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Effect of Closing Processus Vagınalis in Orchıdopexy to Recurrence and Testicular Atrophy – 15 Years Experience

Yıl 2025, Cilt: 47 Sayı: 1, 91 - 94, 17.01.2025
https://doi.org/10.20515/otd.1549070

Öz

Undescended testis is one of the most common pathologies encountered by pediatric surgeons. In traditional orchidopexy operation, patent processus vaginalis (PPV) is dissected from testicular vessels and spermatic cord. In this study, it was aimed to compare the results of undescended testis patients with and without PPV closure in terms of recurrence and atrophy. After the approval of the local ethics committee, patients who were operated for undescended testis between January 2007 and December 2022 were evaluated. Patients were determined in two groups. first group was with PPV ligation (n=171), second group was without PPV ligation (n=1637). Inguinal hernia was not observed after operation in 15 years of follow-up. There were 23 recurrences (%13,4) in group 1 and 48 recurrences (%2,9) in group 2. According to the preoperative evaluation; A decrease in testicular size was detected in 5 patients (2.9%) in Group 1 and 8 patients (0.4%) in Group 2 in the postoperative follow-up. There is no need to ligate the PPV with additional dissection and open the external oblique fascia if it is predicted that the spermatic cord and testicular vessels may come to scrotum without tension in patients who underwent orchiopexy surgery.

Kaynakça

  • 1. Elseth A, Hatley RM. Orchiopexy. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560904/
  • 2. Alchoikani N, Ashour K. Ascending testis: A congenital predetermined condition. J Pediatr Urol. 2021 Apr;17(2):192.e1-192.e3.
  • 3. Radmayr C., Bogaert G., Burgu B., et al. Management of undescended testes. In: EAU Guidlines on Paediatric Urology. 2022. Available at: https://uroweb.org/guidelines/paediatric-urology Accessed on 15 May 2023.
  • 4. Ceccanti S, Zani A, Mele E, Cozzi DA. Orchidopexy without ligation of the processus vaginalis is not associated with an increased risk of inguinal hernia. Hernia. 2014 Jun;18(3):339-42.
  • 5. Thorup J, Haugen S, Kollin C, et al. Surgical treatment of undescended testes. Acta Paediatr. 2007;96(5):631-637.
  • 6. Jain VK, Singh S, Garge S, Joshi M, Sanghvi J. Orchidopexy san ligation technique of orchidopexy. Afr J Paediatr Surg. 2011;8(1):112-114.
  • 7. Tabrizian F, Raisolsadat SM, Houshmand B, Yaghubi MA. Assessment of the necessity of sac high ligation in inguinal hernia open surgery among children. J Pediatr Surg. 2013;48(3):547-549.
  • 8. Zhao W, Su C, Li S, Mo Z. Comparison of the Detection and Ligation of Patent Processus Vaginalis Between Laparoscopy-Assisted Transscrotal Orchiopexy and Single Scrotal Incision Orchiopexy. Front Surg. 2022;8:819057. Published 2022 Jan 31.
  • 9. Tanyel, F.C., Obliteration of processus vaginalis: aberrations in the regulatory mechanism result in an inguinal hernia, hydrocele or undescended testis. Turk J Pediatr, 2004. 46 Suppl: p. 18-27 PMID:15499794
  • 10. Davey RB. Orchidopexy: the relative importance of each step of mobilisation. Pediatr Surg Int. 1997;12(2/3):163-164 PMID:9069223
  • 11. Noseworthy J. Recurrent undescended testes. Semin Pediatr Surg. 2003;12(2):90-93.
  • 12. Dayanç M, Kibar Y, Tahmaz L, Yildirim I, Peker AF. Scrotal incision orchiopexy for undescended testis. Urology. 2004;64(6):1216-1219.
  • 13. Bassel YS, Scherz HC, Kirsch AJ. Scrotal incision orchiopexy for undescended testes with or without a patent processus vaginalis. J Urol. 2007;177(4):1516-1518.
  • 14. Iyer, K.R., Kumar, V., Huddart, S.N., Bianchi A. The scrotal approach. Pediatr Surg Int 10, 58–60 (1995).
  • 15. Shirazi M, Safavi S, Makarem A, Malekmakan L. Comparison Between Processus Vaginalis Sac Tightening Technique and the Conventional Technique in Orchiopexy Surgery Over 10 Years. Res Rep Urol. 2020;12:129-136. Published 2020 Mar 18.
  • 16. Schier F. Laparoscopic inguinal hernia repair-a prospective personal series of 542 children. J Pediatr Surg. 2006;41(6):1081-1084.
  • 17. Handa R, Kale R, Harjai MM. Laparoscopic orchiopexy: is closure of the internal ring necessary?. J Postgrad Med. 2005;51(4):266-268 PMID:16388167
  • 18. Lin J, Li D, Chen J, Lin L, Xu Y. Inguinal hernia repair by Bianchi incision in boys: a retrospective study. Pediatr Surg Int. 2018;34(3):289-295.
  • 19. Ok F, Durmus E, Ayaz M. The role of the resistive index in predicting testicular atrophy after orchiopexy in unilateral undescended testis. Pediatr Surg Int. 2022;39(1):38. Published 2022 Dec 8.

