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Staged Orchiorrhaphy: Therapeutic Procedure in Cryptorchic Testicle With a Short Spermatic Cord

Staged Orchiorrhaphy: Therapeutic Procedure in Cryptorchic Testicle With a Short Spermatic Cord Abstract In 62 planned staged orchiorrhaphies for a "short" spermatic cord, satisfactory location of the testicle following the second operation was achieved in 90% of cases. The testicle was atrophic and had to be excised in only 3.2%. After a follow-up period of two to ten years, the testicle remained satisfactorily located in 77% of cases; adequate size and configuration of the testicle (compared to the contralateral side) was found in 64.5%. In 17%, a partial or complete atrophy developed. No correlation was found between the initial size of the testicle and the late results. It is advocated, therefore, that excision be avoided unless definite atrophy exists. Planned staged orchiorrhaphy is recommended for testicles in high locations that are difficult to bring down. The late preschool period (5 to 6 years) is suggested as the optimal age for the first attempt at orchiorrhaphy and the second stage two years later, if required. References 1. Gross RE, Replogle RL: Treatment of the undescended testis . Postgrad Med 34:266-270, 1964. 2. Brendler H, Wulfsohn MA: Surgical treatment of the high undescended testis . Surg Gynecol Obstet 124:605-608, 1967. 3. Bill AH, Shanahan DA: The management of the undescended testicle . Surg Clin North Am 44:1571-1582, 1964. 4. Boley SJ, Kleinhaus S: A place for the Cheatle-Henry approach in pediatric surgery . J Pediatr Surg 1:394-397, 1966.Crossref 5. Ombredanne L: Indications et technique de l'orchiopexie trans-scrotale chez l'enfant . Presse Med 18:745-746, 1910. 6. Kirillov BP, Volozhin SI: Advances in the treatment of cryptorchism . Khirurgiia Mosk 47:120-122, 1971. 7. Fowler and Stephens, cited by Firor HV: Two-stage orchiopexy . Arch Surg 102:598-599, 1971.Crossref 8. Welch KJ: Orchiopexy: A new anchoring technique, window septopexy . J Pediatr Surg 7:163-167, 1972.Crossref 9. Fonkalsrud EW: Current concepts in the management of the undescended testis . Surg Clin North Am 50:847-852, 1970. 10. Firor HV: Two-stage orchiopexy . Arch Surg 102:598-599, 1971.Crossref 11. Persky L, Albert DJ: Staged orchiopexy . Surg Gynecol Obstet 132:43-45, 1971. 12. Riker WL: Surgical treatment of undescended testis . Am J Surg 101:664-667, 1961.Crossref 13. Cohn BD: Histology of the cryptorchid testis . Surgery 62:536-541, 1967. 14. Scorer CG: Early operation for undescended testis . Br J Surg 54:694-698, 1967.Crossref 15. Johnson DE, Woodhead DM, Pohl DR, et al: Cryptorchism and testicular tumorigenesis . Surgery 63:919-921, 1968. 16. Altman BL, Malament M: Carcinoma of the testis following orchiopexy . J Urol 97:498-504, 1967. 17. Farrington GH: Histologic observations in cryptorchidism . J Pediatr Surg 4:606-613, 1969.Crossref 18. Numanoglu I, Köktürk I, Mutaf O: Light and electron microscopic examinations of undescended testicles . J Pediatr Surg 4:614-619, 1960.Crossref 19. Sohval AR: Testicular dysgenesis in relation to neoplasm of the testicle . J Urol 75:285-291, 1956. 20. Hinman F: Optimum time for orchiopexy in cryptorchidism . Fertil Steril 6:206-214, 1955. 21. Thackray AC: Seminoma . Br J Urol , (suppl 36) , pp 12-27, 1964. 22. Hausfeld KF, Schrandt D: Malignancy of testis following atrophy . J Urol 94:69-72, 1965. 23. Hinman F, Smith GI: Leydig cell neoplasia in experimental testicular atrophy . J Urol 83:706-712, 1960. 24. Haines JS, Grabstald H: Tumor formation in atrophic testes . Arch Surg 60:857-860, 1950.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Staged Orchiorrhaphy: Therapeutic Procedure in Cryptorchic Testicle With a Short Spermatic Cord

