Surgery for Undescended Testis
Definitions
In cases of maldevelopment of testis, resulting in unilateral or bilateral maldescent of testis.
Objectives
To bring and keep the testis in the scrotum by the age of two years or so to:
• Prevent trauma and torsion
• Detect malignancy of testis early
• Improve fertility.
Position
Supine.
Anesthesia
General with endotracheal intubation.
Procedure
1. Open the inguinal canal through skin crease.
2. Divide the cremasteric muscle fibers.
3. Isolate the spermatic cord with testis.
4. Detach the testis from the gubernacular attachments at the lower end.
5. Separate and suture ligate the hernial sac.
6. Mobilize in the retroperitoneal space if required to achieve the length of the spermatic vessels.
7. Fix the testis in the extradartos pouch without any tension.
8. Close the wound in layers.
Options
• Two stage procedure, if the spermatic vessels are short
• Simultaneous orchiopexy, if bilateral maldescent.
Sutures
• 4/0 Catgut 1
• 3/0 Catgut 1
• 4/0 Nylon 1
• 3/0 Silk
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