Trans-scrotal Incision Approach versus Traditional Trans-scrotal Incision Orchiopexy in Children with Cryptorchidism: A Randomized Trial Study

Nazem, Masoud; Hosseinpour, Mehrdad; Alghazali, Abdulhakim

doi:10.4103/abr.abr_26_19

Cited by 9 publications

(4 citation statements)

References 26 publications

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“…When the testicles that suffered a complication were divided and compared on the applied surgical approach, there was not estimated any statistically signi cant difference between the inguinal and the scrotal technique. Our results are in line with the literature, as in many previous studies, the rate of success in these two methods and the rate of complications are similar [25,26].…”

Section: Discussionsupporting

confidence: 93%

Comparison of Scrotal Orchiopexy and Traditional Inguinal Orchiopexy for Palpable Undescended and Retractile Testis in Children: A Single Center’s Study in Greece

Florou,

Koletsa,

Raptou

et al. 2024

Preprint

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PURPOSE: Congenital cryptorchidism and retractile testes are two of the commonest abnormalities of the genitourinary system in boys. Orchidopexy is the final surgical treatment for both clinical conditions. It can be applied either with the traditional two-incision inguinal approach, or with the single-scrotal incision technique. This study aimed to investigate the complications of each orchidopexy procedure in a pediatric surgery department, and then to compare the traditional two-incision with the single incision technique in children diagnosed with cryptorchidism or retractile testes. METHODS: A retrospective analysis of patients with congenital cryptorchidism or retractile testes who underwent orchidopexy from 2015 to 2019 was conducted. Diagnosis, patients’ details, the applied orchidopexy technique, the short-term complications and the long-term complications were recorded. Patients were separated based on the applied orchidopexy either two-incision inguinal approach or single-incision scrotal orchidopexy, and a descriptive statistical analysis followed. RESULTS: We identified 362 children who underwent 443 orchidopexies. The 227 of them were inguinal orchidopexies and the 216 were scrotal orchidopexies. Sixteen orchidopexies (3.6%) applied in fourteen patients (3.8%) had complications. The short-term complications were in four cases (0.9%) and included wound dehiscence. The long-term complications regarding the rest twelve cases (2.7%) included: the recurrence of cryptorchidism for 6 testes (1.3%), the testicular atrophy for 3 patients (0.6%), the presentation of hydrocele and inguinal hernia for 2 (0.4%) and 1 (0.2%) patient respectively. For the 13 out of the 16 orchidopexies the preoperative diagnosis was congenital cryptorchidism, p=0.01, and 12 of them were performed with the two-incision inguinal technique, p=0.07. CONCLUSIONS: The diagnosis of cryptorchidism associates with the orchidopexy complications. Specifically, the preoperative diagnosis of congenital cryptorchidism is a possible risk factor of complications in comparison with the retractile testis diagnosis. Regarding the surgical technique, the single scrotal orchidopexy is a safe management for the palpable undescended testes, in comparison to the two-incision, inguinal orchidopexy. Concerning the high-lying cases of undescended testes, although the single scrotal technique provides also good results and low complication rate, more prospective studies with selected impalpable UDT cases are needed to compete the existing literature.

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Section: Discussionsupporting

confidence: 93%

Comparison of Scrotal Orchiopexy and Traditional Inguinal Orchiopexy for Palpable Undescended and Retractile Testis in Children: A Single Center’s Study in Greece

Florou,

Koletsa,

Raptou

et al. 2024

Preprint

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“…In our study, the mean age of the included patients was 1.7 years in group 1 and 1.9 in group 2, which agree with the results of previous studies [11][12][13] . However, disagree with Al-Mandil et al [14] , who found that the mean age of patients was older than 4 years.…”

Section: Discussionsupporting

confidence: 92%

“…This is in line with several studies [14][15][16]21] . However, this disagrees with Nazem et al [11] , who reported 5 cases of testicular atrophy in the scrotal incision group and 4 cases in the traditional group. This disagreement may be explained by their larger sample size as they included 50 patients in each study group.…”

Section: Discussioncontrasting

confidence: 59%

A Comparative Study between Single Scrotal Incision Orchiopexy and Traditional Inguinal Approach in Treatment of Children with Palpable Low-Lying Undescended Testis

