Repeated surgical interventions for relapses of cryptorchidism in children

Author:

Poddubniy I. V.1ORCID,Fayzulin A. K.2,Fedorova E. V.3,Kalinchenko N. Yu.4ORCID,Tolstov K. N.3,Sytkov V. V.5ORCID,Gorodnicheva Yu. M.6ORCID,Khanov M. M.7,Yarustovsky P. M.7

Affiliation:

1. A.I. Evdokimov Moscow State University of Medicine and Dentistry; Federal Scientific and Clinical Center for Children and Adolescents, FMBA of Russia; Morozovskaya Children’s City Clinical Hospital, Moscow Health Department

2. A.I. Evdokimov Moscow State University of Medicine and Dentistry; Morozovskaya Children’s City Clinical Hospital, Moscow Health Department

3. A.I. Evdokimov Moscow State University of Medicine and Dentistry; Federal Scientific and Clinical Center for Children and Adolescents, FMBA of Russia

4. National Medical Research Center for Endocrinology

5. A.I. Evdokimov Moscow State University of Medicine and Dentistry; Federal Scientific and Clinical Center for Children and Adolescents, FMBA of Russia; Morozovskaya Children’s City Clinical Hospital, Moscow Health Department; Moscow Regional Center for Maternity and Childhood Protection

6. A.I. Evdokimov Moscow State University of Medicine and Dentistry

7. Federal Scientific and Clinical Center for Children and Adolescents; Federal Scientific and Clinical Center for Children and Adolescents, FMBA of Russia

Abstract

The aim of the study is to demonstrate a differentiated approach to recurrent cryptorchidism treatment. Materials and methods. Over the past five years (since 2015), the staff of the Department of Pediatric Surgery of A.I. Evdokimov Moscow State University of Medicine and Dentistry, performed surgical treatment of 20 children aged 2-17 years with recurrent cryptorchidism (22 testicles). Relapse of cryptorchidism on one side was diagnosed in 18 patients. Two patients had a bilateral cryptorchidism recurrence, these children had a combined pathology in the form of Prader-Willi syndrome. In 3 children, surgical treatment at their place of residence was performed two or more times. As a preoperative preparation to increase the elasticity of blood vessels and to lengthen them, a course of human chorionic gonadotropin (hCG) hormone therapy was carried out according to the scheme. The exception was children over the age of 6-7 as administration of hCG at this age can provoke an earlier onset of puberty. Intraoperatively, in 15 children, the testicle was fixed in the scrotum according to the method of Shemaker, Herzen, and others. In 5 children with abdominal cryptorchidism, the testicle was not descended into the scrotum and was fixed in the inguinal canal due to a deficiency in the length of the spermatic cord (SC). On examination, a testicle in the middle or lower third of the inguinal canal was found in 10 patients, at the root of the scrotum - in 7. In 5 patients, the testicle was not detected. The average period between the first and repeated surgery was 3 years (from 4 months to 8 years). Upon admission, all patients underwent a clinical examination, ultrasound examination of the inguinal canals, and a study of the hormonal profile if indicated. Results. After revision of the inguinal canal, 17 testicles were successfully re-descended using the Shemaker technique. Of these, 16 testicles were fixed in the scrotum, 1 testicle - at the root of the scrotum. During the second operation, the vaginal process of the peritoneum was found in 7 children. Laparoscopically-assisted orchipexy was performed in 3 patients. Orchiectomy was performed in 5 cases due to testicular atrophy. The duration of the surgery was 55-120 minutes. There was no intraoperative blood loss. In the long-term postoperative period (after a year or more), postoperative testicular atrophy was not detected.

Publisher

National Medical Research Center for Childrens Health

Reference12 articles.

1. Marret J.B., Ravasse P., Guleryuz K., Haffreingue A., Rod J. Experience of the single scrotal approach for recurrent undercended testis after primary orchiopexy or inguinal surgery. Prog. Urol. 2017; 27(2): 93–7. https://doi.org/10.1016/j.purol.2016.12.006 (in French)

2. Morozov D.A., Nikitina A.S. Connective tissue disorders and postoperative testis retraction in children. Andrologiya i genital’naya khirurgiya. 2008; 9(3): 20–4. (in Russian)

3. Dudley A.G., Sweeney D.D., Docimo S.G. Orchiopexy after prior inguinal surgery A distal approach. J. Urol. 2011; 185(6): 2340–3. https://doi.org/10.1016/j.juro.2011.02.042

4. Noseworthy J. Recurrent undescended testes. Semin. Pediatr. Surg. 2003; 12(2): 90–3. https://doi.org/10.1016/s1055-8586(02)00017-3

5. Sizonov V.V., Orlov V.M., Kogan M.I. Complications after surgical treatment of cryptorchidism. Vestnik Ural’skogo gosudarstvennogo meditsinskogo universiteta. 2017; (1): 112–6. (in Russian)

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3