Our Experience in Transcrotal Orchidopexy in Children Affected by Palpable Undescended Testis/ Досвід трансскротальної орхідопексії в дітей, оперованих з приводу крипторхізму

Eur J Pediatr Surg 2016; 26(01): 013-016
DOI: 10.1055/s-0035-1563674

Salvatore Arena¹, Pietro Impellizzeri¹, Patrizia Perrone¹, Gianfranco Scalfari¹, Antonio Centorrino¹, Nunzio Turiaco¹, Tiziana Russo¹, Pietro Antonuccio¹, Carmelo Romeo¹

• ¹Department of Paediatric, Gynaecological, Microbiological and Biomedical Sciences, University of Messina, Messina, Italy

Abstract

Introduction Classically, surgical approach for palpable undescended testis (pUDT) consists is an inguinal orchidopexy. In fact, a double incision allows an adequate mobilization of the spermatic cord and an easy dissection of a patent processus vaginalis and also to perform a subdartos pouch. For reduce potential mobility of the inguinal approach, in 1989 Bianchi and Squire proposed a transcrotal orchidopexy, using a high scrotal incision. We report our experiences and retrospectively evaluate the feasibility and postoperative success of the transcrotal approach for treatment of pUDT.

Patients and Methods From January 2012 to June 2014, 217 patients, affected by pUDT were treated at our Institution, for a total of 231 orchidopexies (203 monolateral pUDT, 14 bilateral pUDT). Patients, in whom, under anesthesia, the testis could be moved to the neck of the scrotum, have been treated with a transcrotal approach using a high scrotal incision. All patients have been clinically followed up at 1 week and at 1, 2, 3, and 6 months, at 1 year, and then annually and using scrotal sonography with color-Doppler at 2, 3, and 6 months.

Results A total of 205 pUDT (88.7%) were considered eligible for transcrotal. Eight (3.9%) pUDT, that were first approached transcrotally, have been converted to inguinal approach. At follow-up, two moderate scrotal hematomas and one inguinal hernia were noted. No recurrence or testicular atrophy was showed in transcrotal approached testes, while 2 recurrences out of 26 procedures (7.7%) were displayed after inguinal orchidopexy.

Conclusions In our experience, transcrotal approach is possible in almost 90% of pUDT. No major complication, such as recurrence or testicular atrophy, has been complained. Just 3 out of the 205 cases (1.5%) reported minor complications and 1 of which required a successful day-case procedure. Our data confirm that transcrotal orchidopexy can be considered effective, safe, and with a success rate being equivalent or better to classical inguinal approach.