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Ascending testis following inguinal hernia repair in children
1Department of Pediatric Surgery, Firat University Medical Faculty, Elazig, Turkey. unalbakal@hotmail.com.
Insights
Ascending testes after hernia repair occurred in 0.43% of boys, particularly those with retractile testes or scrotal hypoplasia. Early human chorionic gonadotropin (hCG) treatment showed improvement, with some cases requiring scrotal orchiopexy.
Area of Science:
- Pediatric Surgery
- Urology
- Andrology
Background:
- Iatrogenic undescended testes can result from inadequate testicular replacement during hernia repair.
- Ascending testes occur when testes reposition to the inguinal area post-scrotal placement.
Purpose of the Study:
- To assess the incidence and management of ascending testes following inguinal hernia repair in pediatric patients.
Main Methods:
- Retrospective analysis of 910 boys undergoing inguinal hernia repair.
- Postoperative assessment of testicular position within the scrotum.
- Follow-up evaluations to monitor testicular நிலை (sthiti - position/status).
Main Results:
- Ascending testes were identified in 4 (0.43%) patients, aged 1-3 years.
- Associated conditions included scrotal hypoplasia and/or retractile testes.
- Human chorionic gonadotropin (hCG) treatment improved 2 of 3 patients; 2 underwent scrotal orchiopexy.
Conclusions:
- Early postoperative hCG may benefit patients with ascending testes.
- Scrotal orchiopexy might be necessary for persistent cases.
- Combined orchiopexy and herniorrhaphy are recommended for inguinal hernias with retractile testes or scrotal hypoplasia.
Objective:
Failure to replace the testes in the scrotum during hernia repair leads to iatrogenic undescended testes. At other times, the testes may spontaneously move back to the inguinal area after being placed in the scrotum, thus resulting in ascending testes. The cases in this study were assessed.
Patients And Methods:
Records of 910 boys operated due to inguinal hernia were assessed retrospectively. Following hernia repair, the testes were placed in the scrotum. After the operation, all the testes were checked for being in the scrotum. They were called for follow-up after the operation. Their testes were checked for remaining in the scrotum.
Results:
Ascending testes were detected in 4 (0.43%) of the patients. These patients had scrotal hypoplasia and/or retractile testes. Their age ranged between 1-3 years. Ascending testes were bilateral in 2 patients, and on the right side in 2. Human chorionic gonodotropin (hCG) was initiated in 3 patients. Two of them improved. Two underwent scrotal orchiopexy.
Conclusions:
These patients may benefit from hCG in the early postoperative period. Later, scrotal orchiopexy may be needed. Patients who have retractile testes or scrotal hypoplasia in addition to inguinal hernia need orchiopexy together with herniorrhaphy.
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