Orşidopekside Patent Processus Vajinalis Kapatılmasının Nüks ve Atrofi üzerine Etkisi-15 Yıllık Deneyim

Yıl 2025, Cilt: 47 Sayı: 1, 91 - 94, 17.01.2025
https://doi.org/10.20515/otd.1549070

Öz

Undescended testis is one of the most common pathologies encountered by pediatric surgeons. In traditional orchidopexy operation, patent processus vaginalis (PPV) is dissected from testicular vessels and spermatic cord. In this study, it was aimed to compare the results of undescended testis patients with and without PPV closure in terms of recurrence and atrophy. After the approval of the local ethics committee, patients who were operated for undescended testis between January 2007 and December 2022 were evaluated. Patients were determined in two groups. first group was with PPV ligation (n=171), second group was without PPV ligation (n=1637). Inguinal hernia was not observed after any operation. There were 23 recurrences (%13,4) in group 1 and 48 recurrences (%2,9) in group 2. According to the preoperative evaluation; A decrease in testicular size was detected in 5 patients (2.9%) in Group 1 and 8 patients (0.4%) in Group 2 in the postoperative follow-up. There is no need to ligate the PPV with additional dissection and open the external oblique fascia if it is predicted that the spermatic cord and testicular vessels may come to scrotum without tension in patients who underwent orchiopexy surgery.

Etik Beyan

Çalışmamızda yerel etik kuruldan onay alınmıştır.

Destekleyen Kurum

Yok.

Teşekkür

Yok.

