Elemen Levent, Sozubir Selami, Bulut Melih
Department of Pediatric Surgery, Yeditepe University, Medical Faculty, Devlet Yolu, Ankara cad. 102-104 Kozyatagi, Istanbul, Turkey.
J Pediatr Urol. 2008 Oct;4(5):330-2. doi: 10.1016/j.jpurol.2008.02.006. Epub 2008 May 1.
Most undescended testes resolve spontaneously in the first year of life. If the testis remains undescended by the second year, the most probable means of scrotal placement is orchiopexy. After the first successful operation for orchiopexy, many surgical modifications were described. This study presents our limited experience with Prentiss' maneuver in six boys with high undescended testes.
Two left, two right and two bilateral testes, in six patients, were operated. Five patients were admitted with the complaint of unilaterally or bilaterally 'empty scrotum'. The sixth patient previously had a right high undescended testis which had been placed in a high scrotal position. Following the standard steps of inguinal orchiopexy Prentiss' maneuver were performed and yielded adequate distance to place the testes mid scrotum.
On follow-up, Doppler ultrasound examination revealed normal sized testes with normal blood flow in all patients with dimensions correlated with age.
Although perhaps only useful in orchiopexy for high undescended testis, incision of the transversalis fascia preserves testicular blood flow by relieving tension on the testicular vessels.
大多数隐睾在出生后第一年可自行下降。如果睾丸在两岁时仍未下降,阴囊内放置睾丸最可能的方法是睾丸固定术。在首次成功进行睾丸固定术后,人们描述了许多手术改良方法。本研究介绍了我们对6例高位隐睾男孩采用普伦蒂斯手法的有限经验。
对6例患者的2个左侧睾丸、2个右侧睾丸和2个双侧睾丸进行了手术。5例患者因单侧或双侧“阴囊空虚”就诊。第6例患者之前有一个右侧高位隐睾,已被放置在阴囊高位。按照腹股沟睾丸固定术的标准步骤进行普伦蒂斯手法操作,获得了将睾丸放置在阴囊中部的足够距离。
随访时,多普勒超声检查显示所有患者睾丸大小正常,血流正常,其大小与年龄相关。
虽然普伦蒂斯手法可能仅对高位隐睾的睾丸固定术有用,但切开腹横筋膜可通过减轻睾丸血管的张力来保留睾丸血流。