Evaluation of Orchidopexy with or without Opening the External Oblique Fascia in Children with Superficial Inguinal Undescended Testis

Abstract

Orchidopexy is one of the most common pediatric surgeries. In general, the operation for truly undescended testis (UDT) includes opening of the external oblique fascia. The most common location of the testis in UDT is adjacent to the external inguinal canal (superficial inguinal type). Using a new method we performed orchidopexy without opening the fascia. In this clinical trial we compared the outcome after a classic procedure with that obtained using our method. This clinical controlled trial was undertaken in the Al Zahra hospital between 2008 and 2010. Patients were randomized into either into the closed technique group (group A, n=52) or the open group (group B, n=52). The incidence of short-term and long-term complications was recorded with a specific questionnaire at the time of surgery and at follow-up visits. Data were analyzed with the SPSS 15.0 software using chi-square and t-tests. 104 patients were included in this study. The incidence of short-term complications (surgical site hematoma, surgical wound infection, scrotal hematoma) and long-term complications (testicular atrophy) did not differ significantly between the 2 groups. Procedure duration in group A was significantly shorter than in group B (p=0.001). Medial thigh sensory loss was more common in group B (p=0.05). When investigating the surgical management of undescended testes, our study found differences in medial thigh sensory loss rate and procedure duration between the open and closed techniques. Operative treatment of UDT without opening the external oblique fascia is highly recommended.