Comparison of Single-Incision Scrotal Orchidopexy Versus Standard Two-Incision Inguinal Orchidopexy in Children With Palpable Undescended Testis

Abstract

Objective This study compares the operative time and complications including scrotal hematoma and secondary ascent of single-incision scrotal orchidopexy with standard two-incision inguinal orchidopexy in children for the treatment of palpable undescended testis. Methodology An open-label, randomized clinical trial was conducted at the Department of Pediatric Surgery Services Hospital, Lahore, Pakistan, for six months from August 16, 2021, to March 15, 2022. A total number of 266 patients with palpable undescended testis aged 1-10 years were included in this study. Patients were randomized into two groups with an equal number of candidates (n = 133) using the lottery method. In group A, a single-incision scrotal orchidopexy was done while in group B, two-incision inguinal orchidopexy was done. Groups were compared for operative times and frequency of scrotal hematoma formation and secondary ascent one day and one week after the procedure, respectively. Results The mean age of our study children was 2.27+1.36 years; 159 (59.77%) children presented with right-sided palpable undescended testis and 107 (40.23%) children presented with left-sided undescended testis. Mean operative time in groups A and B was 25.35 ± 3.50 min and 45.45 ± 4.55 min, respectively (p < 0.0001). Scrotal hematoma occurred in three (2.3%) patients in group A and in 10 (7.5%) patients in group B. This difference was statistically significant (p = 0.047). In addition, secondary ascent occurred in four (3.0%) patients in group A and two (1.5%) patients in group B. This difference was not statistically significant (p = 0.4). Conclusion Single-Incision scrotal orchidopexy is simple, effective, less time consuming, and has fewer complications in terms of scrotal hematoma and secondary ascent as compared to the two-incision inguinal approach in children of palpable undescended testis.