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Cryptorchidism with short spermatic vessels: staged orchiopexy preserving spermatic vessels

Dessanti, Antonio and Falchetti, Diego and Iannuccelli, Marco and Milianti, Susanna and Altana, Cristian and Tanca, Anna Rita and Ubertazzi, Michele and Strusi, G. P. and Fusillo, Mario (2009) Cryptorchidism with short spermatic vessels: staged orchiopexy preserving spermatic vessels. The Journal of Urology, Vol. 182 (3), p. 1163-1168. ISSN 0022-5347. Article.

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DOI: 10.1016/j.juro.2009.05.050

Abstract

Purpose. Patients with cryptorchidism can have such short spermatic vessels that it is impossible to place the testicle in a satisfactory scrotal position using conventional orchiopexy. In these cases the most commonly used operation is 1 to 2-stage Fowler-Stephens orchiopexy. We present our surgical experience using staged inguinal orchiopexy without section of the spermatic vessels in patients with short spermatic vessels.
Materials and Methods. We used 2-stage inguinal orchiopexy in 38 children with intra-abdominal testis or testis peeping through the internal ring and short spermatic vessels (7 bilateral). Spermatic vessels were not sectioned, but were lengthened through progressive traction of the spermatic cord wrapped in polytetrafluoroethylene pericardial membrane (Preclude®). In the first stage we mobilized the spermatic cord in the retroperitoneal space and then wrapped it in the polytetrafluoroethylene membrane. We subsequently attached the testis to the invaginated scrotal bottom. At 9 to 12 months we performed the second stage, which involved removing the polytetrafluoroethylene membrane.
Results. From the first to the second stage we observed progressive descent of the testicle toward the scrotum. At 1 to 8-year followup after the second stage all 45 testicles were palpable in a satisfactory scrotal position with stable or increased testicular volume.
Conclusions. This technique represents an alternative to Fowler-Stephens orchiopexy, which can be associated with a greater risk of testicular ischemia.

Item Type:Article
ID Code:3512
Status:Published
Refereed:Yes
Uncontrolled Keywords:Cryptorchidism, testis, urogenital abnormalities, urogenital surgical procedures
Subjects:Area 06 - Scienze mediche > MED/20 Chirurgia pediatrica e infantile
Divisions:001 Università di Sassari > 03 Istituti > Scienze radiologiche
001 Università di Sassari > 03 Istituti > Clinica chirurgica generale e terapia chirurgica
Publisher:Elsevier
ISSN:0022-5347
Copyright Holders:© 2009 American Urological Association
Deposited On:22 Jan 2010 13:26

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