Testicular rerouting by modified Prentiss maneuver: Usefulness in bilateral synchronous orchidopexy for high inguinal undescended testes

Abstract

ObjectivesTo describe our experience and illustrate the surgical procedure of synchronous bilateral testicular rerouting in high inguinal undescended testes (HIUT) by extending the use of “modified Prentiss maneuver” in bilateral situation, to establish this as a procedure of choice in bilateral HIUT and secondly to demonstrate the length gained by maneuver itself. MethodsBetween January 2011 and December 2012 ten boys (8months–6years) with diagnosis of bilateral HIUT were included in the study. Bilateral orchidopexy was done by "modified Prentiss maneuver" under general anesthesia. Postoperatively all patients were evaluated at 3months ,6months and 1year by physical examinations and ultrasound. ResultsIt was possible to reroute the testes underneath inferior epigastric artery (IEA) without its mobilization and thus locate testicular pedicle through a fascial hole above pubic tubercle, well medial to IEA. The average gain in scrotal positioning was 16mm (10–22mm).No retractions, atrophy of testis, clinical weakness of anterior abdominal wall or inguinal herniation was noted in any patient up to one year follow up. ConclusionsTesticular re-routing by "modified Prentiss maneuver" is a simple, feasible, safe and efficient method for bilateral orchidopexy in bilateral HIUT. Preserving the inferior epigastric artery bilaterally has physiologic advantages.