended testis (T) and incision at the scrotal/inguinal crease. (B) The spermatic cord is mobilized and adequate spermatic cord length is achieved. A high ligation is performed. (C) A dartos pouch is created for testis placement. (D) After the testis is secured in the dartos pouch, the skin incision is closed.

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