High scrotal orchidopexy for palpable maldescended testes.

Objective: To confirm that most spermatic cords of palpable maldescended testes are long enough to place the testes in the scrotum and therefore that a satisfactory scrotal testicular position can be achieved by a single high scrotal incision with less dissection of the inguinal region.

Methods: Between January 1991 and June 1995, 106 high scrotal orchidopexies (HSOs) for clinically palpable maldescended testes were carried out in 96 patients (mean age 41 months, range 14 months to 11 years). Ten patients had bilateral undescended testes. Regardless of the initial testicular position or the age of the patients, all orchidopexies were commenced with a high scrotal incision. Ninety-two testes (87%) were placed satisfactorily in the scrotum and the remaining 14 testes (13%) required a second inguinal incision.

Results: During the follow-up (mean 16 months, range 8 months to 3 years), 85 testes (80%) showed good anatomical and cosmetic results. Five testes required a repeat conventional orchidopexy 6 months after the HSO. Three testes were excised because they showed atrophic changes; 11 of the 14 testes which required two incisions initially have shown good results.

Conclusions: High scrotal orchidopexy is a satisfactory approach to any palpable maldescended testis, having the advantage of using a single incision and requiring less dissection and anatomical disruption of the inguinal region, with excellent cosmesis.