Department of Pediatric Urology, Jichi Medical University, Children's Medical Center Tochigi, Tochigi, Japan.
Department of Pediatric Urology, Jichi Medical University, Children's Medical Center Tochigi, Tochigi, Japan.
J Urol. 2016 Aug;196(2):542-7. doi: 10.1016/j.juro.2016.02.2962. Epub 2016 Mar 2.
We performed low scrotal approach orchiopexy in patients with prescrotal cryptorchidism. The processus vaginalis was not ligated if it was not widely patent. We retrospectively evaluated the long-term outcomes of low scrotal approach orchiopexy without processus vaginalis ligation.
A total of 137 patients (227 testes) were diagnosed with prescrotal cryptorchidism between October 2009 and April 2014. All patients underwent low scrotal approach orchiopexy. Mean age at surgery was 34.9 months. The processus vaginalis was deemed to be not widely patent when a sound could not be passed into the abdominal cavity through the internal inguinal ring, and the processus vaginalis was not ligated in such cases.
Intraoperative findings revealed that the processus vaginalis was widely patent in 10 testes and was not widely patent in 217. A widely patent processus vaginalis was closed via scrotal approach in 5 testes, while an inguinal approach was necessary in 5. Median followup was 44 months (range 20 to 73). Postoperative complications included reascending testis in 1 case where an inguinal approach was necessary. No patient manifested testicular atrophy or inguinal hernia.
Low scrotal approach orchiopexy is a useful and safe procedure for treating patients with prescrotal cryptorchidism. Ligation is unnecessary when the processus vaginalis is not widely patent.
我们对患有阴囊前型隐睾的患者采用低位阴囊入路睾丸固定术,且如果鞘状突未广泛开放,则不进行结扎。我们回顾性评估了不结扎鞘状突的低位阴囊入路睾丸固定术的长期疗效。
2009 年 10 月至 2014 年 4 月期间,共有 137 例(227 侧睾丸)患者被诊断为阴囊前型隐睾。所有患者均接受了低位阴囊入路睾丸固定术。手术时的平均年龄为 34.9 个月。当无法通过内环将声音传入腹腔,且鞘状突未广泛开放时,我们认为鞘状突未广泛开放,且在这种情况下不进行结扎。
术中发现 10 侧鞘状突广泛开放,217 侧不广泛开放。5 侧广泛开放的鞘状突经阴囊入路关闭,5 侧需要腹股沟入路。中位随访时间为 44 个月(20 至 73 个月)。术后并发症包括 1 例需要腹股沟入路的睾丸再上移。无患者出现睾丸萎缩或腹股沟疝。
对于患有阴囊前型隐睾的患者,低位阴囊入路睾丸固定术是一种有用且安全的手术方法。当鞘状突不广泛开放时,不需要结扎。