title: Long-Term Outcome of Low Scrotal Approach Orchiopexy without Ligation of the Processus Vaginalis.
abstract: OBJECTIVE
  We performed low scrotal approach orchiopexy in patients with prescrotal cryptorchidism. The processus vaginalis was not ligated if it was not widely patent. We retrospectively evaluated the long-term outcomes of low scrotal approach orchiopexy without processus vaginalis ligation.
  
  
  METHODS
  A total of 137 patients (227 testes) were diagnosed with prescrotal cryptorchidism between October 2009 and April 2014. All patients underwent low scrotal approach orchiopexy. Mean age at surgery was 34.9 months. The processus vaginalis was deemed to be not widely patent when a sound could not be passed into the abdominal cavity through the internal inguinal ring, and the processus vaginalis was not ligated in such cases.
  
  
  RESULTS
  Intraoperative findings revealed that the processus vaginalis was widely patent in 10 testes and was not widely patent in 217. A widely patent processus vaginalis was closed via scrotal approach in 5 testes, while an inguinal approach was necessary in 5. Median followup was 44 months (range 20 to 73). Postoperative complications included reascending testis in 1 case where an inguinal approach was necessary. No patient manifested testicular atrophy or inguinal hernia.
  
  
  CONCLUSIONS
  Low scrotal approach orchiopexy is a useful and safe procedure for treating patients with prescrotal cryptorchidism. Ligation is unnecessary when the processus vaginalis is not widely patent.
authors.affiliation: Department of Pediatric Urology, Jichi Medical University, Children's Medical Center Tochigi, Tochigi, Japan. Electronic address: thyuga@jichi.ac.jp.
authors.forename: Taiju
authors.initials: T
authors.lastname: Hyuga
authors.affiliation: Department of Pediatric Urology, Jichi Medical University, Children's Medical Center Tochigi, Tochigi, Japan.
authors.forename: Shina
authors.initials: S
authors.lastname: Kawai
authors.affiliation: Department of Pediatric Urology, Jichi Medical University, Children's Medical Center Tochigi, Tochigi, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Nakamura
authors.affiliation: Department of Pediatric Urology, Jichi Medical University, Children's Medical Center Tochigi, Tochigi, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Pediatric Urology, Jichi Medical University, Children's Medical Center Tochigi, Tochigi, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Nakai
mesh_terms: D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008026:Ligation; D008297:Male; D056126:Orchiopexy / Q000379:methods*; D012189:Retrospective Studies; D012611:Scrotum / Q000601:surgery*; D016896:Treatment Outcome
keywords: cryptorchidism; orchiopexy; testis