One-stage transcrotal orchidopexy in bilateral inguinal cryptorchidism in children
BACKGROUND: The frequency of cryptorchidism varies and depends on gestational age, affecting 1.0-4.6% of full-term and 1.1-45% of preterm newborns. Treatment of this defect is currently surgical. Orchiopexy is one of the frequent surgical aids in the practice of a pediatric surgeon and a pediatric urologist. The need for bilateral inguinal cryptorchidism to perform several incisions or separate operations on each side by time forces pediatric surgeons to continue searching for the optimal way to correct bilateral cryptorchidism. AIM: To determine the possibilities of fixation of both testicles with bilateral cryptorchidism in a physiological position in the scrotum through a single surgical approach with fewer complications and improved cosmetic result in comparison with the previously proposed methods. MATERIALS AND METHODS: From 2012 to 2021, we treated 92 male children with bilateral inguinal cryptorchidism. All boys underwent the developed method of single-stage transcrotal bilateral orchiopexy, accompanied, if necessary, by laparoscopic assistance using the method of single-acar laparoscopic access. RESULTS: The results of treatment of 92 children with bilateral inguinal cryptorchidism (184 gonads) in several clinics using this method are presented. Thanks to the improvement of the technology of orchiopexy in the form of single-acar laparoscopic assistance in cases that do not allow the testicle to be freely lowered into the scrotum, the number of complications associated with surgical access, such as pronounced postoperative edema and inflammation of the postoperative wound area, decreased to 1.62% of cases, and there were no relapses of the disease and persistent inguinal hernias. CONCLUSIONS: The article describes a new method of single-stage transcrotal orchiopexy with laparoscopic assistance and statistically substantiates its use in bilateral inguinal cryptorchidism, which allows fixing both testicles in a physiological position in the scrotum at any position of the testicles in the inguinal region with fewer complications and improved cosmetic result in comparison with the previously proposed methods.