Surgical Management of Undescended Testis in Infants, Single Scrotal Incision Orchiopexy Versus Traditional Inguinal Approach: A Comparative Study

Omar Atef Elekiabi; Ehab Mahroos Oraby; Mohamed Abdallah Zaitoun; Abdelwahab Saleh Almoregy

doi:doi:10.11648/j.js.20200805.13

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Surgical Management of Undescended Testis in Infants, Single Scrotal Incision Orchiopexy Versus Traditional Inguinal Approach: A Comparative Study

Omar Atef Elekiabi, Ehab Mahroos Oraby, Mohamed Abdallah Zaitoun, Abdelwahab Saleh Almoregy

Published in Journal of Surgery (Volume 8, Issue 5)

Received: 13 June 2020 Accepted: 22 June 2020 Published: 3 September 2020

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Abstract

Background: Surgical intervention is mostly needed in many cases of undescended testis to improve fertility; it is still unsure which approach is better than the other in management of undescended testicle in infants; classic inguinal approach or scrotal single incision approach. Aim of the current study was to compare between classic inguinal approach and scrotal single incision approach to perform orchiopexy for management of un-descended testis in infants and to clarify which is better; inguinal orchidopexy or scrotal orchidopexy. Patients and methods: we included forty male patients with undescended testis who were divided into two groups; group A included twenty patients and they were surgically managed with single trans-scrotal orchiopexy and group B included twenty patients and they were surgically managed with classic inguinal approach by two incisions (inguinal and scrotal). We assessed operative time and complications as wound infection, recurrence and testicular atrophy. Results: Operative time in group A was shorter than the operative time of group B which was managed by the inguinal approach (p=0.004). Immediate post-operative complications as; skin site infection, hematoma and edema, in group A were slightly more than the complications in group B (p=0.002). group A showed no recurrence or testicular atrophy after six months while group B showed 2 cases of recurrence and one case of testicular atrophy (p=0.005). At three months after surgery, cosmetic results and patients satisfaction of the incision scar was higher in group A than group B (p<0.001). Conclusions: performing orchiopexy through single scrotal incision approach is better than the approach of inguinal incision regarding operative time, rabid healing time, parents’ satisfaction, fewer long-term complications, less incidence of testicular atrophy and recurrence.

Published in	Journal of Surgery (Volume 8, Issue 5)
DOI	10.11648/j.js.20200805.13
Page(s)	158-162
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Undescended Testis, Single Scrotal Incision, Inguinal Approach

