Shirazi Mehdi, Safavi Salar, Makarem Alireza, Malekmakan Leila
Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran.
Histomorphometry and Stereology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Res Rep Urol. 2020 Mar 18;12:129-136. doi: 10.2147/RRU.S237824. eCollection 2020.
Undescended testis (UDT) is a common congenital urogenital anomaly that is treated by orchiopexy. We aimed to introduce patent processus vaginalis (PPV) sac tightening (PVST) technique and compare it to the conventional technique.
We retrospectively studied all the operated UDT patients during 10 years. In the conventional technique, it was necessary to ligate PPV sac after being peeled off from the spermatic cord. PVST was dissected longitudinally from the two sides of where the PPV sac wall was attached to the spermatic cord till the proximal part, and only a narrow thin layer sticking to the spermatic cord was left and the proximal PVV sac opening was tightened as much as possible with vicryl suture at the internal inguinal ring level. The significance level was <0.05.
Of 821 orchiopexy (mean age 24.5±24.2 months), 36.3% were done by conventional and 63.7% by PVST technique. Hematoma, edema, hydrocele, and wound infection were lower in the PVST technique, but it was not significant (p>0.05). Testicular atrophy and operation time were significantly lower in the PVST than the conventional technique (p<0.001).
The orchiopexy PVST technique has lower complications and seems to be easier, faster and safer than the conventional technique.
隐睾是一种常见的先天性泌尿生殖系统异常,通常通过睾丸固定术进行治疗。我们旨在介绍鞘突管未闭(PPV)囊袋收紧(PVST)技术,并将其与传统技术进行比较。
我们回顾性研究了10年间所有接受手术治疗的隐睾患者。在传统技术中,需要在将PPV囊袋从精索上剥离后进行结扎。PVST技术是从PPV囊袋壁与精索附着处的两侧纵向切开至近端,仅保留一层紧贴精索的狭窄薄层,并在腹股沟内环水平用薇乔缝线尽可能收紧近端PVV囊袋开口。显著性水平为<0.05。
在821例睾丸固定术(平均年龄24.5±24.2个月)中,36.3%采用传统技术,63.7%采用PVST技术。PVST技术的血肿、水肿、鞘膜积液和伤口感染发生率较低,但差异无统计学意义(p>0.05)。PVST技术的睾丸萎缩和手术时间明显低于传统技术(p<0.001)。
睾丸固定术的PVST技术并发症较少,似乎比传统技术更简便、快速且安全。