Comparison Between Processus Vaginalis Sac Tightening Technique and the Conventional Technique in Orchiopexy Surgery Over 10 Years

Abstract

Background

Undescended testis (UDT) is a common congenital urogenital anomaly that is treated by orchiopexy. We aimed to introduce patent processus vaginalis (PPV) sac tightening (PVST) technique and compare it to the conventional technique.

Methods

We retrospectively studied all the operated UDT patients during 10 years. In the conventional technique, it was necessary to ligate PPV sac after being peeled off from the spermatic cord. PVST was dissected longitudinally from the two sides of where the PPV sac wall was attached to the spermatic cord till the proximal part, and only a narrow thin layer sticking to the spermatic cord was left and the proximal PVV sac opening was tightened as much as possible with vicryl suture at the internal inguinal ring level. The significance level was <0.05.

Results

Of 821 orchiopexy (mean age 24.5±24.2 months), 36.3% were done by conventional and 63.7% by PVST technique. Hematoma, edema, hydrocele, and wound infection were lower in the PVST technique, but it was not significant (p>0.05). Testicular atrophy and operation time were significantly lower in the PVST than the conventional technique (p<0.001).

Conclusion

The orchiopexy PVST technique has lower complications and seems to be easier, faster and safer than the conventional technique.

Keywords:

• UDT
• orchiopexy
• testis atrophy
• hernia
• PVST technique

Acknowledgment

The authors would like to thank Dr Nasrin Shokrpour for the editorial assistance in the Research Consulting Center (RCC) of Shiraz University of Medical Science and improvement of the use of English in the manuscript and Afsaneh Ghasemi for helping to extract data.

Ethical Approval

This study was conducted in accordance with the Declaration of Helsinki and approved by the local ethics committee of Shiraz University of Medical Sciences (IR.sums.med.rec.1397.117) on June 2, 2018 written informed consent was obtained from a parent for each of the participants.

Author Contributions

All authors contributed to data analysis, drafting or revising the article, gave final approval of the final version to be published, and agreed to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest in this work.

Additional information

Funding

The Vice-Chancellery of Research and Technology of Shiraz University of Medical Sciences, Shiraz, Iran financially supported this study (grants No 15600) that was extracted from the thesis of Salar Safavi M.D.