Our Summary

The research paper discusses two types of surgeries for fixing undescended testes (when a boy’s testicles haven’t moved down into the scrotum before birth): open orchiopexy (OO) and laparoscopic orchiopexy (LO). The researchers wanted to understand which method was more effective, safer, and cost-effective.

They found that certain actions taken during the LO procedure, like high dissection and the Prentiss maneuver, didn’t improve the success rate and actually increased the risk of complications. The success and complication rates for both LO and OO were similar. However, LO was more expensive than OO.

Based on these findings, the researchers concluded that OO should be the preferred procedure since it offers a better cost-benefit ratio. LO can be an alternative, but unnecessary steps like high dissection and the Prentiss maneuver should be avoided.

FAQs

  1. What are the two types of surgeries for fixing undescended testes discussed in the research paper?
  2. What were the findings of the researchers about the effectiveness, safety, and cost of open orchiopexy (OO) and laparoscopic orchiopexy (LO)?
  3. Why did the researchers conclude that open orchiopexy (OO) should be the preferred procedure for undescended testes?

Doctor’s Tip

A doctor might advise a patient undergoing undescended testicle surgery to discuss with their surgeon the most appropriate procedure for their specific case. They may also recommend following post-operative instructions carefully, including avoiding strenuous activity and keeping the surgical area clean and dry to promote proper healing. Additionally, it’s important to attend follow-up appointments to monitor recovery and address any concerns promptly.

Suitable For

Patients who have undescended testicles are typically recommended undescended testicle surgery. This condition is usually diagnosed in young boys, and surgery is recommended to prevent potential complications such as infertility, testicular cancer, and inguinal hernias. The choice between open orchiopexy and laparoscopic orchiopexy will depend on factors such as the patient’s age, the location of the undescended testicle, and the surgeon’s expertise.

Timeline

Before surgery:

  1. Patient is diagnosed with an undescended testicle during a physical examination.
  2. Patient may undergo imaging tests such as ultrasound to confirm the diagnosis.
  3. Patient and their family discuss treatment options with a urologist, including the possibility of surgery.
  4. Surgery is scheduled and pre-operative instructions are given to the patient.

After surgery:

  1. Patient undergoes either open orchiopexy (OO) or laparoscopic orchiopexy (LO) to bring the testicle down into the scrotum.
  2. Patient is monitored in the recovery room and then discharged home with post-operative instructions.
  3. Patient may experience pain, swelling, and bruising in the scrotum following surgery.
  4. Patient follows up with the urologist for post-operative care and monitoring.
  5. Patient gradually resumes normal activities as pain and swelling subside.
  6. Patient’s testicle is now in the correct position in the scrotum, potentially improving fertility and reducing the risk of complications such as testicular cancer.

Overall, the surgery for an undescended testicle aims to correct the positioning of the testicle to improve long-term health outcomes for the patient.

What to Ask Your Doctor

Some questions a patient should ask their doctor about undescended testicle surgery include:

  1. What are the risks and benefits of both open orchiopexy and laparoscopic orchiopexy?
  2. Which surgical method do you recommend for my specific case and why?
  3. What is the success rate of each procedure in terms of bringing the testicle down into the scrotum?
  4. What are the potential complications associated with each type of surgery?
  5. How long is the recovery period for each type of surgery?
  6. Will I need follow-up appointments after the surgery, and if so, how often?
  7. Are there any lifestyle changes or restrictions I should be aware of post-surgery?
  8. What is the cost difference between open orchiopexy and laparoscopic orchiopexy, and will my insurance cover the procedure?
  9. Are there any specific steps or techniques during the surgery that I should be aware of based on the research findings?
  10. What is the expected long-term outcome of the surgery in terms of fertility and overall testicular health?

Reference

Authors: Mentessidou A, Gargano T, Lima M, Mirilas P. Journal: J Pediatr Surg. 2022 Apr;57(4):770-775. doi: 10.1016/j.jpedsurg.2021.07.003. Epub 2021 Jul 6. PMID: 34304904