Inguinal cordopexy: a simple and effective new technique for securing the testes in reoperative orchiopexy

A new procedure is described for securing the testis in the scrotum in patients with a past history of inguinal sugery and testes in an unsatisfactory position.

Twenty-seven patients with 29 abnormally positioned testes (two bilateral) were evaluated. All patients had a past history of inguinal surgery, and ages ranged between 4 and 16 years (mean, 7.2). Previous surgical procedures included 23 orchiopexies, 4 inguinal herniorrhaphies, and 2 testicular detorsions of undescended testis. In all reoperations an attempt was made to fix a strip (two nonabsorbable stitches) of the fascia attached to the cord, to the pubic bone, or to the tendinosous part of the gracilis muscles (cordopexy), so that the distal part of the cord and the testis lay freely in the scrotum without tension. Patients underwent follow-up every 6 months after the operation with physical and ultrasound examinations.

Cordopexy was possible in 11 (38%) of the 29 inguinal reoperations. In all cases, orchiopexy was the previous surgical procedure. One hundred percent of the testes remain within the scrotum after a mean follow-up of 21 months (range, 8 to 38).

When feasible, inguinal cordopexy is a simple and effective technique for securing testicles in reoperative orchiopexy procedures.