Re-do orchidopexy in a general surgical unit-reliability of clinical diagnosis and the outcome of surgery.
BACKGROUND
Re-do Orchidopexy is not very common, expertise is limited and the results of clinical examination and ultrasonography are not always reliable.


METHODS
This cross-sectional study was based on medical records of patients under-going re-exploration of inguinal region for a missing testicle after previous groin surgery, and no mention of orchidectomy. All patients were thoroughly examined, investigated with ultrasonography and offered re-exploration. Results were graded as Good, Fair and Poor.


RESULTS
Out of 11 boys included in the study, 7 (63.63%) had failed orchidopexy. Another 3 (27.27%) were opened for 2nd stage orchidopexy and 1 (9.09%) had iatrogenic ascent of testis after herniotomy. On clinical examination 4 (36.36%) had a palpable testicle at the superficial ring, 2 (18.18%) were in inguinal canal (1 doubtful!), and no testicle could be palpated in 5 (45.45%). Ultrasonography picked up 2 testicles (18.18%) at the superficial Inguinal ring, 1 (9.09%) in Inguinal canal and 1 (9.09%) testicle in the abdominal cavity. On reexploration, 10 (90.9%) testicles were found and brought down, 7 (63.63%) being considered of reasonable consistency and size. Another 3 (27.27%) were considered soft or small in size, and in 1 (9.09%)), no testicle was found. In 5 patients (45.45%), the testicle was at superficial ring, in 3 (27.27%) in the inguinal canal, and in 2 (18.18%) in the abdominal cavity. Results were considered good in 6 (54.54%), fair in 3 (27.27%)) and poor in 2 (18.18%).


CONCLUSIONS
Groin examination after previous inguinal surgery is tricky. Ultrasonography is also not very reliable. Re-exploration via the inguinal approach is adequate and recommended. Thorough exploration is essential before declaring the testicle absent
Khattak
Irfanud Din
ID
Department of Surgery, Ayub Medical College, Abbottabad, Pakistan. irfankhattak64@hotmail.com
Zafar
Arshad
A
Khan
Ishtiaq Ali
IA
Akbar
Muhammad
M
Owais
Muhammad
M
Ahmad
Shahzad
S
D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D006801:Humans; D007223:Infant; D008297:Male; D009919:Orchiectomy / Q000379:methods*; D012086:Reoperation; D016896:Treatment Outcome