Outcome Analysis of Redo Orchiopexy: Scrotal vs Inguinal

Lopes, Roberto Iglesias; Naoum, Naimet Kamal; Chua, Michael; Canil, Thomas; Santos, Joana Dos; Farhat, Walid A.

doi:10.1016/j.juro.2016.04.085

Cited by 13 publications

(9 citation statements)

References 14 publications

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“…However when the testis is in a higher position, such as in the inguinal canal or just at the external ring, TSO brings troublesome complications include injury to the vas deferens and testicular vessels. In 2016, Lopes et al published articles about post-operation complications ( 15 , 16 ). Hernia, hydrocele, testicle ascending and atrophy happens, owing to insufficient (retroperitoneal) mobilization of vas and vessels and/or inadequate high ligation of patent processus vaginalis.…”

Section: Discussionmentioning

confidence: 99%

Single-Port Laparoscopic Assisted Transcrotal Orchidopexy for Palpable Inguinal Canalicular Cryptorchidism Accompany With Indirect Inguinal Hernia

Cai

et al. 2018

Front. Pediatr.

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Purpose: To assess the outcomes of a novel laparoscopic assisted transcrotal orchidopexy (LATO) combined with percutaneous extraperitoneal closure (PEC) for palpable inguinal canalicular cryptorchidism accompany with indirect inguinal hernia, and evaluate its safety and efficiency.Materials and Methods: A retrospective cohort study for single-port LATO-PEC and traditional inguinal orchidopexy (TIO) was performed between 2011 and 2014. Totally 53 children with both palpable inguinal canalicular testes and indirect inguinal hernia were included. Median patient age was 15month (range, 6 months to 4 years). Of them, 35 patients underwent LATO-PEC procedure, utilizing an umbilical trocar for laparoscope, transcrotal dissection for orchidopexy, and an inner two-hooked cannula for ligation of the patent processus at the level of the internal ring. Three of them were bilateral, 12 on the left side and 20 on the right. Eighteen patients received TIO, seven of them on the left side and 11 on the right. Patient demographics, surgical technique, complications, and clinical outcomes were reviewed. Follow-up visits were performed to reassess position and size of the testes.Results: All 56 undescended testes were delivered into the scrotum successfully. In the LATO-PEC group, nine contralateral herniorrhaphy were accomplished simultaneously. Fifteen contralateral patent processus vaginalis (PPVs) in 32 unilateral undescended testis (UDT) were newly confirmed during the laparoscopy, while 6 of them received percutaneous extra-peritoneal herniorrhaphy for visible inguinal bubble in pneumoperitoneum condition. No additional port placement or conversion to open procedure was needed. Mean operative time for unilateral and bilateral LATO-PEC in this study was (37.81 ± 5.23) min and (53.33 ± 2.98) min, respectively. In TIO group, mean operative time was (41.11 ± 8.67) min. There was no statistical difference in operative time between the two approaches for unilateral UDTs (p = 0.098). Median follow-up interval was 24 months (range, 12–84 months). No operative complications were found in either group to date.Conclusions: Singe-port LATO-PEC is a safe, effective, and cosmetic choice for inguinal canalicular cryptorchidism accompany with indirect inguinal hernia, minimizing injuries to the vas deferens and testicular vessels. Laparoscopy can provide a diagnostic and therapeutic solution of contralateral PPV.

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Section: Discussionmentioning

confidence: 99%

Single-Port Laparoscopic Assisted Transcrotal Orchidopexy for Palpable Inguinal Canalicular Cryptorchidism Accompany With Indirect Inguinal Hernia

Cai

et al. 2018

Front. Pediatr.

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“…9 As described, all the re-ascent cases reported in this cohort were of severe proximal hypospadias and associated with postoperative hypospadias complication. The reason could be phenotypic-genotypic characteristics with defect in the wound healing and tissue regeneration among this subset of patients.…”

Section: Discussionmentioning

confidence: 52%

Single penile incision for combined hypospadias and inguinal surgery: A comparative study

Chua

Alqarni

Ming

et al. 2017

CUAJ

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Introduction: We sought to compare the surgical outcomes of hypospadias repair with correction of inguinal pathology using a single penile incision vs. conventional approach using two incisions. Methods: This is a retrospective study that reviewed all patients who underwent concurrent surgical repair for both hypospadias and inguinal pathologies between January 2003 and November 2015. Patients were classified into Group A, conventional (inguinal or scrotal and penile incision) approach; or Group B, single penile incision approach. Baseline characteristics, including age, degree of hypospadias, type and laterality of inguinal pathology, operative time, and surgical outcomes, were collected. Between groups, variable comparisons were analyzed using Mann-Whitney U-Test and Fisher-exact test. Statistical significant set at <0.05. Results: Seventy-six patients (Group A: 40; Group B: 36) were eligible for study. Baseline characteristics of both groups were comparable, with no significant statistical difference. Overall mean operative time for Group A was 139.3 ± 56.2 minutes, while Group B was 107.8 ± 46.7 minutes (Z=2.6; U=470.5; p=0.009). Two patients in Group A and two patients in Group B had testicular ascension, all of which also had hypospadias-related complications (p=1.0). Hypospadias-related complications in Group A included seven urethrocutaneous fistulae and two repair dehiscence. Eight urethrocutaneous fistulae, one urethral stricture, and two repair dehiscence occurred in Group B (p=0.448). Surgical outcome appearance in both groups were comparable, with no statistically significant difference (p=0.466). Conclusions: Single penile incision for both hypospadias repair and correction of inguinal pathology is a feasible technique and comparable to the conventional approach, with similar surgical outcomes and shorter overall operative time.