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Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1975.01360100029006
Publisher site
See Article on Publisher Site

Abstract

Abstract In 62 planned staged orchiorrhaphies for a "short" spermatic cord, satisfactory location of the testicle following the second operation was achieved in 90% of cases. The testicle was atrophic and had to be excised in only 3.2%. After a follow-up period of two to ten years, the testicle remained satisfactorily located in 77% of cases; adequate size and configuration of the testicle (compared to the contralateral side) was found in 64.5%. In 17%, a partial or complete atrophy developed. No correlation was found between the initial size of the testicle and the late results. It is advocated, therefore, that excision be avoided unless definite atrophy exists. Planned staged orchiorrhaphy is recommended for testicles in high locations that are difficult to bring down. The late preschool period (5 to 6 years) is suggested as the optimal age for the first attempt at orchiorrhaphy and the second stage two years later, if required. References 1. Gross RE, Replogle RL: Treatment of the undescended testis . Postgrad Med 34:266-270, 1964. 2. Brendler H, Wulfsohn MA: Surgical treatment of the high undescended testis . Surg Gynecol Obstet 124:605-608, 1967. 3. Bill AH, Shanahan DA: The management of the undescended testicle . Surg Clin North Am 44:1571-1582, 1964. 4. Boley SJ, Kleinhaus S: A place for the Cheatle-Henry approach in pediatric surgery . J Pediatr Surg 1:394-397, 1966.Crossref 5. Ombredanne L: Indications et technique de l'orchiopexie trans-scrotale chez l'enfant . Presse Med 18:745-746, 1910. 6. Kirillov BP, Volozhin SI: Advances in the treatment of cryptorchism . Khirurgiia Mosk 47:120-122, 1971. 7. Fowler and Stephens, cited by Firor HV: Two-stage orchiopexy . Arch Surg 102:598-599, 1971.Crossref 8. Welch KJ: Orchiopexy: A new anchoring technique, window septopexy . J Pediatr Surg 7:163-167, 1972.Crossref 9. Fonkalsrud EW: Current concepts in the management of the undescended testis . Surg Clin North Am 50:847-852, 1970. 10. Firor HV: Two-stage orchiopexy . Arch Surg 102:598-599, 1971.Crossref 11. Persky L, Albert DJ: Staged orchiopexy . Surg Gynecol Obstet 132:43-45, 1971. 12. Riker WL: Surgical treatment of undescended testis . Am J Surg 101:664-667, 1961.Crossref 13. Cohn BD: Histology of the cryptorchid testis . Surgery 62:536-541, 1967. 14. Scorer CG: Early operation for undescended testis . Br J Surg 54:694-698, 1967.Crossref 15. Johnson DE, Woodhead DM, Pohl DR, et al: Cryptorchism and testicular tumorigenesis . Surgery 63:919-921, 1968. 16. Altman BL, Malament M: Carcinoma of the testis following orchiopexy . J Urol 97:498-504, 1967. 17. Farrington GH: Histologic observations in cryptorchidism . J Pediatr Surg 4:606-613, 1969.Crossref 18. Numanoglu I, Köktürk I, Mutaf O: Light and electron microscopic examinations of undescended testicles . J Pediatr Surg 4:614-619, 1960.Crossref 19. Sohval AR: Testicular dysgenesis in relation to neoplasm of the testicle . J Urol 75:285-291, 1956. 20. Hinman F: Optimum time for orchiopexy in cryptorchidism . Fertil Steril 6:206-214, 1955. 21. Thackray AC: Seminoma . Br J Urol , (suppl 36) , pp 12-27, 1964. 22. Hausfeld KF, Schrandt D: Malignancy of testis following atrophy . J Urol 94:69-72, 1965. 23. Hinman F, Smith GI: Leydig cell neoplasia in experimental testicular atrophy . J Urol 83:706-712, 1960. 24. Haines JS, Grabstald H: Tumor formation in atrophic testes . Arch Surg 60:857-860, 1950.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Apr 1, 1975

References