Total Inguinal Canal Mobilization in Two-Stage Orchiopexy

Background: Many different techniques have been described to treat undescended testes. We aimed to study a new technique of two-stage orchiopexy with total inguinal canal mobilization to prevent cord damage and testicular atrophy. Methods: Between March 2002 and July 2005, we operated on 16 testes with short spermatic cord. In the first stage, the testes were anchored to the pubic tubercle and 6 months later (second stage) they were fixed in the scrotum through total inguinal canal mobilization. The patients were followed up by pre and postoperative physical examination, sonography of scrotum, and serum testosterone level measurement for 6-12 months. Results: Two of the 16 testes developed atrophy but 14 had volume increase. Mean testicular volumes of preoperative and 1 and 6 months postoperative testes were 0.69 ± 0.22 ml, 0.84 ±0.26 ml, and 1.06 ±0.33 ml respectively. The volume increase was not only significant 1 (P=0.012) and 6 (P=0.002) months after the second operation compared with the first operation but also a significant increase in the volume was noted between the 1st and 6th month after the operation (P=0.003). All testes were in scrotum after 6-12 months and the patients had normal serum testosterone level for their ages before and after the operation. Conclusion: Two-stage orchiopexy with total inguinal canal mobilization prevents vascular damage in the second stage of operation.