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“…İnmemiş testis operasyonu en sık yapılan ameliyatlardan biri olup testisin indirilememesi ya da nüksü %1-10 arasında bildirilmiştir. Genellikle ilk operasyonlarını dış merkezlerde olan hastalarda detaylı operasyon bilgisi olmadan yeni ameliyatlar gerekmekte ve bu operasyonlar ilkine göre daha zor olan, deneyim, teknik ve özen isteyen vakalar olmaktadır (1)(2)(3)(4)(5).…”

Section: Discussionunclassified

“…Çünkü amaç tüm yetenek, beceri ve bakım tekniklerini kullanarak tes-tisi korumak ve testiküler fonksiyonların zarar görmesini engellemektir. Hidrosel ve inguinal herni onarımı sonrası inmemiş testis en yüksek %2 görülürken bu oran inguinal orşiopeksi sonrası %10-13 olarak bildirilmiştir (1)(2)(3)(4)(5). Sekonder ve tersiyer inmemiş testis onarımlarında inguinal, skrotal, laparoskopik, preperitoneal olmak üzere yazarlar çeşitli metodlarını tarif etmişler ve kendi tekniklerinin testis ve vaz deferensi korumak için en güvenilir teknik old-uğunu savunmuşlardır (1-9).…”

Section: Introductionunclassified

Our Surgical Experiences in Recurrence Undescended Testis

Kaya

Kapısız

Karabulut

et al. 2022

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi

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Amaç: İnmemiş testis nedeniyle ameliyat edilen hastalarda başarı oranı yüksek olmasına rağmen, daha önce inmemiş testis veya inguinal herni/hidrosel onarımı yapılıp sonrasında inmemiş testis gelişen hastalarda cerrahi işlem sırasında daha dikkatli olmak ve testisi korumak için tüm yetenek, beceri ve bakım tekniklerini kullanmak gerekir. Biz de bu çalışma ile kliniğimizde gerçekleştirdiğimiz nüks orşiopeksi deneyimlerimizi rapor ediyoruz. Gereç ve Yöntemler: Ocak 2000- Nisan 2022 yılları arasında tekrar orşiopeksi uygulanan hastaları retrospektif olarak inceledik. Bu hastaların ilk ameliyat sebebi, ilk operasyon yaşı, bu ilk ameliyat ve sonraki ameliyat için bekleme periyodu, ameliyat özellikleri, testisin durumu ve komplikasyonlar değerlendirildi. Bulgular: Toplam 17 hastaya yeniden orşiopeksi ameliyatı gerçekleştirildi. Hastaların ortalama yaşı 3.11±0.84 /yıl(1ay-12y) iken ilk ameliyatla ikinci ameliyat arası bekleme süresi ise 1.23±0.25 /yıl (3ay-4 yıl) idi. 4 hastanın ilk operasyonu inguinal herni veya hidrosel iken, 13 hastanın ilk ameliyatı inmemiş testis nedeniyleydi. Nüks inmemiş testis için yapılan ameliyatların 13’ü sağ (%76.5), 4’ü (%23.5) sol yerleşimliydi. Ameliyatlar sonrasında 3 hastada insizyonda seroma ve 1 hastada hematom meydana geldi. Postoperatif dönemde 4 hastada testis yerleşimi nihai sonuç olarak supraskrotal yerleşimliydi. Takiplerde 2 hastada postoperatif atrofi gelişti. Sonuç: İnmemiş testis operasyonun nükslerinde mutlaka patent procesus vaginalis diseksiyonu yapılmalı ve gerektiğinde farklı metodlarla alternatif üretilebilecek deneyimli merkezler tercih edilmeli ve testisin korunmasına çalışılmalıdır.

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Outcome Analysis of Redo Orchiopexy: Scrotal vs Inguinal

Abstract: Scrotal and inguinal orchiopexy appear to be viable in managing secondarily ascending testes, with the scrotal approach offering some advantage in terms of length of procedure.

Cited by 13 publications

References 14 publications

Single-Port Laparoscopic Assisted Transcrotal Orchidopexy for Palpable Inguinal Canalicular Cryptorchidism Accompany With Indirect Inguinal Hernia

Single-Port Laparoscopic Assisted Transcrotal Orchidopexy for Palpable Inguinal Canalicular Cryptorchidism Accompany With Indirect Inguinal Hernia

Single penile incision for combined hypospadias and inguinal surgery: A comparative study

Our Surgical Experiences in Recurrence Undescended Testis

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