20 years of transcrotal orchidopexy for undescended testis: Results and outcomes

Single high scrotal incision orchidopexy for unilateral palpable testis: A randomised controlled study

“…In this study, the complication rates were comparable to other reported in the literature [8] without statistical significant difference between both groups. Some studies reported short mean operative time for scrotal approach.…”

“…The rate of conversion from high scrotal incision to inguinal approach is quite variable in the literature; ranging from 0% to 13%. [8] In this study 3 cases (8.5%) of Group I converted to the classic inguinal approach to gain more cord length. All these 3 cases and the 35 cases from group II had their testis in the scrotum by the end of the procedure.…”

“…However this modification was argued that it does not help to find the testis and does not allow adequate creation of scrotal pouch. [8] But bearing in mind the anatomical difference between the child and adult regarding the inguinal canal; that it is clearly shorter, less oblique plane running in a more antero-posterior direction, skin and subcutaneous tissue are thin and mobile and that nearly 80% of UDT are palpable and low so being amenable for scrotal approach. [3,4,9,10] Bianchi and Squire [3] and Hazebroek et al, [11] confirmed that in the majority of palpable testes neither the vessels nor the vas are the limiting factor but actually after dissection of the cremasteric muscle and PPV if present help to locate the testis into the scrotum without tension.…”

“…Docimo [14] reported that more proximal testes tend to have a poor outcome. However Gordon et al, [8] in their series reported that transcrotal orchidopexy can be attempted for proximal UDT, bearing in mind that if more length is needed to bring the testis into the scrotum a second groin incision can be safely made. Dayanc et al, [13] found that single scrotal incision can be sufficient for orchidopexy in patients with palpable UDT with an overall success rate of 94%.…”

Canadian Urological Association-Pediatric Urologists of Canada (CUA-PUC) guideline for the diagnosis, management, and followup of cryptorchidism

“…[37][38][39][40][41] Evidence suggests that most palpable testicles can be successfully managed through this incision. 37,38 According to a recent review that analyzed 1558 scrotal orchidopexies, recurrence was observed in only nine cases, testicular hypo/atrophy in five, and surgical site infections in 13. A secondary inguinal incision was needed in 3.5% of the boys to facilitate high (proximal) testicular dissection.…”