References

[1]	Badbarin D, Ehsan S, Toomatari M, Aslanabadi S, Farhadi E, Salamat SA. A Comparative Study of Single Scrotal Incision Orchiopexy of Children with Palpable Low-Lying Undescended Testis with Traditional Inguinal Method. Adv Pediatr Surg. 2019 Jun; 25 (1): 14-19.
[2]	Koivusalo A, Taskinen S, Rintala RJ. Cryptorchidism in boys with congenital abdominal wall defects. Pediatr Surg Int 1998; 13: 143-5.
[3]	Aslan Abadi S, Kazemi Rashed F. Study of prevalence of hidden testis in the children under one year in city of Tabriz with study diagnostic role of the social workers in referral system. Med J Tabriz Univ Med Sci 2006; 28: 25-8.
[4]	Esposito C, De Lucia A, Palmieri A, Centonze A, Damiano R, Savanelli A, et al. Comparison of five different hormonal treatment protocols for children with cryptorchidism. Scand J Urol Nephrol 2003; 37: 246-9.
[5]	Shaoguang Feng, Huajun Yang, Xiang Li, Junjia Yang, Jie Zhang, Aihe Wang et al., Single scrotal incision orchiopexy versus the inguinal approach in children with palpable undescended testis: a systematic review and meta-analysis Pediatr Surg Int (2016) 32: 989–995.
[6]	Na SW, Kim SO, Hwang EC, Oh KJ, Jeong SI, Kang TW, et al. Single scrotal incision orchiopexy for children with palpable low-lying undescended testis: early outcome of a prospective randomized controlled study. Korean J Urol 2011; 52: 637-41.
[7]	Karaman I, Karaman A, Erdoğan D, Çavuşoğlu YH. The transscrotal approach for recurrent and iatrogenic undescended testes. Eur J Pediatr Surg 2010; 20: 267-9.
[8]	Zouari M, Dhaou MB, Jallouli M, Mhiri R. Single scrotal-incision orchidopexy for palpable undescended testis in children. Arab J Urol 2015; 13: 112-5.
[9]	Bianchi A, Squire BR. Transscrotal orchidopexy: orchidopexy revised. Pediatr Surg Int 1989; 4: 189-92.
[10]	Lais A, Ferro F (1995) Trans-scrotal approach for surgical correction of cryptorchidism and congenital anomalies of the processus vaginalis. Eur Urol 29 (2): 235–238.
[11]	Thong M, Lim C, Fatimah H. Undescended testes: incidence in 1,002 consecutive male infants and outcome at 1 year of age. Pediatr Surg Int 1998; 13: 37-41.
[12]	Dayanç M, Kibar Y, Tahmaz L, Yildirim I, Peker AF. Scrotal incision orchiopexy for undescended testis. Urology 2004; 64: 1216-8.
[13]	Gordon M, Cervellione RM, Morabito A, Bianchi A. 20 years of transscrotal orchidopexy for undescended testis: results and outcomes. J Pediatr Urol 2010; 6: 506–12.
[14]	Bassel YS, Scherz HC, Kirsch AJ. Scrotal incision orchiopexy for undescended testes with or without a patent processus vaginalis. J Urol 2007; 177: 1516-8.
[15]	Callewaert PR, Rahnama MS, Biallosterski BT, Van Kerrebroeck PE. Scrotal approach to both palpable and impalpable undescended testes: should it become our first choice? Urology 2010; 76: 73–6.
[16]	Ramzan M, Sheikh AH, Qureshi MS, Zubair M, Majid F. Single incision transscrotal versus standard inguino-scrotal orchidopexy in children with palpable undescended testis: our experience from April 2007 to April 2010. Pak J Med Sci 2012; 28: 827–9.

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Omar Atef Elekiabi, Ehab Mahroos Oraby, Mohamed Abdallah Zaitoun, Abdelwahab Saleh Almoregy. (2020). Surgical Management of Undescended Testis in Infants, Single Scrotal Incision Orchiopexy Versus Traditional Inguinal Approach: A Comparative Study. Journal of Surgery, 8(5), 158-162. https://doi.org/10.11648/j.js.20200805.13

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ACS Style

Omar Atef Elekiabi; Ehab Mahroos Oraby; Mohamed Abdallah Zaitoun; Abdelwahab Saleh Almoregy. Surgical Management of Undescended Testis in Infants, Single Scrotal Incision Orchiopexy Versus Traditional Inguinal Approach: A Comparative Study. J. Surg. 2020, 8(5), 158-162. doi: 10.11648/j.js.20200805.13

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AMA Style

Omar Atef Elekiabi, Ehab Mahroos Oraby, Mohamed Abdallah Zaitoun, Abdelwahab Saleh Almoregy. Surgical Management of Undescended Testis in Infants, Single Scrotal Incision Orchiopexy Versus Traditional Inguinal Approach: A Comparative Study. J Surg. 2020;8(5):158-162. doi: 10.11648/j.js.20200805.13

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@article{10.11648/j.js.20200805.13,
  author = {Omar Atef Elekiabi and Ehab Mahroos Oraby and Mohamed Abdallah Zaitoun and Abdelwahab Saleh Almoregy},
  title = {Surgical Management of Undescended Testis in Infants, Single Scrotal Incision Orchiopexy Versus Traditional Inguinal Approach: A Comparative Study},
  journal = {Journal of Surgery},
  volume = {8},
  number = {5},
  pages = {158-162},
  doi = {10.11648/j.js.20200805.13},
  url = {https://doi.org/10.11648/j.js.20200805.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200805.13},
  abstract = {Background: Surgical intervention is mostly needed in many cases of undescended testis to improve fertility; it is still unsure which approach is better than the other in management of undescended testicle in infants; classic inguinal approach or scrotal single incision approach. Aim of the current study was to compare between classic inguinal approach and scrotal single incision approach to perform orchiopexy for management of un-descended testis in infants and to clarify which is better; inguinal orchidopexy or scrotal orchidopexy. Patients and methods: we included forty male patients with undescended testis who were divided into two groups; group A included twenty patients and they were surgically managed with single trans-scrotal orchiopexy and group B included twenty patients and they were surgically managed with classic inguinal approach by two incisions (inguinal and scrotal). We assessed operative time and complications as wound infection, recurrence and testicular atrophy. Results: Operative time in group A was shorter than the operative time of group B which was managed by the inguinal approach (p=0.004). Immediate post-operative complications as; skin site infection, hematoma and edema, in group A were slightly more than the complications in group B (p=0.002). group A showed no recurrence or testicular atrophy after six months while group B showed 2 cases of recurrence and one case of testicular atrophy (p=0.005). At three months after surgery, cosmetic results and patients satisfaction of the incision scar was higher in group A than group B (pConclusions: performing orchiopexy through single scrotal incision approach is better than the approach of inguinal incision regarding operative time, rabid healing time, parents’ satisfaction, fewer long-term complications, less incidence of testicular atrophy and recurrence.},
 year = {2020}
}

