Comparison of Laparoscopic Orchiopexy and Traditional Inguinal Incision Orchiopexy for Palpable Undescended Testes in Cryptorchidism
Publication: Journal of Laparoendoscopic & Advanced Surgical Techniques
Volume 31, Issue Number 5
Abstract
Background: Laparoscopic orchiopexy (LO) has become a standard procedure for the treatment of nonpalpable undescended testes (UDT). LO for palpable UDT is still controversial. The aim of this study is to explore the method and effect of LO procedure for palpable UDT in children suffering from cryptorchidism.
Methods: A retrospective study was performed for LO and traditional inguinal incision orchiopexy (TIO) for palpable UDT. A total of 291 children were enrolled, and they were aged 9–96 months with either left- or right-side palpable inguinal canalicular testes. Patients with testes that were nonpalpable, ectopic, and retractable were excluded. One hundred seventy patients received LO and 121 patients received TIO. Patient age, operative time, and clinical outcomes were reviewed. Independent t-test and Fisher's exact test were performed by SPSS 25.0 software.
Results: The mean operative time (30.77 ± 6.02 minutes versus 44.76 ± 6.70 minutes) and postoperative normal activity time (1.25 ± 0.43 days versus 2.48 ± 0.68 days) of LO were significantly shorter than those of TIO group (P < .05). Forty-seven of 49 cases (95.9%) aged <1 year successfully achieved LO.
Conclusion: LO is an appropriate choice for palpable UDT, especially in younger children aged <2 years. The success rate of LO decreased with age.
Get full access to this article
View all available purchase options and get full access to this article.
Disclaimer
The author confirms that the study described has not been published before, it is not under consideration for publication elsewhere,its publication has been approved by all coauthors, if any, and its publication has been approved (tacitly or explicitly) by the responsible authorities at the institution where the study is carried out. The author agrees to publish in the journal indicated hereunder and also in English by BMC Surgery Journal.
References
1. Virtanen HE, Toppari J. Epidemiology and pathogenesis of cryptorchidism. Hum Reprod Update 2008;14:49–58.
2. Barthold JS, Gonzalez R. The epidemiology of congenital cryptorchidism, testicular ascent and orchiopexy. J Urol 2003;170(6 Pt 1):2396–2401.
3. Niedzielski JK, Oszukowska E, Slowikowska-Hilczer J. Undescended testis—Current trends and guidelines: A review of the literature. Arch Med Sci 2016;12:667–677.
4. Kolon TF, Herndon CD, Baker LA, et al. Evaluation and treatment of cryptorchidism: AUA guideline. J Urol 2014;192:337–345.
5. Dar SA, Bali RS, Zahoor Y, Rashid Kema A, Bhardwaj R. Undescended testes and laparoscopy: Experience from the developing world. Adv Urol 2018;2018:1620470.
6. You J, Li G, Chen H, Wang J, Li S. Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases. BMC Pediatr 2020;20:124.
7. Riquelme M, Elizondo RA, Aranda A. Palpable undescended testes: 15 years of experience and outcome in laparoscopic orchiopexy. J Endourol 2015;29:978–982.
8. Elderwy AA, Kurkar A, Abdel-Kader MS, et al. Laparoscopic versus open orchiopexy in the management of peeping testis: A multi-institutional prospective randomized study. J Pediatr Urol 2014;10:605–609.
9. Docimo SG, Moore RG, Adams J, Kavoussi LR. Laparoscopic orchiopexy for the high palpable undescended testis: Preliminary experience. J Urol 1995;154:1513–1515.
10. Riquelme M, Aranda A, Rodriguez C, Villalvazo H, Alvarez G. Laparoscopic orchiopexy for palpable undescended testes: A five-year experience. J Laparoendosc Adv Surg Tech A 2006;16:321–324.
11. Braga LH, Lorenzo AJ, Romao RLP. Canadian Urological Association-Pediatric Urologists of Canada (CUA-PUC) guideline for the diagnosis, management, and followup of cryptorchidism. Can Urol Assoc J 2017;11:E251–E260.
