Comparative investigation of two surgical techniques of orchiopexy in the post-operative recurrence rate and testicular size in children in clinical trial study


Department of General Surgery, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran


Background: Cryptorchidism is a common problem which is prevalent in 3% of male infants. This study aimed to determine the effect of both trans fixation and Dartos pouch fixation methods on the postoperative recurrence rate and testicular changes.
Materials and Methods: In a clinical trial study, 70 children were randomly divided into two groups. In the first group, the correction of cryptorchidism was done by Dartos pouch without suture and in the second group; testis was sutured using common trans fixation. The size of testicles was measured before and 6 months after surgery, children were followed on postoperative complications, trauma to testicles and recurrence of disease in both groups. Data were analyzed using SPSS soft ware.
Results: The mean size of testicles was 87.16 ± 20.6 mm2 in the group with fixed testicle and 182.4 ± 37.9 mm2 in the group with not-fixed testicle before operation and the difference between the two groups was significant (P = 0.013). After surgery, the mean size of testicles was 90.8 ± 19.9 mm2 in the group with fixed testicle and 183.7 ± 41.2 mm2 in the group with not-fixed testicle and the difference between them was significant (P = 0.026). The average of changes in testicular size was 3.62 ± 1.93 and 1.25 ± 5.35 mm2 in both fixed and not-fixed groups, respectively and changes in testicular size had no significant difference between the two groups. (P = 0.68).
Conclusions: Type of fixation had no effect on the size of testes or relevance to the level of retraction. The above management protocol did very well in our hands, and we recommend it for application in the management of undescended testis.


Holder and ashcrafts pediatric surgery ped surg. 2014. p. 706-11.  Back to cited text no. 1
Berkowitz GS, Lapinski RH, Dolgin SE, Gazella JG, Bodian CA, Holzman IR. Prevalence and natural history of cryptorchidism. Pediatrics 1993;92:44-9.  Back to cited text no. 2
Taskinen S, Hovatta O, Wikstrom S. Early treatment of cryptorchidism, semen quality and testicular endocrinology. J Urol 1996;156:82-4.  Back to cited text no. 3
Aetiology of testicular cancer: Association with congenital abnormalities, age at puberty, infertility and exercise. United Kingdom Testicular Cancer Study Group BMJ 1994;308:1393-9.  Back to cited text no. 4
Lotan G, Golan R, Efrati Y, Vigodner M, Lewin LM, Shochat L, et al. An experimental study of the effect of two distinct surgical techniques of orchiopexy on spermatogenesis and testicular damage in cryptorchid testes. Fertil Steril 2005;84:749-55.  Back to cited text no. 5
Pesce C, d':Agostino S, Costa L, Musi L, Manzi M. Re-operative orchiopexy: Surgical aspects and functional outcome. Ped Surg Int 2001;17:62-4.  Back to cited text no. 6
Maizels M, Gomez F, Firlit CF. Surgical correction of the failed orchiopexy. J Urol 1983;130:955-7.  Back to cited text no. 7
Adamsen S, Borgesson B. Tension on the spermatic cord increases the risk of orchiopexy failure. Acta Chir Scand 1985;134:529-33.  Back to cited text no. 8
Davey RB. Orchiopexy: The relative importance of each step of mobilization. Pediatr Surg Int 1997;12:163-4.  Back to cited text no. 9
Welch KJ. Orchiopexy: A new anchoring technique, window septopexy. J Pediatr Surg 1972;7:163-7.  Back to cited text no. 10
Ghnnam WM, Saed B, GHazy H. A modified technique of scrotal fixation during orchiopexy. Afr J Paediatr Surg 2011;8:203-5.  Back to cited text no. 11
[PUBMED]  Medknow Journal  
Koop CE. Technique of herniorrhaphy and orchiopexy. Birth Defects Orig Artic Ser 1977;13:293-303.  Back to cited text no. 12
Rajfer J. Technique of orchiopexy. Urol Clin North Am 1982;9:421-7.  Back to cited text no. 13
Osama M. Redo Inguinal Orchiopexy is a safe option for still high test. Life Sci J 2013;10:569-72.  Back to cited text no. 14