title: Testicular rerouting by modified Prentiss maneuver: usefulness in bilateral synchronous orchidopexy for high inguinal undescended testes.
abstract: OBJECTIVE
  To describe our experience and illustrate the surgical procedure of synchronous bilateral testicular rerouting in high inguinal undescended testes (HIUT) by extending the use of "modified Prentiss maneuver" in bilateral situation, to establish this as a procedure of choice in bilateral HIUT and secondly to demonstrate the length gained by maneuver itself.
  
  
  METHODS
  Between January 2011 and December 2012 ten boys (8months-6years) with diagnosis of bilateral HIUT were included in the study. Bilateral orchidopexy was done by "modified Prentiss maneuver" under general anesthesia. Postoperatively all patients were evaluated at 3 months ,6 months and 1 year by physical examinations and ultrasound.
  
  
  RESULTS
  It was possible to reroute the testes underneath inferior epigastric artery (IEA) without its mobilization and thus locate testicular pedicle through a fascial hole above pubic tubercle, well medial to IEA. The average gain in scrotal positioning was 16mm (10-22mm).No retractions, atrophy of testis, clinical weakness of anterior abdominal wall or inguinal herniation was noted in any patient up to one year follow up.
  
  
  CONCLUSIONS
  Testicular re-routing by "modified Prentiss maneuver" is a simple, feasible, safe and efficient method for bilateral orchidopexy in bilateral HIUT. Preserving the inferior epigastric artery bilaterally has physiologic advantages.
authors.affiliation: Department of Urology, King George's Medical University, Lucknow, India. Electronic address: drjpswami@gmail.com.
authors.forename: Jai
authors.initials: J
authors.lastname: Prakash
authors.affiliation: Department of Urology, King George's Medical University, Lucknow, India.
authors.forename: Deepansh
authors.initials: D
authors.lastname: Dalela
authors.affiliation: Department of Urology, King George's Medical University, Lucknow, India.
authors.forename: Apul
authors.initials: A
authors.lastname: Goel
authors.affiliation: Department of Urology, King George's Medical University, Lucknow, India.
authors.forename: Divakar
authors.initials: D
authors.lastname: Dalela
authors.affiliation: Department of Urology, King George's Medical University, Lucknow, India.
authors.forename: Manoj
authors.initials: M
authors.lastname: Kumar
authors.affiliation: Department of Urology, King George's Medical University, Lucknow, India.
authors.forename: Satya Narayan
authors.initials: SN
authors.lastname: Sankhwar
authors.affiliation: Department of Pediatric Surgery, King George's Medical University, Lucknow, India.
authors.forename: Shiv Narain
authors.initials: SN
authors.lastname: Kureel
mesh_terms: D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007264:Inguinal Canal; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D056126:Orchiopexy / Q000379:methods*; D012189:Retrospective Studies; D013737:Testis / Q000601:surgery*; D016896:Treatment Outcome
keywords: Bilateral orchidopexy; High inguinal undescended testes; Modified Prentiss maneuver; Testicular rerouting