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Background And Purpose: Most of the current literature concerning laparoscopy in patients with cryptorchidism reports on those with nonpalpable testes. The purpose of this study is to share our experience and outcome in laparoscopic orchiopexy on patients with palpable undescended testes.
Patients And Methods: From January 1999 to July 2014, 240 cryptorchid testes were treated of which 192 (155 patients) were palpable and were operated on by laparoscopy. Before starting, the bladder is emptied with a Foley catheter. Four trocars are used: One 5 mm for the lens (45 degree), one 10 mm (transscrotal), and two 3 mm placed at the subcostal midclavicular line for the instruments. We localize the deep inguinal ring and open the peritoneum. The spermatic vessels and vas deferens are dissected in a cephalic direction. The epigastric vessels are dissected and sectioned to facilitate the localization of the testicle inside the canal. Once found, the testis is dissected and taken into the abdominal cavity where the gubernaculum testis is cut. A 10-mm trocar is introduced through the scrotal sac into the peritoneal cavity. The testicle is grabbed and pulled down to the scrotum where it will be fixed with a 5-0 polypropylene suture in the usual manner.
Results: Of 192 cryptorchid palpable testes treated with laparoscopy, only one procedure was converted to conventional open orchiopexy because of an ectopic testicle (above the aponeurosis of the oblique muscle). The rest of the testicles could be moved down to the scrotal sac. Our follow-up ranges from 6 months to 15 years, and we have not found atrophy in any of the testicles. To date, only two (0.4%) testicles have reascended.
Conclusion: Laparoscopy is a great and safe option for patients with palpable undescended testes, regardless of its position in the inguinal canal.
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http://dx.doi.org/10.1089/end.2015.0118 | DOI Listing |
Pak J Med Sci
October 2024
Komal Lajpat, MBBS, FCPS. Civil Hospital Karachi (CHK), Dow University of Health Sciences (DUHS) Karachi, Pakistan.
Objective: To assess the effectiveness of diffusion-weighted magnetic resonance imaging (DW-MRI) in the detection of non-palpable undescended testis (NPUT) and to compare DW-MRI results with surgical findings.
Methods: This descriptive, cross-sectional study was carried out at Dow Institute of Radiology, Dow University of Health Sciences. Karachi on a cohort of patients who underwent DW-MRI for suspected NPUT between 15 September, 2022 to 16 March, 2023.
J Pediatr Urol
September 2024
Division of Urology, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address:
J Pediatr Urol
October 2024
Service of Radiology, University of Sassari Medical School, Sassari, Italy.
Background: Treatment of high cryptorchidism can be challenging, often with frustrating results. We report 25 years of experience in the treatment of the cryptorchidism with very short spermatic vessels using an original two-stage orchiopexy that preserves the spermatic vessels.
Methods: We reviewed the clinical charts of children affected by cryptorchidism with very short spermatic vessels treated through our original surgical approach in tree Institutes of Pediatric Surgery.
J Pediatr Urol
October 2024
Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address:
Introduction And Objective: Previous studies showed that extra blood supply can decrease testicular atrophy following laparoscopic orchiopexy. We evaluated the impact of preserving the gubernacular attachment (which contains blood supply from cremasteric artery and its anastomoses) on atrophy rates following open conventional orchiopexy.
Study Design: This double-blinded randomized trial was implemented from March 2022 to September 2023.
Int J Surg Case Rep
August 2024
Department of Pediatric Surgery, Faculty of Medicine, University of Aleppo, Aleppo, Syria. Electronic address:
Introduction: Transverse testicular ectopia (TTE) is a rare congenital condition characterized by migration of both testes through the same inguinal canal and often presents with an inguinal hernia. TTE is associated with various genitourinary anomalies.
Case Presentation: A three-year-old boy presented with a non-palpable right testis and a palpable undescended left testis in the left inguinal area.
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