One-day surgery cryptorchidism including intraoperative estimation of gonad condition
Article published in Urologia Polska 2004/57/3.

authors

Wojciech Korlacki, Józef Dzielicki

Katedra i Klinika Chirurgii Wad Rozwojowych Dzieci i Traumatologii Śląskiej Akademii Medycznej w Zabrzu
Kierownik kliniki: prof. dr hab. Józef Dzielicki

keywords

testis, cryptorchidism, pediatric surgery, one-day surgery, children

summary

aim of the study

Estimating one-day surgery for juvenile cryptorchidism and usefulness of a scale for intraoperative assessment of the defect.

Material and methods

In the period 1993-2003 1021 boys were treated, subjected to 1188 one-day surgery for cryptorchidism. Age of the patients varied from 6 months to 14 years, average of 3,1 years. Qualification for the surgical treatment and perioperative treatment were conformed to the earlier accepted schemes. Typical Schoemaker-Petrivalsky procedure was performed. The condition of the testis, its placement, size and junction with epididymis were estimated during the operation according to Beltran-Brown scale.

Results

Surgical or anesthesiological complications occurred in 1,51 percent. Six patients suffered from laryngo- and bronchospasm in the recovery phase, prolonged nausea and vomiting in 4 and long recovery in 2 patients. Surgical complications included wound infection in 3 children and hematoma of the scrotum in 3 others. Thirty percent of testes were of normal size, 62,7 percent were smaller than normal, size of 6,3 percent indicated to their imminent atrophy; in 1 percent of patients testis was not found. In 87,6 percent the testis was discovered in the inguinal canal or its external ring while in 11,4 percent it was present at the internal inguinal ring or in the abdominal cavity.

Conclusions

1. One-day surgery for the treatment of cryptorchidism in boys is safe, equally favourable for the patient and for the institution.

2. Low rate of surgical or anesthesiological intra- and postoperative complications proves that algorhythms applied for qualification and choice of the procedure are correct.

3. Using a standard scale for intraoperative estimation of the testis condition helps to classify its defect and objective postoperative control of the gonad function.