Laparoscopic orchidopexy in persistent Mullerian duct syndrome

Abstract

Purpose When faced with the diagnosis of PMDS, the question still remains as to  what is the best approach to Müllerian structures. The aim of this study was to  describe a novel operative approach considering the vascular anatomy and malignant potential of these structures.
Methods Two boys with PMDS underwent orchidopexy by means of en-masse descent of Müllerian-gonad complex onto the scrotum. The gonads were biopsied and fixed in the scrota and the Müllerian structures occupied the region of the median raphe.
Results The operating time was the same as that taken for orchidopexy. The children were discharged on the day after surgery and were well at 6-month follow-up.
Conclusion The preservation of Müllerian structures and placement in the scrotum allow for easy palpation and recognition of changes in size and consistency  heralding malignancy. The risk of operative injury to the vas and vessels is minimized.

Keywords: laparoscopic orchidopexy, persistent Mu¨ llerian duct syndrome, undescended testis