Editorial Comment

Abstract

This article partly shares our previously published experience with the prescrotal approach for the palpable testicle. 1 Al-Mandil M. Khoury A.E. El-Hout Y. et al. Potential complications with the prescrotal approach for the palpable undescended testis? A comparison of single prescrotal incision to the traditional inguinal approach. J Urol. 2008; 180: 686-689 Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar Likewise, we demonstrated the feasibility and safety of the prescrotal approach with a follow-up of 6-42 months. We found a potential hernia rate of 3% (2 patients), a complication that was not noted in this article. Interestingly, this article introduces an unorthodox approach by broadening the utility of the prescrotal approach to the impalpable testicle, a situation inarguably managed by laparoscopy. The authors report on 46 impalpable testicles, 15 of which were intra-abdominal, with a successful prescrotal orchidopexy in 11 (73%). Although tempting to adopt, we feel that patient selection for the prescrotal approach to the impalpable testicle is crucial and might be more feasible for the younger patient and when the processus vaginalis is patent, as mentioned in the article. When no testicle is encountered with the prescrotal approach, it might be tedious and challenging to explore the retroperitoneum more proximally before declaring a vanished testicle, a task visually more feasible with laparoscopy. Albeit it might be challenging to access the retroperitoneum with a prescrotal approach, the surgeon may need to extend the prescrotal incision into the groin to achieve better exposure, and hence avoid conversion to laparoscopy. Scrotal Approach to Both Palpable and Impalpable Undescended Testes: Should It Become Our First Choice?UrologyVol. 76Issue 1PreviewTo determine the advantages of scrotal incision in the treatment of undescended testis. Undescended testis is a common pediatric condition and is conventionally managed surgically by orchidopexy. A single scrotal incision orchidopexy has become accepted as a valid approach for patients with palpable undescended testicles. Because this approach also allows easy detection of atrophic testes or testicular remnants, it recently has also emerged as an alternative initial surgical approach to impalpable undescended testicles. Full-Text PDF