Department of Pediatric Surgery of Hazrat Masoume Hospital, Qom University of Medical Sciences, Qom, Iran.
Student Research Committee, Qom University of Medical Sciences, Qom, Iran.
The ligation of the patent processus vaginalis (PPV) is the challenging issue during the orchidopexy in the patients who suffering undescended testis (UDT). In the present study we aimed to comparing the advantages of the orchidopexy with high-ligation method and the san-ligation method as a modified orchidopexy in our more than 6 years` experiences.
Materials and Methods
The medical records of 2,659 boys with UDT who undergone orchidopexy in xx hospital, Qom-Iran, between February 2010 and October 2016 were analyzed. The exclusion criteria were consisting of critical cases, presence of concomitant obvious clinical hernia, re-operation due to re-ascending, abdominal UDT, and coincidence with other anomalies. Two surgical method were performed based upon the medical records: 1- orchidopexy with PPV high-ligation, and 2- orchidopexy with PPV san-ligation.
A total of 2,659 medical records with 3,208 UDTs were reviewed. Of them, 2,210 (79.4%) patients had unilateral UDT. Of the total UDTs, 1,956 (61%) UDTs were located in the inguinal canal. The mean age of the patients was 21.3 ±2.7 months. Of the total UDTs, 2,187 (68.2%) and 1,021 (31.8%) were undergone orchidopexy with high-ligation and san-ligation PPV, respectively. The operative time significantly decreases in the san-ligation PPV group (11.2 minutes vs. 18.4 minutes; P =0.03). A total of 207 (6.45%) complications were occurred in the 187(7%) patients. The commonest complication was spermatic cord/testicular edema which was no significant difference in both surgical groups (P=0.769).
The modified orchidopexy with san-ligation of PPV does not significantly increase the risk of post-operative complications. However, this method significantly reduces the operative time.