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Background: Surgical intervention is mostly needed in many cases of undescended testis to improve fertility; it is still unsure which approach is better than the other in management of undescended testicle in infants; classic inguinal approach or scrotal single incision approach. Aim of the current study was to compare between classic inguinal approach and scrotal single incision approach to perform orchiopexy for management of un-descended testis in infants and to clarify which is better; inguinal orchidopexy or scrotal orchidopexy. Patients and methods: we included forty male patients with undescended testis who were divided into two groups; group A included twenty patients and they were surgically managed with single transscrotal orchiopexy and group B included twenty patients and they were surgically managed with classic inguinal approach by two incisions (inguinal and scrotal). We assessed operative time and complications as wound infection, recurrence and testicular atrophy. Results: Operative time in group A was shorter than the operative time of group B which was managed by the inguinal approach (p=0.004). Immediate post-operative complications as; skin site infection, hematoma and edema, in group A were slightly more than the complications in group B (p=0.002). group A showed no recurrence or testicular atrophy after six months while group B showed 2 cases of recurrence and one case of testicular atrophy (p=0.005). At three months after surgery, cosmetic results and patients satisfaction of the incision scar was higher in group A than group B (p<0.001). Conclusions: performing orchiopexy through single scrotal incision approach is better than the approach of inguinal incision regarding operative time, rabid healing time, parents' satisfaction, fewer long-term complications, less incidence of testicular atrophy and recurrence.

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