SCROTAL FIXATION - A DIFFERENT SURGICAL APPROACH IN THE MANAGEMENT OFTHE LOW UNDESCENDED TESTES

Objectives. To evaluate the feasibility of using the scrotal approach in patients with undescended testes. Methods. Over an 18-month period, 165 patients were diagnosed to have 208 undescended testes. Of these, 28 were nonpalpable. Results. At exploration, 7 testes were abdominal , 33 were canalicular, 165 were in the region of the external ring/pub ic tubercle, and 1 was perineal. There were 2 cases of unilateral mona rchism. The operative procedure performed was as follows: orchiectomy for 6 abnormal testes, orchiopexy for 142, and scrotal fixation (SF) f or 58. (In this series, 9 patients were converted from SF to an orchio pexy at the time of the initial operative procedure.) SF involves a sc rotal incision extending down to the tunica vaginalus. The cord is the n mobilized from below, after which the testis is placed in an extra-d artos pouch. Conclusions. Our study has shown that there are a signifi cant number of undescended testes that lie in the region of the pubic tubercle, lack a hernial sac, and can be managed by a scrotal mobiliza tion alone. Based on our experience with SF, we have used a simple cla ssification of undescended testis that has therapeutic and prognostic justifications. (C) 1997, Elsevier Science Inc.