Comparative Study on Surgical Approaches for Undescended Testis

Undescended testis prevalence at birth and one year after is 2%–4% and less than 1%, respectively. Surgical management is the recommended treatment for congenital cryptorchidism in order to prevent testicular degeneration and improve fertility. The surgical approach for undescended testicle in infants is debatable between the classic inguinal approach or scrotal single incision approach.

To clarify this, researchers conducted a comparative study between the classic inguinal approach (inguinal orchidopexy) and the scrotal single incision approach (scrotal orchidopexy) in infants with undescended testis. The trial details were published in the Journal of Surgery in October 2020.

Study Details

A total of 40 male patients with undescended testis were included in the study. They were divided into two groups:

• Group A: Twenty patients underwent single trans-scrotal orchiopexy surgery.
• Group B: Twenty patients underwent inguinal orchidopexy (by two incisions: inguinal and scrotal).

Researchers assessed primary outcomes such as operative time for the surgery and complications such as wound infection, recurrence, and testicular atrophy.

Key Findings

• Researchers found the operation time for Group A (single trans-scrotal orchiopexy) was comparatively less than Group B (inguinal orchidopexy).
• Immediate post-operative complications such as skin site infection, hematoma, and edema were slightly more in Group A than in Group B.
• 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.
• At three months after surgery, cosmetic results and patient satisfaction with the incision scar were higher in Group A than in Group B.

The authors concluded, "performing orchiopexy through a single scrotal incision approach is better than the approach of inguinal incision regarding operative time, rapid healing time, parent's satisfaction, fewer long-term complications, less incidence of testicular atrophy and recurrence".

For Further Information

Read the full study