Undescended testis (UDT) is a developmental defect in which one or both testicles do not arrive in the scrotum. Its prevalence at birth and one year after is 2%–4% and less than 1%, respectively. Currently, surgery is recommended to treat congenital cryptorchidism in order to prevent testicular degeneration. Classic method is performed via incision in inguinal and scrotum and the new method is done via incision in scrotum.
Sixty male participants with 65 UDT undergoing surgery were randomly assigned to scrotal incision (n=31) and classic inguinal incision methods (n=34). Patients were followed for 6 months and testicular atrophy, infection, recurrence, and duration of surgery were compared between two groups.
Scrotal incision compared to classic incision method had significantly lower duration of surgery (19.06±2.96 minutes vs. 30±10.42 minutes; p=0.002) and recurrence during follow-up (0 vs. 5 cases; p=0.026). There was only one surgical site infection in the scrotal incision method. There were hematoma and post-operative swelling in 13.3% of cases after scrotal incision method.
Scrotal incision is an alternative method for the UDT with lower duration of surgery, lower recurrence rate, and better cosmetic results.
Untreated cryptorchidism contributes to infertility and may play a role in increasing the risk of malignancy. The appropriate time of operation was considered before school age in 1970s, 2 years of age in 1980s, and between 1 and 2 years of age from 1990s to present time. Orchiopexy is the most common operation for congenital urological problem of children. We analyze our experience of orchiopexies to evaluate the results and to identify the role of the pediatric surgeon. We reviewed the medical records of 91 patients who underwent orchiopexy from January 1996 to December 2007. The patient age at orchiopexy were as follows: 48 cases (52.7 %) under 2 years of age, 24 cases (26.4 %) between 3 and 5 years, 16 cases (17.6 %) between 6 and 10 years, and 3 cases (3.3 %) over 11 years. Location of testes was preperitoneum in all 91 cases. There were 84 unilateral and 7 bilateral cases. Among the unilateral cases, the undescended testes were on right side in 54 cases and on the left side in 30 cases. The surgical procedure employed in all cases was trans-inguinal orchiopexies. Seventy-nine patients had excellent results. There were 12 complications; 5 cases of wound infection and 7 cases of temporary incomplete descent. Seven cases of incomplete descent have become normal from 3 to 6 months after orchiopexy. According to our results, 43 cases (47.3 %) underwent orchiopexies over 2 years of age. In conclusion, orchiopexies were successful in most cases of cryptorchidism in terms of testicular position and growth. We suggest that pediatric surgeons should educate their primary care physicians and parents concerning the potential complications of cryptorchidism and the appropriate time of operation.
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