Modified orchiopexy: a "real dartos pocket"

A modified technique of surgical treatment of undescended testes, termed the "real dartos pocket", is presented. The method may be briefly described as transinguinal orchiofuniculolysis, utilizing internal fixation of the tunica vaginalis and/or the gubernaculum to the everted dartos pocket (the tunica dartos of the septum being also grasped), with application of an additional inguinoscrotal incision, and cordopexy, if necessary. The narrowing of the opening on the Colles' fascia cranially, and on the tunica dartos at the scrotal entrance caudally, through the inguinoscrotal incision, are additional safeguards against retraction of the testis. Eighty-two patients underwent surgery, using the new technique in its present form. The patients were under follow-up from 5 to 41 months, and results have been anatomically and cosmetically excellent. In our experience, all undescended testes with an adequate length of the cord and mild to moderate tension, may be treated using our modified technique, with excellent anatomic and cosmetic results.