[Long term results of orchidopexy: transscrotal fixation versus Dartos-pouch].
The aim in treating the undescended testis is to move the testis, without tension, permanently and deeply into the scrotum. Depending on the treatment, literature reveals a quote of relapses up to > 10 %. It was the aim of our investigations to judge in how far the quote of relapses after operative treatment of undescended testes can be related to the technique of operation.


METHODS
Two groups with maldescensus testis treated by two different techniques of orchidopexy were compared retrospectively. 692 boys (mean age: 4.7 years; median age: 4.0 years) with 867 undescended testes underwent operative orchidopexy by the Gross technique (group 1). In comparison, the Petrivalsky/Schoemaker technique was performed on 493 boys (mean age: 5.0 years; median age: 4.0 years) with 609 undescended testes (group 2). Three months to eight years after operative treatment, the localisation and size of the testis was recorded.


RESULTS
(1) In group 1 there were 39.3 % right-sided, 35.4 % left-sided and 25.3 % bilateral undescended testes. Primary operations were performed on 612 of 692 boys (88.4 %), whereas 469 patients (76.6 %) had a follow-up examination: the operation by using the Gross technique was successful in 90.6 % of the cases; there was an atrophy of the testis in 0.2 % and relapses were found in 9.2 %. (2) In group 2 there were 41.2 % right-sided, 35.3 % left-sided and 23.5 % bilateral undescended testes. Primary operations were performed on 446 of 493 boys (90.5 %), whereas 353 patients (79.1 %) had a follow-up examination: the operation using the Petrivalsky/Schoemaker technique was successful in 95.5 % of the cases; there was an atrophy of the testis in 0.3 % and relapses were found only in 4.2 %. (3) Under the same outer conditions the amount of relapses after orchidopexy was significantly (p < 0.025) smaller in group 2 (Petrivalsky/Schoemaker technique) than in group 1 (Gross technique).


CONCLUSIONS
Our observations show that the Petrivalsky/Schoemaker technique for the operative treatment of undescended testis results in a significantly lower rate of relapses. However, the consequences of both techniques concerning fertility must be discussed after further investigations.
Meyer
T
T
Abteilung für Kinderchirurgie, Chirurgische Universitätsklinik und Poliklinik, Julius-Maximilians-Universität, Würzburg. thomas.meyer@mail.uni-wuerzburg.de
Höcht
B
B
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D012611:Scrotum / Q000601:surgery; D013737:Testis / Q000601:surgery; D013997:Time Factors