Advertisement

Cryptorchidism pp 115-126 | Cite as

Surgical Treatment of Cryptorchidism

  • J. R. Woodard
  • T. S. Trulock

Abstract

Despite the current research and renewed enthusiasm for hormones, surgery remains the cornerstone of therapy for cryptorchidism. Orchiopexy was apparently first attempted by Rosenmerkel in 1820, but the operation did not gain popularity until the end of the nineteenth century when Bevan described the dissection of the cord to provide the length necessary for the testis to reach the scrotum [1, 2]. While there was no provision for anchoring the testis in the scrotum in Bevan’s original operation, he later described a purse-string suture at the neck of the scrotum. Subsequently, various methods of testicular fixation have been suggested. Torek advocated fixation of the testis to the fascia lata subcutaneously on the inner aspect of the thigh with a second operation 3 months later to release the testis into the scrotum [3]. Ombredanne anchored the testis by passing it across the scrotal septum to the opposite scrotal compartment [4].

Keywords

Spermatic Cord Undescended Testis Tunica Albuginea Spermatic Vein Scrotal Skin 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Rosenmerkel JF (1820) Über die Radikalkur des in der Weiche liegenden Testikels bei nicht erfolgtem Descensus desselben. J Lindauer, MunichGoogle Scholar
  2. 2.
    Bevan AD (1899) Operation for undescended testicle and congenital inguinal hernia. JAMA 33:773CrossRefGoogle Scholar
  3. 3.
    Torek F (1909) The technic of orchiopexy. NY J Med 90:948Google Scholar
  4. 4.
    Ombredanne L (1927) Sur lorchiopexie. Bull Soc Pédiatr Paris 25:473Google Scholar
  5. 5.
    Cabot H, Nesbit RM (1931) Undescended testis. Arch Surg 22:850CrossRefGoogle Scholar
  6. 6.
    Lattimer JK (1957) Scrotal pouch technique for orchio pexy. J Urol 78:628PubMedGoogle Scholar
  7. 7.
    Flinn RA, King LR (1971) Experiences with the midline transabdominal approach in orchiopexy. Surg Gynecol Obstet 133:285PubMedGoogle Scholar
  8. 8.
    Hunt JB, Withington R, Smith AM (1981) The midline preperitoneal approach to orchiopexy. Am Surg 47:184PubMedGoogle Scholar
  9. 9.
    Burrow M, Gough MH (1970) Bilateral absence of testes. Lancet 1:366Google Scholar
  10. 10.
    Campbell MF (1970) Anomalies of the genital tract. In: Campbell MF, Harrison JH (eds) Urology. Saunders, Philadelphia, p 1625Google Scholar
  11. 11.
    Jost A (1953) Problems of fetal endocrinology. Rec Prog Horm Res 8:379Google Scholar
  12. 12.
    Abeyarotine MC, Aherne WA, Scott JES (1969) The vanishing testis. Lancet 2:822CrossRefGoogle Scholar
  13. 13.
    Levitt SB, Kogan SJ, Engel RM, Weiss RM, Martin DC, Ehrlich RM (1978) The impalpable testis: a rational approach to management. J Urol 120:515PubMedGoogle Scholar
  14. 14.
    Lunderquist A, Rafstedt S (1967) Roentgenologic diagnosis of cryptorchidism. J Urol 98:219PubMedGoogle Scholar
  15. 15.
    White JJ, Haller JA Jr, Dorst JP (1970) Congenital inguinal hernia and inguinal herniography. Surg Clin North Am 50:823PubMedGoogle Scholar
  16. 16.
    Weiss RM, Glickman MG, Lytton B (1977) Venographic localization of the non-palpable undescended testis in children. J Urol 117:513PubMedGoogle Scholar
  17. 17.
    Madrazo BL, Klugo RC, Parks JA, Diloreto R (1979) Ultrasonographic demonstration of undescended testes. Radiology 133:181PubMedGoogle Scholar
  18. 18.
    Lee JKT, McClennan BC, Stanley RJ, Sagel SS (1980) Utility of computed tomography in the localization of the undescended testis. Radiology 135:121PubMedGoogle Scholar
  19. 19.
    Wolverson MK, Jagannadharao B, Sundarm M, Riaz MA, Nalesnik WJ, Houttuin E (1980) CT in localization of impalpable cryptorchid testes. Am J Roentgenol 134:725Google Scholar
  20. 20.
    Silber SJ, Cohen R (1980) Laparoscopy for cryptorchidism. J Urol 124:928PubMedGoogle Scholar
  21. 21.
    Marshall FF, Weissman RM, Jeffs RD (1980) Cryptorchidism : The surgical implications of non-union of the epididymis and testis. J Urol 125:560Google Scholar
  22. 22.
    Brothers LR III, Weber CH Jr, Bull TR Jr (1978) Anorchism versus cryptorchism: The importance of a diligent search for intra-abdominal testis. J Urol 119:707PubMedGoogle Scholar
  23. 23.
    Martin DC, Menck HR (1975) The undescended testis: management after puberty. J Urol 114:77PubMedGoogle Scholar
  24. 24.
    Snyder WH Jr, Chaffín L (1955) Surgical management of undescended testes. Report of 363 cases. JAMA 157:129CrossRefGoogle Scholar
