Modified scrotal (Bianchi) mid raphe single incision orchiopexy for low palpable undescended testis: early outcomes

Purpose: We compared the results of low transscrotal mid raphe orchiopexy, high scrotal incision (Bianchi) and conventional inguinal approach in patients with palpable undescended testes.

Materials and methods: Orchiopexies performed between January 2003 and September 2009 with a minimum 3-month followup were included. Low scrotal incision (group 1) and high scrotal incision (group 2) were compared to the traditional inguinal 2-incision technique (group 3). We retrospectively reviewed operative time, success as defined by mid or lower scrotal position of the testis, and complications at 12 weeks and 1 year postoperatively.

Results: A total of 286 orchiopexies were performed in 214 patients with palpable undescended testes. Group 1 included 81 patients with 125 undescended testes. Group 2 consisted of 44 patients with 60 undescended testes. Group 3 included 89 patients with 101 undescended testes. Postoperatively the testes were located in a good position within the scrotum in 99% of patients in group 1, 98% in group 2 and 100% in group 3. Mean±SD operative time for unilateral undescended testes was significantly shorter for low transscrotal compared to inguinal orchiopexy (28±10 vs 37±12 minutes, p<0.0001) but equivalent to a high scrotal incision (27±10 minutes, p=0.59). For all 160 children followed for 1 year no long-term atrophy or secondary reascent was observed.

Conclusions: Low transscrotal mid raphe orchiopexy appears to be an excellent alternative to high scrotal incision or standard inguinal orchiopexy for low palpable undescended testes, especially bilateral cases.