Single scrotal incision orchiopexy - a systematic review

A search was performed using Pubmed, through which 16 articles were selected out of a total of 133. The following conditions were considered exclusion criteria: other surgical methods such as an inguinal procedure or a laparoscopic approach, retractile testes, or patients with previous testicular or inguinal surgery.

Results

A total of 1558 orchiopexy surgeries initiated with a transcrotal incision were analyzed. Patients' ages ranged between 5 months and 21 years. Thirteen studies used high scrotal incisions, and low scrotal incisions were performed in the remainder of the studies. In 55 cases (3.53%), there was a need for inguinal incision. Recurrence was observed in 9 cases, testicular atrophy in 3, testicular hypotrophy in 2, and surgical site infections in 13 cases. High efficacy rates were observed, varying between 88% and 100%.

Conclusions

Single scrotal incision orchiopexy proved to be an effective technique and is associated with low rates of complications.

Cryptorchidism; Orchiopexy; Scrotum; Surgical Procedures, Operative

Authors	Year	Design	No. of patients	No. of Orchiopexies	Incision	Patent Processus Vaginalis	Inguinal incision	Age	Intraoperative complications	Postoperative complications	Follow-up	Eficacy (%)	Reference
Lais A et al	1996	Prospective	50	50	High scrotal	13	3	5 months to 14 years (mean 5 years)	0	Hematoma: 3; Recurrence: 1; Hipotrophy: 2	3 to 5 years	88	15
Misra D et al	1997	Prospective	NE	67	High scrotal	0	9	1 to 12 years (mean: 6.8 years)	0	0	1 to 5 years	86.5	14
Jawad AJ	1997	Prospective	96	106	High scrotal	NE	14	14 months to 11 years (mean: 41 months)	0	Recurrence: 5; Atrophy: 2; Hematoma: 16; Infection: 2	8 to 36 months (mean: 16 months)	93.3	2
Caruso A et al	2000	Prospective	34	42	High scrotal	3	1	media: 03 years (mean: 14 months)	0	Recurrence: 1	6 months to 2 years (mean: 1 year)	96.6	4
Parsons JK et al	2003	Prospective	52	66	Low scrotal	13	0	Below 2 years-old: 16 patients; 2 to 6 years: 19 patients; 6 years: 17 patients	0	0	3 months	100	17
Russinko PJ et al	2003	Retrospective	78	85	High scrotal	58	1	4.5 years (0.5 a 24 years)	0	Recurrence: 2; Hematoma: 1; Atrophy: 1; Infection: 1	1 to 36 months (mean: 6 months )	95.2	16
Handa R et al	2006	Prospective	28	35	High scrotal	NE	0	10 months to 9 years	0	Infection: 1; Hernia: 1	2 to 6 months	100	19
Dayanc M et al	2007	Prospective	166	204	High scrotal	72	12	10 months to 12 years (mean 2.2 years; median 3.2 years)	NE	Hydrocele: 1; Hernia: 01;	16 to 68 months	92.7	1
Bassel YS et al	2007	Retrospective	103	121	High scrotal	75	0	6 months a 13 years (mean: 4.5 years)	0	Infection: 4	6 months to 1 year	100	21
Samuel DG et al	2008	Prospective	156	206	High scrotal	NE	1	1 a 21 years (mean: 4.26 years)	0	Infection: 2	2 years	99.95	11
Takahashi M et al	2009	Prospective	32	49	Low scrotal	14	0	11.5 a 114.0 months (mean: 39.3 months)	0	Recurrence: 1	12.1 to 68.8 months (mean: 39.1 months)	97.95%	18
Al-Mandil M et al	2008	Retrospective	56	63	Low scrotal	NE	0	4.6 years	0	Recurrence: 1; Hydrocele: 1; Hernias: 2; Infection: 1	6 to 42 months	98.41	20
Callewaert PR et al	2009	Prospective	154	194	High scrotal	11	2	4 a 229 months (mean: 71 months)	Seccion of vas deferens: 1	Hematoma: 1; Infection: 2	3 to 22 months (mean: 10 months)	100	12
Gordon M et al	2010	Retrospective	118	122	Low scrotal	NE	3	10 months to 8 years	0	Recurrence: 12	6 months to 1 year	89.3	6
Cloutier J et al	2011	Retrospective	44	60	High scrotal	NE	1	53 (± 23) months	0	Recurrence: 1; Hematoma: 1	3 months to 2 years	99.3	3
Yucel S et al	2011	Retrospective	74	88	High scrotal	65	8	6 months to 11 years (mean: 4.9 years)	0	0	3 to 12 months (mean: 7.1 months)	90.9	13
Authors	2007 - 2009	Prospective	16 (more 2 patients was re-do)	20 (more 2 cases was re-do)	Low scrotal	16	0	3 to 108 months (mean 42.5 months)	0	0	3 to 17 months (mean: 18 months)	100	-

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[1] Correspondence address: Dr. Ubirajara Barroso Jr., Rua Sócrates Guanaes Gomes, 73 / 2004, Cidade Jardim, Salvador, Bahia, 40296-720, Brazil, E-mail: ubarroso@uol.com.br