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Single scrotal incision orchiopexy for the palpable undescended testicle
A P Caruso1, R A Walsh, J W Wolach
1Department of Pediatric Urology, Children's Hospital, University of Colorado School of Medicine, Denver, Colorado, USA.
Purpose:
We prospectively evaluated the Bianchi single high scrotal incision technique for orchiopexy in boys with palpable undescended testis distal to the external inguinal ring.
Materials And Methods:
A total of 60 Bianchi orchiopexies were performed in 48 patients. We identified a group with primary undescended and secondary ascended testis, and a trapped testicle associated with previous inguinal surgery, respectively. Testicular position and size were assessed at 6 weeks of followup.
Results:
We evaluated group 1-34 patients with bilateral (8), right (17) and left (9) primary undescended testis, group 2-3 with secondary ascended testis and group 3-11 with bilateral (4), right (4) and left (3) trapped testis. Average surgical time was 15, 35 and 35 minutes, respectively. Four patients required conversion to a traditional inguinal incision to achieve adequate cord length. All but 2 patients had a palpable testicle of acceptable size compared with the contralateral mate in the dependent scrotum at the end of the operation and 6 weeks postoperatively. Those returning for 1-year followup had identical findings. In groups 1 and 2 a single testicle normal to palpation resided in a high scrotal position and 1 testis required secondary orchiectomy for infarction, respectively. Scrotal hematoma resolved spontaneously without injury to the testis in 1 case. No hernias were evident.
Conclusions:
A single high scrotal incision for palpable primary, secondary ascended or even trapped testis is well tolerated, cosmetically pleasing and associated with a short operative time. The complication rate is acceptably low.