Arda I S, Ersoy E
Baskent University Faculty of Medicine, Department of Pediatric Surgery, Ankara, Turkey.
Scand J Urol Nephrol. 2001 Dec;35(6):505-8. doi: 10.1080/003655901753367631.
We aimed to compare the three techniques of dartos pouch orchiopexy, suture fixation to the scrotal wall and narrowing of the neck of pouch with or without suture fixation, in regard to the postoperative ascensus of testes.
We operated on 150 unilateral palpable undescended testis with the scrotal pouch orchiopexy technique. In this prospective study, patients were randomly divided into three groups: Testes were fixed to the scrotal wall in the first group, they were placed into the scrotal pouch without fixation but the neck of the dartos pouch was narrowed around the vas deferens and the vessels in the second group and testes were fixed to the scrotum with a suture and the dartos fascial opening was narrowed concomitantly in the third group.
Patients were followed between 6 and 48 months (28.0 +/- 11.4). Only four testes of the first group (8.0%) were replaced upward after the operation where all the other two groups' testes were in their places.
We believe that only narrowing of the dartos fascia around the vas deferens and vessels without fixation to the scotum prevents ascending of the testis upward after orchiopexy operations. We think this technique decrease the risk of supposed damage to the testicular tissue due to suture material.
我们旨在比较肉膜囊睾丸固定术、缝合固定于阴囊壁以及肉膜囊颈部缩窄（有无缝合固定）这三种技术在术后睾丸上升方面的情况。
我们采用阴囊肉膜囊睾丸固定术对150例单侧可触及的隐睾患者进行手术。在这项前瞻性研究中，患者被随机分为三组：第一组将睾丸固定于阴囊壁，第二组将睾丸置于阴囊肉膜囊内但不固定，而是在输精管和血管周围缩窄肉膜囊颈部，第三组用缝线将睾丸固定于阴囊并同时缩窄肉膜筋膜开口。
患者随访6至48个月（28.0±11.4）。术后第一组仅有4个睾丸（8.0%）向上移位，而其他两组的睾丸均在原位。
我们认为，仅在输精管和血管周围缩窄肉膜筋膜而不固定于阴囊，可防止睾丸固定术后睾丸向上上升。我们认为这种技术降低了因缝合材料对睾丸组织造成假定损伤的风险。
