An Experimental Study of Methods to Produce Intrascrotal Testicular Fixation

Rodriguez, Luis; Kaplan, George W.

doi:10.1016/s0022-5347(17)42526-2

Cited by 41 publications

(14 citation statements)

References 18 publications

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“…In fact, experimentally, when the tunica vaginalis is everted, scarification had similar efficacy to suture fixation. 35 As noted previously, in another experimental model, Ribeiro et al demonstrated that suture testicular fixation resulted in adverse histological consequences. 16 In a clinical study of 22 men who underwent prepubertal orchiopexy with chromic testicular fixation, US demonstrated tunica albuginea calcification in 32% and subtunical hypoechogenicity in 14%.…”

Section: Transparenchymal Suture Fixationmentioning

confidence: 60%

Surgical Management of the Undescended Testis: Recent Advances and Controversies

Elder

2016

Eur J Pediatr Surg

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Undescended testis (UDT) is the most common disorder of sexual development in boys and affects 3.5% of male newborns. Although approximately half of newborn UDTs descend spontaneously, some boys develop an ascending testis later in childhood. Recent guideline recommendations advocate orchiopexy by 18 months of age to maximize potential for fertility and perhaps reduce the risk for testicular carcinoma in the future. For palpable testes, a standard inguinal approach is appropriate. However, the prescrotal approach is often effective for low inguinal testes and reduces surgical time and patient discomfort with an equivalent success rate in boys with an ascending testis. Some advocate monitoring until adolescence to determine whether the testis will spontaneously descend into the scrotum, but data do not support this approach. Instead, prompt orchiopexy is recommended. In boys with a nonpalpable testis, approximately 50% are abdominal or high in the inguinal canal and 50% are atrophic, typically in the scrotum. Routine inguinal/scrotal ultrasound is not recommended, although in an older boy who is overweight, it is appropriate. If the patient has contralateral testicular hypertrophy, scrotal exploration is appropriate, and removal of the testicular remnant and contralateral scrotal orchiopexy to prevent future contralateral testicular torsion is recommended. In most cases, diagnostic laparoscopy is advised to determine whether the testis is abdominal. For the abdominal testis, there are numerous treatment options. If the testis is mobile or a peeping testis just distal to the internal inguinal ring, standard one-stage laparoscopic or open orchiopexy should be attempted using the Prentiss maneuver. If the testicular vessels are short or the testis is not mobile, a two-stage Fowler-Stephens orchiopexy is appropriate. The second stage can be performed laparoscopically or open. Another option is microvascular testicular autotransplantation, which is a technically demanding procedure. Surgical results of abdominal orchiopexy are highly variable, short term, and highly subjective. Prospective clinical trials with follow-up into adolescence and adulthood are necessary to assess the success of various surgical approaches.

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Section: Transparenchymal Suture Fixationmentioning

confidence: 60%

Surgical Management of the Undescended Testis: Recent Advances and Controversies

Elder

2016

Eur J Pediatr Surg

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“…Our technique of orchidopexy offers the combined advantages of eversion of the tunica vaginalis, which has been shown previously to produce excellent fixation to the scrotal wall and avoidance of injury to testicular parenchyma, whilst offering an additional protection from re‐torsion in the form of non‐absorbable sutures through the tunica vaginalis into the posterior scrotal wall. There is also an additional benefit of perceived reduced scrotal discomfort after surgery, as chronic irritation of tunica albuginea by sutures is avoided.…”

Section: Discussionmentioning

confidence: 99%

A novel method of scrotal orchidopexy: description of the technique and short‐term outcomes

et al. 2012

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“…Rodriguez and Kaplan carried out a similar study, re‐exploring the testes at 30 days 16 . However, instead of creating a window in the tunica vaginalis, the tunica vaginalis was completely everted and sutured behind the testis, as in the Jaboulay hydrocele repair, without any testicular fixation sutures.…”

Section: Techniques To Produce Testicular Fixationmentioning

confidence: 99%

Recurrent torsion after previous testicular fixation

Sells

Moretti

Burfield

2002

ANZ Journal of Surgery

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The higher incidence of recurrent torsion after fixation using absorbable rather than non-absorbable sutures in the literature may be caused by a greater number of fixations being carried out using absorbable suture. Use of non-absorbable suture is limited by the high rate of abscess formation. The most important factor for adhesion formation would appear to be the eversion of the tunica vaginalis and it is recommended that this is carried out at all testicular fixations.

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An Experimental Study of Methods to Produce Intrascrotal Testicular Fixation

Cited by 41 publications

References 18 publications

Surgical Management of the Undescended Testis: Recent Advances and Controversies

Surgical Management of the Undescended Testis: Recent Advances and Controversies

A novel method of scrotal orchidopexy: description of the technique and short‐term outcomes

Recurrent torsion after previous testicular fixation

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