Scrotal incision orchiopexy for undescended testis

Abstract

Objectives To evaluate prospectively the success of scrotal incision orchiopexy (Bianchi technique) with or without inguinal hernia in patients with an undescended testis within the inguinal canal or beyond the external inguinal ring. Methods A total of 72 orchiopexies were performed in 56 patients with a primary undescended testis. The testicular position and size were assessed again at 1 year of follow-up. Results A total of 56 patients had bilateral (n = 14), right (n = 26), and left (n = 18) primary undescended testes. Scrotal orchiopexy was attempted in 72 testes and was successful in 68; the remaining 4 patients required conversion to traditional inguinal orchiopexy because of inadequate mobilization. In 34 children (43 testes), the testis was distal to the external inguinal ring (group 1). Scrotal orchiopexy was performed successfully in 42 testes in this group, and only 1 patient required conversion to a traditional inguinal incision. The average operating time was 18 minutes. In 22 children (29 testes), the testis was located within the inguinal canal (group 2); 3 cases required conversion to traditional inguinal orchiopexy. The average operative time was 25 minutes in group 2. All patients had satisfactory scrotal placement with at least one follow-up examination. Conclusions A scrotal incision for a palpable primary testis is well tolerated, cosmetically pleasing, and associated with a short operative time.