Surgical Management of Undescended Testis - Timetable and Outcome: A Debate

Thorup, Jørgen; Cortes, Dina

doi:10.1159/000496417

Cited by 22 publications

(28 citation statements)

References 64 publications

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“…Cryptorchid individuals have been found to have higher levels of gonadotropins and lower levels of inhibin. 2,[20][21][22][23] In unilateral cryptorchidism, the undescended testis is typically smaller than the normally positioned one, which typically hypertrophies to compensate for the reduced function of the contralateral testis. 22,24 Testicular volume has been estimated by various means: the orchidometer of Prader and Rochester, rulers, and ultrasonographically.…”

Section: Discussionmentioning

confidence: 99%

Correlation between testicular volume and histological findings in children with unilateral cryptorchidism: Potential impact on future fertility

et al. 2021

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Objectives: Our aim is to assess the correlation between testicular volume and histological findings in children with unilateral cryptorchidism. Methods: From September 2016 to August 2018, from 60 patients surgically treated for cryptorchidism, 45 children were enrolled in this single-center prospective study. Depending on the degree of testicular volume reduction, patients were divided into Group 1 with <20% reduction and Group 2 with reduction ⩾20%. Patients underwent unilateral orchidopexy and simultaneous biopsy of the undescended testis. Tanner stage was assigned. Tubular Fertility Index was measured. Results: Group 1 included 20 patients (44.4%) and Group 2 included 25 patients (55.5%). Mean age was 2.10 years (range 12 months–3.8 years) in Group 1 and 2.8 years (range 18 months–4.41 years) in Group 2. Although there is a positive correlation between testicular volume and Tubular Fertility Index, no significant association was found between groups ( p-value = 0.29). Furthermore, histological patterns did not differ significantly among groups. Conclusions: The degree of volume reduction in undescended testis does not seem to correlate significantly with the severity of histological changes that accompany cryptorchidism. Tubular Fertility Index could serve as objective tool for the assessment of future fertility.

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Section: Discussionmentioning

confidence: 99%

Correlation between testicular volume and histological findings in children with unilateral cryptorchidism: Potential impact on future fertility

et al. 2021

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“…The best time to perform orchiopexy is between 6 to 12 months of age [10]. Many operative procedures were presented for treatment of Cryptorchidism whoever palpable or non-palpable testis [11,12]. All these procedures faced short spermatic cord problem by producing traction on testis and spermatic cord by sutures for some time and make procedure multiple stages.…”

Section: Discussionmentioning

confidence: 99%

Lasheen technique for lengthening of spermatic cord in management cryptorchidism (Lasheen spiral spring)

Lasheen¹

2020

J Surg Surgical Res

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Background: Undescended testis is the most common anomaly of male genitalia. In these cases the testis lies at any position other than the normal scrotal position. The goal of surgery is to move the testis to scrotum, but short spermatic cord represent the big problem. Our study offers new technique for lengthening spermatic cord depends on tissue expansion theory. Methods: Twenty one undescended high inguinal testis patients were included in our study. After complete dissection of testis and spermatic cord of surrounding tissue through inguinal incision. Fine spring made of delicate steel spiral wire was put around cord to produce fi ne continuous pushing force on testis and spermatic cord toward the scrotum. The inguinal wound was closed with spiral spring in right position and proximal end of spring fi xed at the skin by one stitch. After the testis reach normal scrotal position, the spring removed by applied light traction with clockwise rotation on proximal spring end. The mean follow up period was 12 months (ranging from 6 to 18 months). Results: The mean patients age was 2.5 years (ranging from 1 to 4 years). Congenital inguinal hernia sacs were presented in 15 cases, which excised during surgery. The time needed for putting the testis at the bottom of scrotum ranged from 3 to 4 weeks. The testis was normal in position, vasculature, and size during follow up period by manual examination and Doppler study. Conclusion: Lasheen technique for lengthening of spermatic cord is safe, easy, and effective in management of undescended testis.

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“… • Children diagnosed as cryptorchidism or hydrocele via physical examination and ultrasound and other related examinations 9 , 10 ; • Children who need to be hospitalized for laparoscopic surgery; • Children whose parents know and sign the consent form; • Children who can cooperate and accurately describe their subjective symptoms and feelings; • Children aged 5-12 years old. …”

Section: Methodsmentioning

confidence: 99%

“…• Children diagnosed as cryptorchidism or hydrocele via physical examination and ultrasound and other related examinations 9 , 10 ;…”

Section: Methodsmentioning

confidence: 99%

Application of Dexmedetomidine combined with Propofol Intravenous Anesthesia in Laparoscopic Day Surgery in Pediatric Urology

Wang¹,

Yang

Fan³

et al. 2021

Pak J Med Sci

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Objectives: To evaluate the sedative and analgesic effects of dexmedetomidine combined with propofol intravenous anesthesia in laparoscopic day surgery in pediatric urology. Methods: Eighty male children with cryptorchidism and hydrocele who underwent laparoscopic daytime surgery in our hospital from January 2019 to January 2021 were selected and randomly divided into two groups: the experimental group and the control group. Children in the experimental group ranged in age from 5.7 to 11.3, with an average of 8.52±2.17 years old, while those in the control group ranged in age from 5.3 to 12.0, with an average of 8.60±2.07 years old. There were 12 cases of cryptorchidism and 28 cases of hydrocele in the experimental group, and 14 cases of cryptorchidism and 26 cases of hydrocele in the control group. Children in the control group received conventional propofol intravenous combined anesthesia, while those in the experimental group were given dexmedetomidine (2-5 ug/kg) intranasally on the basis of conventional propofol intravenous anesthesia. The anesthetic effect, analgesic effect, serum levels of inflammatory cytokines before and after surgery and adverse drug reactions in the two groups were compared and analyzed. Results: The awakening time, extubation time and retention time in the resuscitation room of the experimental group were shorter than those of the control group, with a statistically significant difference (P<0.05); The VAS pain scores of the experimental group were significantly lower than those of the control group at 15minutes, 12hour and 24hour after awakening, with a statistically significant difference (P<0.05). In addition, the levels of TNF-a, CRP, IL-6 and other inflammatory factors in the control group were significantly higher compared with those in the experimental group 24h after surgery, with a statistical significance (TNF-a, P=0.02; CRP, P=0.00; IL-6, P=0.03); The incidence of adverse drug reactions in the experimental group was 17.5%, while that in the control group was 12.5%, which was not statistically significant (P=0.53). Conclusion: Dexmedetomidine combined with intravenous propofol anesthesia may be helpful to shorten the extubation time, the recovery time and the stay time in the anesthesia resuscative room, improve the analgesic effect, and may reduce the inflammatory response and the expression of serum inflammatory cytokines, with no significant increase in side effects. doi: https://doi.org/10.12669/pjms.38.1.4378 How to cite this:Wang X, Yang B, Fan L, Guo N, Song H. Application of Dexmedetomidine combined with Propofol Intravenous Anesthesia in Laparoscopic Day Surgery in Pediatric Urology. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4378 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Surgical Management of Undescended Testis - Timetable and Outcome: A Debate

Cited by 22 publications

References 64 publications

Correlation between testicular volume and histological findings in children with unilateral cryptorchidism: Potential impact on future fertility

Correlation between testicular volume and histological findings in children with unilateral cryptorchidism: Potential impact on future fertility

Lasheen technique for lengthening of spermatic cord in management cryptorchidism (Lasheen spiral spring)

Application of Dexmedetomidine combined with Propofol Intravenous Anesthesia in Laparoscopic Day Surgery in Pediatric Urology

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