High Transverse Scrotal Incision Orchiopexy for Undescended Testes. 2019

M S Ali, and N Khan, and M B Uddin, and M S Hossain, and L Mushtabshirah
Dr Mohammad Showkot Ali, Assistant Professor, Department of Paediatric Surgery, Mymensingh Medical College (MMC), Mymensingh, Bangladesh.

Bianchi squire first described scrotal incision orchiopexy as an alternative to the traditional approach in the1980s. In maximum premature and some mature infants, palpable testis is a common surgical problem. There are several surgical technique applied to overcome this surgical problems like combined inguinal and scrotal incision or single high transverse scrotal incision. The goal of this study assessed single high transverse scrotal incision for the management of PUT as regards to evaluate operative time, postoperative success and final cosmetic results. One hundred twenty patients were managed at the Paediatric Surgery Department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh with PUT during the period from 2015 to March 2018. We operated all cases between 6 to 12 months and excluded more than 12 months of age and recurrent cases. This technique involves manipulation of the testis down to the scrotum so that it is secured between the thumb and index finger as a fixation is performed. After fixation of testis high transverse scrotal incision was given, all layers were separated. Then enter into inguinal cannel by cutting of external ring. After dissecting the testis come down through the incision. After making dartos pouch through the same incision and orchidopexy done. All infants were followed-up at 1 month, 2 months and 6 months to detect operative times as well as position, testicular atrophy and the final cosmetic appearance. Patient age ranged from 6 months to 12 months. A total of 120 PUTs were operated upon in 100 patients. PUT was bilateral in 15 patients, right-sided in 55 cases and left-sided in 30 cases. Among 120 testes 40 testes were located distal to external inguinal ring (EIR), 70 testes were at internal inguinal ring (IIR) and 10 testes were in between EIR and IIR. A total of 100 patients were successfully placed within scrotum using a single incision. Operative time ranged from 20-36 minutes. There were no cases of testicular atrophy or ascent. The only complications were 3 wound infections (3%), which were successfully treated with antibiotics. Single high transverse scrotal incision was sufficient to deal with PUT especially, in young infants (age 6 months). The procedure results in shorter operative times, similar success and complication rates, and a more cosmetically appealing outcome compared to inguinal orchiopexy.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003456 Cryptorchidism A developmental defect in which a TESTIS or both TESTES failed to descend from high in the ABDOMEN to the bottom of the SCROTUM. Testicular descent is essential to normal SPERMATOGENESIS which requires temperature lower than the BODY TEMPERATURE. Cryptorchidism can be subclassified by the location of the maldescended testis. Testis, Undescended,Abdominal Cryptorchidism,Bilateral Cryptorchidism,Cryptorchidism, Unilateral Or Bilateral,Cryptorchism,Inguinal Cryptorchidism,Testes, Undescended,Undescended Testis,Unilateral Cryptorchidism,Cryptorchidism, Abdominal,Cryptorchidism, Bilateral,Cryptorchidism, Inguinal,Cryptorchidism, Unilateral,Undescended Testes
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001459 Bangladesh A country in Southern Asia, bordering the Bay of Bengal, between Burma and India. The capital is Dhaka.
D012611 Scrotum A cutaneous pouch of skin containing the testicles and spermatic cords. Scrotums
D056126 Orchiopexy A surgical procedure in which an undescended testicle is sutured inside the SCROTUM in male infants or children to correct CRYPTORCHIDISM. Orchiopexy is also performed to treat TESTICULAR TORSION in adults and adolescents. Laparoscopic Orchiopexy,Orchidopexy,Laparoscopic Orchiopexies,Orchidopexies,Orchiopexies,Orchiopexies, Laparoscopic,Orchiopexy, Laparoscopic
D061646 Operative Time The duration of a surgical procedure in hours and minutes. Length of Operative Time,Surgical Time,Time Length of Surgery,Operative Time Length,Operative Time Lengths,Operative Times,Surgery Time Length,Surgery Time Lengths,Surgical Times,Time Length, Operative,Time Lengths, Operative,Time, Operative,Time, Surgical,Times, Operative,Times, Surgical

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