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TY  - JOUR
T1  - Surgical Management of Undescended Testis in Infants, Single Scrotal Incision Orchiopexy Versus Traditional Inguinal Approach: A Comparative Study
AU  - Omar Atef Elekiabi
AU  - Ehab Mahroos Oraby
AU  - Mohamed Abdallah Zaitoun
AU  - Abdelwahab Saleh Almoregy
Y1  - 2020/09/03
PY  - 2020
N1  - https://doi.org/10.11648/j.js.20200805.13
DO  - 10.11648/j.js.20200805.13
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 158
EP  - 162
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20200805.13
AB  - Background: Surgical intervention is mostly needed in many cases of undescended testis to improve fertility; it is still unsure which approach is better than the other in management of undescended testicle in infants; classic inguinal approach or scrotal single incision approach. Aim of the current study was to compare between classic inguinal approach and scrotal single incision approach to perform orchiopexy for management of un-descended testis in infants and to clarify which is better; inguinal orchidopexy or scrotal orchidopexy. Patients and methods: we included forty male patients with undescended testis who were divided into two groups; group A included twenty patients and they were surgically managed with single trans-scrotal orchiopexy and group B included twenty patients and they were surgically managed with classic inguinal approach by two incisions (inguinal and scrotal). We assessed operative time and complications as wound infection, recurrence and testicular atrophy. Results: Operative time in group A was shorter than the operative time of group B which was managed by the inguinal approach (p=0.004). Immediate post-operative complications as; skin site infection, hematoma and edema, in group A were slightly more than the complications in group B (p=0.002). group A showed no recurrence or testicular atrophy after six months while group B showed 2 cases of recurrence and one case of testicular atrophy (p=0.005). At three months after surgery, cosmetic results and patients satisfaction of the incision scar was higher in group A than group B (pConclusions: performing orchiopexy through single scrotal incision approach is better than the approach of inguinal incision regarding operative time, rabid healing time, parents’ satisfaction, fewer long-term complications, less incidence of testicular atrophy and recurrence.
VL  - 8
IS  - 5
ER  -

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Author Information

Omar Atef Elekiabi

Department of Pediatric Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Ehab Mahroos Oraby

Department of General Surgery, Faculty of Medicine, Benha University, Benha, Egypt
Mohamed Abdallah Zaitoun

Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Abdelwahab Saleh Almoregy

Department of General Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt

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APA Style

Omar Atef Elekiabi, Ehab Mahroos Oraby, Mohamed Abdallah Zaitoun, Abdelwahab Saleh Almoregy. (2020). Surgical Management of Undescended Testis in Infants, Single Scrotal Incision Orchiopexy Versus Traditional Inguinal Approach: A Comparative Study. Journal of Surgery, 8(5), 158-162. https://doi.org/10.11648/j.js.20200805.13

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ACS Style

Omar Atef Elekiabi; Ehab Mahroos Oraby; Mohamed Abdallah Zaitoun; Abdelwahab Saleh Almoregy. Surgical Management of Undescended Testis in Infants, Single Scrotal Incision Orchiopexy Versus Traditional Inguinal Approach: A Comparative Study. J. Surg. 2020, 8(5), 158-162. doi: 10.11648/j.js.20200805.13

