Utilization of scrotal orchidopexy for palpable undescended testes among surgeons

Fahad A Alyami; Abdulaziz Fahad Bin Yahya; Hamad Fahad Albraidi; Nawaf Abdullah Almarek; Mohammed Abdulaziz Alkhalifa; Hamdan Alhazmi; Mahmoud Salem Trbay; Khalid Fouda Neel

doi:10.4103/UA.UA_54_18

Utilization of scrotal orchidopexy for palpable undescended testes among surgeons

Urol Ann. 2018 Oct-Dec;10(4):380-385. doi: 10.4103/UA.UA_54_18.

Authors

Fahad A Alyami¹, Abdulaziz Fahad Bin Yahya², Hamad Fahad Albraidi², Nawaf Abdullah Almarek², Mohammed Abdulaziz Alkhalifa², Hamdan Alhazmi², Mahmoud Salem Trbay², Khalid Fouda Neel²

Affiliations

¹ Department of Surgery, Division of Urology, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
² Department of Surgery, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.

Abstract

Introduction: Scrotal orchidopexy for palpable undescended testicle (UDT) has received attention in the last decade due to its lower morbidity. This study was conducted to determine the frequency and factors related to the use of the scrotal approach in the surgical treatment of palpable UDT among surgeons.

Methods: An observational cross-sectional study was carried out using an online survey, which was sent to different pediatric urologists, pediatric surgeons, and urologists groups. The survey consisted of questions on demographics as well as surgeons opinions and experience toward scrotal orchidopexy.

Results: Of 163 respondents, 57 (35.0%) were pediatric surgeons, 98 (60.1%) were pediatric urologists, and 8 (4.9%) were urologists. There were 86 respondents (52.8%) who used the scrotal orchidopexy approach for UDT at any time in their practice. Pediatric urologists tended to use the scrotal orchidopexy approach for UDT more significantly than others (P < 0.001). There were significantly more scrotal orchidopexies for UDT performed by the pediatric urologists throughout their practice and per year compared to others, respectively (P < 0.001). Fifty-two respondents (31.9%) claimed that scrotal orchidopexy is not a good option for their patients, while seven respondents (4.3%) claimed that the procedure was hard to perform.

Discussion: Based on the results of this study, we believe that there is a discrepancy in the reported advantages and success rate of scrotal orchidopexy in the published literature and the utilization of such an approach among surgeons managing palpable UDT in children.

Conclusion: Scrotal orchidopexy is an underutilized approach in the management of palpable UDT in children. Only 52.8% of our respondents used it for UDT. One of the main reasons why scrotal orchidopexy is underutilized is due to the surgeons' perception that scrotal orchidopexy is not the procedure of choice for their patients and their unfamiliarity with the procedure.

Keywords: Cryptorchidism; scrotal orchidopexy; surgical approach; undescended testis.