Zaki

Elshamy

Moussa

2023

International Journal of Medical Arts

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Article informationBackground: The management of undescended testis encompasses both endocrine therapy and surgical intervention. Nevertheless, the efficacy of endocrine therapy is imprecise and linked with unfavorable outcomes. Consequently, surgical intervention remains the favored approach for addressing cases of undescended testis. Aim of the work:We aimed to compare the outcomes of single scrotal incision orchiopexy versus the traditional inguinal approach in the treatment of children suffering from the palpable low-lying undescended testis [PUDT].Patients and Methods: This is a prospective randomized controlled comparative study that included 40 patients presented with palpable low-lying undescended testis to the pediatric surgery outpatient clinic and admitted to the pediatric surgery unit at the general surgery department of Al-Azhar University Hospitals, Assiut. Patients were randomly divided into 2 equal groups 20 patients each: Group 1: underwent the traditional inguinal approach for orchiopexy. Group 2: underwent single scrotal incision orchiopexy. Results:As regards the operative time, we found that the mean operative time was higher in group 1 than in group 2 [30.5, and 22 minutes respectively], with a statistically significant difference between the two groups [P value = 0.001]. As regards the postoperative complications, we found that five patients [25%] in group 1 developed complications which is higher than that of group 2 in which the total reported complications were in 3 [15%.] patients. In terms of Wound infections and dehiscence, they were the most common postoperative complication in our study which represent 45% of the total reported complications. We reported four cases in the traditional inguinal approach orchiopexy group and 2 cases in the single scrotal incision orchiopexy group. Conclusion:As a less invasive surgical option for PUDT, single scrotal incision orchiopexy is safe, effective, promising, and potentially successful.

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“…[7][8][9] Later, other scrotal techniques were used like the high scrotal approach, low scrotal approach & pre-scrotal approach. 10,11 Median Raphe scrotal orchiopexy is through an existing median raphe scar in the scrotum. 12 It has several advantages, including easy access, early recovery, minimal postop complications, and virtually scar-less surgery.…”

Section: A H E a D O F P R I N Tmentioning

confidence: 99%

Single Median Raphe Scrotal incision Orchiopexy: A safe & feasible approach for fixation of Palpable Undescended testes

Jan¹,

Hassan²,

Shalaan³

et al. 2021

Pak J Med Sci

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Background: We wish to share our outcome of single median raphe scrotal incision orchiopexy (SMRSO) regarding safety & feasibility of technique by evaluating ease of access, conversion rate, duration of surgery, success rate, complications, and the need for redo-surgery. Methods: We retrospectively analyzed data of 277 orchiopexies performed in our department on 224 patients operated on between June 2016 to June 2019. SMRSO was considered for palpable testes that can be brought to the upper limit of the scrotum under anesthesia. The conventional inguinoscrotal approach was used for high lying testes. A median raphe incision was made to access & mobilize the testis on either side, ligation of processus vaginalis performed, and the testes secured in the scrotal pouch. The approach was utilized for both unilateral and bilateral orchiopexies. Follow-up done at one week, one month & six months to evaluate the outcome. Results: A total of 277 orchiopexies were performed in 224 patients. 237 (86%) orchiopexies were via the median raphe scrotal approach in 184 patients. Out of these, 53 cases had bilateral orchiopexies. 30 (11%) performed via a conventional inguinoscrotal approach and 10 (4%) by laparoscopic approach. The mean duration of surgery for SMRSO was 24 minutes for unilateral and 42 minutes for bilateral cases. Immediate postoperative complications included scrotal hematoma in three (1.6%) cases, Hematoma of the abdominal wall in one case, and scrotal edema in 4 (2%) patients. All complications were treated conservatively & resolved. No wound infection or testicular atrophy was reported. Long-term complications included testicular ascend in three cases [1.6%]. Conclusion: Single-incision Median Raphe Scrotal orchiopexy is an attractive alternative to the standard inguinoscrotal orchiopexy for palpable low lying undescended testes with a better cosmetic outcome. doi: https://doi.org/10.12669/pjms.37.7.4261 How to cite this:Jan IA, Hassan M, Shalaan I, Alshehhi MA. Single Median Raphe Scrotal incision Orchiopexy: A safe & feasible approach for fixation of Palpable Undescended testes. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4261 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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Trans-scrotal Incision Approach versus Traditional Trans-scrotal Incision Orchiopexy in Children with Cryptorchidism: A Randomized Trial Study

Cited by 9 publications

References 26 publications

Comparison of Scrotal Orchiopexy and Traditional Inguinal Orchiopexy for Palpable Undescended and Retractile Testis in Children: A Single Center’s Study in Greece

Comparison of Scrotal Orchiopexy and Traditional Inguinal Orchiopexy for Palpable Undescended and Retractile Testis in Children: A Single Center’s Study in Greece

A Comparative Study between Single Scrotal Incision Orchiopexy and Traditional Inguinal Approach in Treatment of Children with Palpable Low-Lying Undescended Testis

Single Median Raphe Scrotal incision Orchiopexy: A safe & feasible approach for fixation of Palpable Undescended testes

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