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AMA Style

Omar Atef Elekiabi, Ehab Mahroos Oraby, Mohamed Abdallah Zaitoun, Abdelwahab Saleh Almoregy. Surgical Management of Undescended Testis in Infants, Single Scrotal Incision Orchiopexy Versus Traditional Inguinal Approach: A Comparative Study. J Surg. 2020;8(5):158-162. doi: 10.11648/j.js.20200805.13

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@article{10.11648/j.js.20200805.13,
  author = {Omar Atef Elekiabi and Ehab Mahroos Oraby and Mohamed Abdallah Zaitoun and Abdelwahab Saleh Almoregy},
  title = {Surgical Management of Undescended Testis in Infants, Single Scrotal Incision Orchiopexy Versus Traditional Inguinal Approach: A Comparative Study},
  journal = {Journal of Surgery},
  volume = {8},
  number = {5},
  pages = {158-162},
  doi = {10.11648/j.js.20200805.13},
  url = {https://doi.org/10.11648/j.js.20200805.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200805.13},
  abstract = {Background: Surgical intervention is mostly needed in many cases of undescended testis to improve fertility; it is still unsure which approach is better than the other in management of undescended testicle in infants; classic inguinal approach or scrotal single incision approach. Aim of the current study was to compare between classic inguinal approach and scrotal single incision approach to perform orchiopexy for management of un-descended testis in infants and to clarify which is better; inguinal orchidopexy or scrotal orchidopexy. Patients and methods: we included forty male patients with undescended testis who were divided into two groups; group A included twenty patients and they were surgically managed with single trans-scrotal orchiopexy and group B included twenty patients and they were surgically managed with classic inguinal approach by two incisions (inguinal and scrotal). We assessed operative time and complications as wound infection, recurrence and testicular atrophy. Results: Operative time in group A was shorter than the operative time of group B which was managed by the inguinal approach (p=0.004). Immediate post-operative complications as; skin site infection, hematoma and edema, in group A were slightly more than the complications in group B (p=0.002). group A showed no recurrence or testicular atrophy after six months while group B showed 2 cases of recurrence and one case of testicular atrophy (p=0.005). At three months after surgery, cosmetic results and patients satisfaction of the incision scar was higher in group A than group B (pConclusions: performing orchiopexy through single scrotal incision approach is better than the approach of inguinal incision regarding operative time, rabid healing time, parents’ satisfaction, fewer long-term complications, less incidence of testicular atrophy and recurrence.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Surgical Management of Undescended Testis in Infants, Single Scrotal Incision Orchiopexy Versus Traditional Inguinal Approach: A Comparative Study
AU  - Omar Atef Elekiabi
AU  - Ehab Mahroos Oraby
AU  - Mohamed Abdallah Zaitoun
AU  - Abdelwahab Saleh Almoregy
Y1  - 2020/09/03
PY  - 2020
N1  - https://doi.org/10.11648/j.js.20200805.13
DO  - 10.11648/j.js.20200805.13
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 158
EP  - 162
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20200805.13
AB  - Background: Surgical intervention is mostly needed in many cases of undescended testis to improve fertility; it is still unsure which approach is better than the other in management of undescended testicle in infants; classic inguinal approach or scrotal single incision approach. Aim of the current study was to compare between classic inguinal approach and scrotal single incision approach to perform orchiopexy for management of un-descended testis in infants and to clarify which is better; inguinal orchidopexy or scrotal orchidopexy. Patients and methods: we included forty male patients with undescended testis who were divided into two groups; group A included twenty patients and they were surgically managed with single trans-scrotal orchiopexy and group B included twenty patients and they were surgically managed with classic inguinal approach by two incisions (inguinal and scrotal). We assessed operative time and complications as wound infection, recurrence and testicular atrophy. Results: Operative time in group A was shorter than the operative time of group B which was managed by the inguinal approach (p=0.004). Immediate post-operative complications as; skin site infection, hematoma and edema, in group A were slightly more than the complications in group B (p=0.002). group A showed no recurrence or testicular atrophy after six months while group B showed 2 cases of recurrence and one case of testicular atrophy (p=0.005). At three months after surgery, cosmetic results and patients satisfaction of the incision scar was higher in group A than group B (pConclusions: performing orchiopexy through single scrotal incision approach is better than the approach of inguinal incision regarding operative time, rabid healing time, parents’ satisfaction, fewer long-term complications, less incidence of testicular atrophy and recurrence.
VL  - 8
IS  - 5
ER  -

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