12. Bianchi A, Squire BR. Transscrotal orchidopexy: Orchidopexy revised. Pediatric Surg Int 1989;4:189–192.
13. Novaes HF, Carneiro Neto JA, Macedo A Jr, Barroso Júnior U. Single scrotal incision orchiopexy—A systematic review. Int Braz J Urol 2013;39:305–311.
14. Gordon M, Cervellione RM, Morabito A, Bianchi A: 20 years of transcrotal orchidopexy for undescended testis: Results and outcomes. J Pediatr Urol 2010;6:506–512.
15. Hutson JM, Li R, Southwell BR, Newgreen D, Cousinery M. Regulation of testicular descent. Pediatr Surg Int 2015;31:317–325.
16. Szarek M, Li R, Vikraman J, Southwell B, Hutson JM. Molecular signals governing cremaster muscle development: Clues for cryptorchidism. J Pediatr Surg 2014;49:312–316; discussion 316.
17. Barthold JS, Wintner A, Hagerty JA, Rogers KJ, Hossain MJ. Cryptorchidism in boys with cerebral palsy is associated with the severity of disease and with co-occurrence of other congenital anomalies. Front Endocrinol (Lausanne) 2018;9:151.
18. Aggarwal H, Kogan BA, Feustel PJ. One third of patients with a unilateral palpable undescended testis have a contralateral patent processus. J Pediatr Surg 2012;47:1711–1715.
19. Mathers MJ, Sperling H, Rubben H, Roth S. The undescended testis: Diagnosis, treatment and long-term consequences. Dtsch Arztebl Int 2009;106:527–532.
20. Rafiei MH, Jazini A. Is the ligation of hernial sac necessary in herniotomy for children? A randomized controlled trial of evaluating surgical complications and duration. Adv Biomed Res 2015;4:97.
21. Riquelme M, Aranda A, Rodriguez C, Cortinas J, Carmona G, Riquelme QM. Incidence and management of the inguinal hernia during laparoscopic orchiopexy in palpable cryptoorchidism: Preliminary report. Pediatr Surg Int 2007;23:301–304.
22. Khairi A, Shehata S, El-Kholi N. Is it necessary to close the peritoneum over the deep inguinal ring during laparoscopic orchidopexy? J Pediatr Urol 2013;9:157–160.
23. Mohta A, Jain N, Irniraya KP, Saluja SS, Sharma S, Gupta A. Non-ligation of the hernial sac during herniotomy: A prospective study. Pediatr Surg Int 2003;19:451–452.
24. Narayanan SK, Puthenvariath JN, Somnath P, Mohanan A. Does the internal inguinal ring need closure during laparoscopic orchiopexy with Prentiss manoeuvre? Int Urol Nephrol 2017;49:13–15.
Information & Authors
Information
Published In
Journal of Laparoendoscopic & Advanced Surgical Techniques
Volume 31 • Issue Number 5 • May 2021
Pages: 598 - 603
PubMed: 33595353
Copyright
Copyright 2021, Mary Ann Liebert, Inc., publishers.
History
Published online: 14 May 2021
Published in print: May 2021
Published ahead of print: 15 February 2021
Topics
Availability of Data and Materials
The data sets used and/or analyzed during this study are available from the corresponding author on reasonable request.
Authors
Authors' Contributions
S.D.G. and H.L. design the study; S.D.G. and Y.-X.W. collected the data; S.D.G. wrote the article; Y.-X.W. and H.L. revised the article; all the authors read and approved the final article.
Disclosure Statement
No competing financial interests exist.
Funding Information
No funding was received for this article.
Ethics Approval and Consent to Participate
The research has been performed in accordance with the declaration of Helsinki. Our study was approved by the Ethics Committee of The First People's Hospital of Lianyungang (JSYY-20131228001).
Metrics & Citations
Metrics
Citations
Export Citation
Export citation
Select the format you want to export the citations of this publication.
View Options
Access content
To read the fulltext, please use one of the options below to sign in or purchase access.⚠ Society Access
If you are a member of a society that has access to this content please log in via your society website and then return to this publication.