Single scrotal-incision orchidopexy without ligation of processus vaginalis for palpable undescended testis

CHEN Yi; ZHAO Jun-feng; WANG Fu-ran; LI Yan; SHI Zhan; ZHONG Hong-ji; ZHU Jian-ming

doi:10.13263/j.cnki.nja.2017.08.007

Abstract：Objective:To determine the feasibility and short-term effect of single scrotal-incision orchidopexy (SSIO) without ligation of the processus vaginalis (PV) in the treatment of palpable undescended testis (PUDT).Methods:This retrospective study included 109 cases of PUDT (125 sides) and 15 cases of impalpable undescended testis (IUDT).The former underwent SSIO without PV ligation (group A,n =53) or standard inguinal orchidopexy with PV ligation (group B,n =56) while the latter received laparoscopic exploration (group C).We analyzed the success rate of SSIO in the management of PUDT,postoperative complications,and incidence rates of hernia and hydrocele,and compared the relevant parameters between groups A and B.Results:The median age of the PUDT patients was 1.4 (0.6-11.0) years.Group A included 24 cases of left PUDT (2 with hydrocele),20 cases of right PUDT (1 with hydrocele),and 9 cases of bilateral PUDT,the success rate of which was 95.1％.Group B consisted of 27 eases of left PUDT,22 eases of right PUDT (3 with hernias),and 7 cases of bilateral PUDT.The rate of PV patency in the PUDT patients was 80.8％ (101/125).Laparoscopic exploration of the 15 IUDT patients revealed 2 cases of congenital testis absence,6 cases of testis dysplasia,all treated by surgical removal,3 cases of staying around the inner ring,descended by inguinal orchidopexy,and the other 4 treated by laparoscopic surgery.The incisions healed well in all cases,with no testicular atrophy,inguinal hernia or hydrocele.Conclusion:Single scrotal-incision orchidopexy without PV ligation is a safe and feasible procedure for the treatment of palpable undescended testis,which avoids the risk of inguinal hernia or hydrocele.