Comparison of three different surgical approaches to children with cryptorchidism in differet locations

Abstract

Objective To evaluate the clinical efficacy of three different surgical approaches in the treatment of cryptorchidism. Methods One hundred and fifty nine patients (213 testes) diagnosed of cryptorchidism in different positions were admitted to our hospital from January 2010 to June 2017. The ages ranged from 5 months to 14 years. Three different surgical treatments (laparoscopic orchidopexy, scrotal incision surgery and open inguinal surgery) were performed in these cases according to the preoperative and intraoperative physical examination, the development of testes and so on. The effects and complications of these three treatments were compared. Results Ninety cases underwent laparoscopic orchidopexy, 61 cases underwent scrotal incision surgeries plus laparoscopic approach to find patnet processus vaginalis(PPV), and 62 cases underwent open inguinal surgeries. Among 105 patients diagnosed of unilateral cryptorchidism, 85(80.95%) were found with PPV in the same side and 40(38.10%) with CPPV. While 31 cases (57.41%) were found bilateral PPV in 54 patients with bilateral cryptorchidism. Two testes were removed because of dysplasia. The rest were fixed at the bottom of scrotum without tension. The follow-up endured for 3 months to 6 years. One case was found recurrence. No testicular atrophy or retraction was found in all patients. There was no significant difference among the three surgical approaches in the treatment of cryptorchidism (P>0.05). Conclusion Laparoscopic orchidopexy is recommended as the first choice for intra-abdominal testes, and scrotal incision surgery is better for low cryptorchidism. Open inguinal surgery still has a major value and significance in diagnosing absence or dysplasia of testes. Key words: Children, cryptorchidism; Orchidopexy; laparoscopy