Single Stage Laparoscopic Orchiopexy for Impalpable Low Abdominal Undescended Testis in Children- Analysis of Outcome

Abstract

Objective: To evaluate clinical efficacy of single stage laparoscopic orchiopexy by modified Prentiss procedure for the treatment of impalpable undescended testis within 2.5 cm from deep ring in children. Study Design: This was a retrospective case series study design. Place and Duration of Study: Department of surgery, section of pediatric surgery. Northern Area Armed Forces Hospital Hafer Al Batin, Saudi Arabia, from June 15, 2011, to Sep 15, 2021. Materials and Methods: All the children admitted with diagnosis of impalpable undescended testis were treated by single stage laparoscopic orchiopexy by modified Prentiss technique during the study period from June 15, 2011, till Sep 15, 2021. The total number of patients was 22. The age of the patients ranged from 1 year to 7 years. Seventeen (77.26 %) children had unilateral (10 with left sided and 7 with right sided) impalpable undescended testis. Five (22.72%) children had bilateral impalpable undescended testis. All the patients were evaluated by ultrasound and MRI abdomen to confirm the abdominal location. The patients were operated by single stage laparoscopic orchiopexy using modified Prentiss technique by single senior pediatric surgeon after confirming the location of testis within 2.5 cm from deep inguinal ring. All the patients were followed up in outpatient clinic after 1 week, after 6 months and after 1 year. The operative time, degree of post- operative pain, per operative and post- operative complications and follow up results were analyzed to evaluate the clinical outcome in terms of testicular location in the scrotum and size. Results: A total of 22 children were treated successfully by single stage laparoscopic orchiopexy by modified Prentiss technique. The age ranged from one year to 7 years at the time of surgery. Ten (45.45%) patients had left sided non-palpable testis, 7 (31.81%) had right sided and 5 (22.72%) children were having bilateral non palpable testis. There was no per-operative complication. One patient (4.54%) had scrotal hematoma which resolved spontaneously. All the children had successful outcome in terms of testicular size and location within scrotum after surgery on follow up of more than one year. There was no case (0%) of testicular atrophy in this series. Thirteen (59%) patients had testis in lowest position of scrotum, eight (36.36%) patients had testis in the middle scrotum and one (4.54%) patient had testis in the neck of the scrotum. Conclusion: Single stage Laparoscopic orchiopexy by modified Prentiss procedure is feasible, safe and effective technique to treat children with impalpable low abdominal undescended testis in children

Keywords

• abdominal testis
• complications
• impalpable undescended testis
• laparoscopic orchiopexy
• single stage
• testicular atrophy.