Kaynakça

  • 1. Elseth A, Hatley RM. Orchiopexy. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560904/
  • 2. Alchoikani N, Ashour K. Ascending testis: A congenital predetermined condition. J Pediatr Urol. 2021 Apr;17(2):192.e1-192.e3.
  • 3. Radmayr C., Bogaert G., Burgu B., et al. Management of undescended testes. In: EAU Guidlines on Paediatric Urology. 2022. Available at: https://uroweb.org/guidelines/paediatric-urology Accessed on 15 May 2023.
  • 4. Ceccanti S, Zani A, Mele E, Cozzi DA. Orchidopexy without ligation of the processus vaginalis is not associated with an increased risk of inguinal hernia. Hernia. 2014 Jun;18(3):339-42.
  • 5. Thorup J, Haugen S, Kollin C, et al. Surgical treatment of undescended testes. Acta Paediatr. 2007;96(5):631-637.
  • 6. Jain VK, Singh S, Garge S, Joshi M, Sanghvi J. Orchidopexy san ligation technique of orchidopexy. Afr J Paediatr Surg. 2011;8(1):112-114.
  • 7. Tabrizian F, Raisolsadat SM, Houshmand B, Yaghubi MA. Assessment of the necessity of sac high ligation in inguinal hernia open surgery among children. J Pediatr Surg. 2013;48(3):547-549.
  • 8. Zhao W, Su C, Li S, Mo Z. Comparison of the Detection and Ligation of Patent Processus Vaginalis Between Laparoscopy-Assisted Transscrotal Orchiopexy and Single Scrotal Incision Orchiopexy. Front Surg. 2022;8:819057. Published 2022 Jan 31.
  • 9. Tanyel, F.C., Obliteration of processus vaginalis: aberrations in the regulatory mechanism result in an inguinal hernia, hydrocele or undescended testis. Turk J Pediatr, 2004. 46 Suppl: p. 18-27 PMID:15499794
  • 10. Davey RB. Orchidopexy: the relative importance of each step of mobilisation. Pediatr Surg Int. 1997;12(2/3):163-164 PMID:9069223
  • 11. Noseworthy J. Recurrent undescended testes. Semin Pediatr Surg. 2003;12(2):90-93.
  • 12. Dayanç M, Kibar Y, Tahmaz L, Yildirim I, Peker AF. Scrotal incision orchiopexy for undescended testis. Urology. 2004;64(6):1216-1219.
  • 13. Bassel YS, Scherz HC, Kirsch AJ. Scrotal incision orchiopexy for undescended testes with or without a patent processus vaginalis. J Urol. 2007;177(4):1516-1518.
  • 14. Iyer, K.R., Kumar, V., Huddart, S.N., Bianchi A. The scrotal approach. Pediatr Surg Int 10, 58–60 (1995).
  • 15. Shirazi M, Safavi S, Makarem A, Malekmakan L. Comparison Between Processus Vaginalis Sac Tightening Technique and the Conventional Technique in Orchiopexy Surgery Over 10 Years. Res Rep Urol. 2020;12:129-136. Published 2020 Mar 18.
  • 16. Schier F. Laparoscopic inguinal hernia repair-a prospective personal series of 542 children. J Pediatr Surg. 2006;41(6):1081-1084.
  • 17. Handa R, Kale R, Harjai MM. Laparoscopic orchiopexy: is closure of the internal ring necessary?. J Postgrad Med. 2005;51(4):266-268 PMID:16388167
  • 18. Lin J, Li D, Chen J, Lin L, Xu Y. Inguinal hernia repair by Bianchi incision in boys: a retrospective study. Pediatr Surg Int. 2018;34(3):289-295.
  • 19. Ok F, Durmus E, Ayaz M. The role of the resistive index in predicting testicular atrophy after orchiopexy in unilateral undescended testis. Pediatr Surg Int. 2022;39(1):38. Published 2022 Dec 8.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Çocuk Cerrahisi, Çocuk Ürolojisi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Nilsun Kuas 0000-0001-6951-3494

Ufuk Ateş 0000-0001-6591-7168

Ergun Ergün 0000-0001-8806-4022

Aysel Mammadlı 0009-0008-6531-1279

İrem Semiha Köksaldı 0000-0002-4786-2981

Atike Atasoy 0000-0002-8267-197X

Gulnur Gollu 0000-0001-8163-2226

Meltem Koloğlu 0000-0001-7726-7633

Aydın Yağmurlu 0000-0002-3294-4482

Ahmet Çakmak 0000-0002-4870-8361

Yayımlanma Tarihi 17 Ocak 2025
Gönderilme Tarihi 22 Eylül 2024
Kabul Tarihi 12 Aralık 2024
Yayımlandığı Sayı Yıl 2025 Cilt: 47 Sayı: 1

Kaynak Göster

Vancouver Kuas N, Ateş U, Ergün E, Mammadlı A, Köksaldı İS, Atasoy A, Gollu G, Koloğlu M, Yağmurlu A, Çakmak A. Effect of Closing Processus Vagınalis in Orchıdopexy to Recurrence and Testicular Atrophy – 15 Years Experience. Osmangazi Tıp Dergisi. 2025;47(1):91-4.


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