Trans-scrotal single-incision orchidopexy compared with conventional orchidopexy in palpable undescended testis in a Nigerian Tertiary Hospital

Abstract

Background The standard method of treatment of palpable undescended testes is  through inguinal mobilization and a scrotal sub-dartos pouch. Trans-scrotal single-incision orchidopexy may be a suitable alternative.

Aim The aim of this study was to assess as to how trans-scrotal orchidopexy compares with conventional orchidopexy in terms of the suitable placement of the testis in a dependent position in the scrotum and the surgical outcome.

Patients and methods Forty children with 42 palpable undescended testes were randomly allotted into the conventional and the trans-scrotal orchidopexy groups over an 18-month period. The age, the testicular position, the side involved, the length of the vas gained after isolation and the division of the processus vaginalis, as well as the placement of the testes in the sub-dartos pouch without tension, were recorded. Postoperative complications and the subjective score of the cosmetic appearance of the scars during follow-up for at least 6 months. Success was defined as suitable placement of the testes in the sub-dartos pouch during operation, no conversion of patients in the single-orchidopexy group to the conventional inguinal approach, no complications and excellent cosmetic appearance of scars.

Results The two study groups were well matched for age and testicular positions. About 22 (55%) patients had rightsided undescended testes and 16 (40%) had left-sided undescended testes, and in two (5%) patients, it was bilateral. All testes were satisfactorily placed in the subdartos pouch at surgery. Testicular retraction  was observed in one patient in the conventional group, but in two patients in the trans-scrotal group. All wounds healed satisfactorily without infection. The overall wound complication rate in the trans-scrotal and the conventional groups were 2/21 and 3/21, respectively. In terms of the cosmetic appearance of the scar, patients in the trans-scrotal group had excellent cosmetic appearance as the scars were less visible and hidden in the rugal fold compared with the conventional method.

Conclusion Trans-scrotal orchidopexy for palpable undescended testis is simple, safe and has a better cosmetic scar compared with the conventional approach

Keywords: conventional, orchidopexy, testis, trans-scrotal