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Low Transscrotal Orchidopexy Is a Safe and Effective Approach for Undescended Testes Distal to the External Inguinal Ring

Objectives: To review the results of a low transscrotal orchidopexy in patients with palpable undescended testes located distal to the external inguinal ring. Methods: Between July 1998 and June 2005, transscrotal orchidopexy with a single low scrotal incision was performed in 32 patients for 49 undescended testes. The indication was an undescended testis that lay distal to the external ring and could be pulled down manually into the scrotum under general anesthesia. Results: All testes that were treated with the low transscrotal approach were successfully fixed in the middle or lower portion of the scrotum. The mean operative time was significantly shorter for the low transscrotal orchidopexy (45.2 min) than for the inguinal orchidopexy (66.6 min) for 107 undescended testes at similar locations. The median follow-up duration was 39.1 months; all testes except 1 (97.7%) were located in a good position within the scrotum and had a good consistency; 1 testis ascended postoperatively and required inguinal orchidopexy. No inguinal hernias or hydroceles occurred after the surgery. Conclusions: Low transscrotal orchidopexy appears to be an excellent alternative to the standard inguinal orchidopexy for undescended testes located distal to the external inguinal ring.