Modified testicular traction in intra-abdominal testes, do we really need to wait for 6 weeks?

We previously published our modified testicular traction technique, including an intracorporeal suture, gubernacular preservation, and minimal dissection. We used to fix the testis to a mobile part of the abdominal wall to enhance lengthening with respiratory movement rather than fixing near a bony landmark. This study compares our approximately 7-day traction period to the traditional 6-week period adopted earlier.

Patients with intra-abdominal testes who underwent intracorporeal placement of a traction suture, as a modification of staged traction laparoscopic-orchiopexy, were prospectively divided into two groups across five centers in three Arabian Gulf countries between February 2018 and October 2024. In Group 1, the interval between the two stages was approximately 7 days, whereas in Group 2, the waiting interval was 6 weeks.

Group 1 included 92 testes, while group 2 included 58 testes. All patients tolerated both stages of surgery well without complications. During the second stage, four testes were identified as detached from the anterior abdominal wall in Group 2. Two individuals required a repeat of the initial stage, while the other two were sufficiently long to be placed in the scrotum without tension. The mean operative time was marginally prolonged in n Group 2, attributed to the time required for testicular adhesiolysis. At 1-year follow-up, a successful outcome was observed in all cases.

Short interval modified staged traction orchiopexy demonstrated comparable efficacy to the original staged traction orchiopexy. Additionally, the operative time for the second stage of traction was reduced, with a shorter interval, attributed to simpler dissection. It may also be associated with a lower likelihood of repeating the first stage.