  25. 25.
    Gross RE, Jewett TC (1956) Surgical experiences from 1,222 operations for undescended testes. JAMA 160:634CrossRefGoogle Scholar
  26. 26.
    Persky L, Albert DJ (1971) Staged orchiopexy. Surg Gynecol Obstet 132:43PubMedGoogle Scholar
  27. 27.
    Firor HV (1971) Two-stage orchiopexy. Arch Surg 102:598PubMedCrossRefGoogle Scholar
  28. 28.
    Zer M, Wooloch Y, Dintsman M (1975) Staged orchiorhaphy. Therapeutic procedure in cryptorchid testicle with a short spermatic cord. Arch Surg 110:387PubMedCrossRefGoogle Scholar
  29. 29.
    Kiesewetter WB, Mammen K, Kalyglou M (1981) The rationale and results in two-stage orchiopexies. J Pediatr Surg[Suppl] 16:631CrossRefGoogle Scholar
  30. 30.
    Corkery JJ (1975) Staged orchiopexy -a new technique. J Pediatr Surg 10:515PubMedCrossRefGoogle Scholar
  31. 31.
    Redman JF (1977) The staged orchiopexy: a critical review of the literature. J Urol 117:113PubMedGoogle Scholar
  32. 32.
    Fowler R, Stephens FO (1959) The role of testicular vascular anatomy in the salvage of high undescended testes. Aust NZ J Surg 29:92CrossRefGoogle Scholar
  33. 33.
    Bevan AD (1903) The surgical treatment of undescended testicle: A further contribution. JAMA 41:718CrossRefGoogle Scholar
  34. 34.
    Brendler H, Wulfson MA (1967) Surgical treatment of high undescended testis. Surg Gynec and Obst 124:605Google Scholar
  35. 35.
    Clatworthy HW Hr, Hollanbaugh RS, Grosfeld JL (1972) The “long loop vas”orchiopexy for high undescended testis. Amer Surg 38:69Google Scholar
  36. 36.
    Johnston JH: Prune Belly syndrome (1977) In: Eckstein HB, Huhenfellner R, Williams DI (eds) Surgical Pediatric Urology. Philadelphia, Saunders WB Co., p 240Google Scholar
  37. 37.
    Gibbons MD, Cromie WJ, Duckett JW Jr (1979) Management of the abdominal undescended testicle. J Urol 122:76PubMedGoogle Scholar
  38. 38.
    Silber SJ, Kelly J (1976) Successful autotransplantation of an intra-abdominal testis to the scrotum by microvascular technique. J Urol 115:452PubMedGoogle Scholar
  39. 39.
    Martin DC, Salibian A (1980) Orchiopexy utilizing microvascular surgical techniques. J Urol 123:263Google Scholar
  40. 40.
    Romas NA, Janecka I, Krisiloff M (1978) Role of microsurgery in orchiopexy. Urology 12:670PubMedCrossRefGoogle Scholar
  41. 41.
    MacMahon RA, O’Brien B McC, Cussen JL (1976) The use of microsurgery in the treatment of the undescended testis. J Ped Surg 11:521CrossRefGoogle Scholar
  42. 42.
    Wacksman J, Dinner M, Straffon RP (1980) Technique of testicular autotransplantation using a microvascular anastomosis. Surg Gyn and Obst 150:399Google Scholar
  43. 43.
    Woodard JR, Parrott TS (1978) Orchiopexy in the prune belly syndrome. Br J Urol 50:348PubMedCrossRefGoogle Scholar
  44. 44.
    Gross RE, Replogle RL (1963) Treatment of the undescended testis. Opinions gained from 1,767 operations. Postgrad Med 34:266Google Scholar
  45. 45.
    Bill AH Jr, Shanahan DA (1964) The management of undescended testicle. Surg Clin North Am 44:1571Google Scholar
  46. 46.
    Williams DI, Burkholder GV (1967) The prune belly syndrome. J Urol 98:244PubMedGoogle Scholar
  47. 47.
    Lynn HB (1969) Undescended testis. Can Family Physi cian 15:33Google Scholar
  48. 48.
    Moschcowitz AV (1910) The anatomy and treatment of undescended testis: With especial reference to the Bevan operation. Ann Surg 52:821PubMedCrossRefGoogle Scholar
  49. 49.
    Mixter CG (1924) Undescended testicle: Operative treatment and end-results. Surg Gynecol Obstet 39:275Google Scholar
  50. 50.
    MacCollum DW (1935) Clinical study of the spermatogenesis of undescended testicles. Arch Surg 31:290CrossRefGoogle Scholar
  51. 51.
    Fowler R Jr, Stephens FD (1963) The role of testicular vascular anatomy in the salvage of high undescended testes. In: Webster R (ed) Congenital malformations of the rectum, anus, and genito-urinary tracts. E &S Livingstone Ltd, London, pp 306–320Google Scholar
  52. 52.
    Jones PG (1966) Undescended testes. Aust Paediatr J 2:36Google Scholar
  53. 53.
    Datta NS, Tanaka T, Zinner NR, Mishkin FS (1977) Division of spermatic vessels in orchiopexy: Radionuclide evidence of preservation of testicular circulation. J Urol 118:447PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin · Heidelberg 1983

Authors and Affiliations

  • J. R. Woodard
  • T. S. Trulock

There are no affiliations available

Personalised recommendations