High (trans) scrotal orchidopexy for palpable undescended testes in children: Influence of age and testicular position

Abstract

Objectives: To assess the influence of increasing age of subjects and testicular position on the outcome of single incision orchidopexy.

Subjects and methods: A prospective randomized study of children aged ≤ 15 years with palpable undescended testes. The study was conducted between July 2015 and December 2016 in a Nigerian tertiary hospital. Patients were randomized into two groups: single incision orchidopexy and conventional orchidopexy group by simple balloting. The parameters studied were the patients’ bio-data, most caudal position of the testes, duration of surgery, wound complications such as wound infection, scrotal edema and haematoma. Others included testicular position at 6 months post-operatively, testicular hypotrophy and cosmetic appearance of scar. A p-value <0.05 was deemed significant.

Results: There were 52 patients with 59 testes. Their ages ranged from 1 year to 13 years with a mean of 6.5 ± 3.5 years. The age groups and testicular positions were well matched, p > 0.05. There was no conversion from high scrotal to conventional orchidopexy irrespective of the age and testicular position during surgery. The operative time was shorter in the high scrotal group compared to conventional group, p < 0.05. The rate of testicular reascent between both groups did not attain statistical significance, p > 0.05. Within the high scrotal group, increasing age and testicular location had no influence on the operative time, p > 0.05. There was no statistical significant difference in the rate of testicular retraction between the young and relatively older children among the high scrotal group, p > 0.05. All wounds healed without wound infection, scrotal edema and haematoma.

Conclusion: Increasing age of patients and location of testes had no effect on the outcome of high scrotal orchidopexy in terms of successful placement of testes in the scrotum and rate of testicular retraction  when compared to the conventional orchidopexy. However, the operative time was shorter and the cosmetic appearance of scar was better in the high scrotal group compared to the conventional orchidopexy.

Keywords: High scrotal; Single; Orchidopexy; Outcome; Testicular retraction; Operative time