The Transscrotal Approach for Recurrent and Iatrogenic Undescended Testes

Abstract

Purpose: Aim of the study was to evaluate the efficacy of the transscrotal approach in redo orchiopexy.

Material and Methods: Redo orchiopexy using the transscrotal approach was used to treat 16 testes during a 4-year period from 2005 to 2009. Five of these cases occurred following inguinal hernia repair and 11 after previous orchiopexy. Only testes located distal to the external ring that could be moved to the upper part of the scrotum were included in the study. The vas deferens and testicular vessels were dissected free from the surrounding tissue using a scrotal approach and the testis placed into a dartos pouch.

Results: All testes except one could be placed into the scrotum with the transscrotal approach. The mean duration of surgery was 33±13 min. No patient suffered from atrophy or reascending testes.

Conclusion: The transscrotal approach is a fast, simple and reliable method for redo procedures for undescended testes.

Key words

undescended testes - transscrotal orchiopexy - redo orchiopexy

References

• 1 Al-Mandil M, Khoury AE, El-Hout Y. et al . Potential complications with the prescrotal approach for the palpable undescended testis? A comprasion of single prescrotal incision to the traditional inguinal approach.  J Urol. 2008;  180 686-689
• 2 Bianchi A, Squire BR. Transscrotal orchidopexy: orchidopexy revised.  Pediatr Surg Int. 1989;  4 189-192
• 3 Cartwright PC, Velagapudi S, Snyder HM. et al . A surgical approach to reoperative orchiopexy.  J Urol. 1993;  149 817-818
• 4 Caruso AP, Walsh RA, Wolach JW. et al . Single scrotal incision orchiopexy for the palpable undescended testicle.  J Urol. 2000;  164 156-159
• 5 Hutson JM. Undescended testes.. In: Stringer MD, Oldham KT, Mouriquand PDE (eds) Pediatric Surgery and Urology: Long-Term Outcomes. 2nd edn. Cambridge: Cambridge University Press; 2006: 652-663
• 6 Iyer KR, Kumar V, Huddart SN. et al . The scrotal approach.  Pediatr Surg Int. 1995;  10 58-60
• 7 Leung MWY, Chao NSY, Wong BPY. Laparoscopic mobilization of testiculer vessels: an adjunctive step in orchidopexy for impalpable and redo undescended testis in children.  Pediatr Surg Int. 2005;  21 767-769
• 8 Noseworthy J. Recurrent undescended testes.  Semin Pediatr Surg. 2003;  12 90-93
• 9 Palacio MM, Sferco A, Fernanndez AEG. et al . Inguinal cordopexy: A simple and effective new technique for securing the testes in reoperative orchiopexy.  J Pediatr Surg. 1999;  34 424-425
• 10 Pesce C, d’Agostino S, Costa L. et al . Reoperative orchiopexy: Surgical aspects and functional outcome.  Pediatr Surg Int. 2001;  17 62-64
• 11 Redman JF. Inguinal reoperation for undescended testis and hernia: Approach to the spermatic cord through the cremaster fascia.  J Urol. 2000;  164 1705-1707
• 12 Taran I, Elder JS. Results of orchiopexy for the undescended testis.  World J Urol. 2006;  24 231-239

Notice:
This article was changed according to the following erratum on May 13th 2010.

Erratum:
This article was published with a misspelled author's name. The authors are: I. Karaman, A. Karaman, D. Erdoğan, Y. H. Çavuşoğlu

Correspondence