Unilateral cryptic testis surgery method

The health of children is what parents care about most, so waiting for the birth of a child is a long and anxious process. However, some diseases are congenital in children, such as cryptorchidism, which means that one of the two testicles of a child is in a state of atrophy, which is more harmful to the human body and requires surgical treatment.

Orchiopexy is the main method for treating cryptorchidism. If the initial diagnosis is more than 6 months or hormone treatment is ineffective, surgical treatment can be performed after 1 year old. External fixation of the testicular sac with an oblique incision in the inguinal groove has been widely used at home and abroad. For cryptorchidism with short spermatic vessels, two-stage surgery can be performed to fully ensure the blood supply of the testicles. However, there is also the possibility of accidental injury to the spermatic vessels in the second surgery, which is very important for The Fowler-Stephens procedure can be used for high-positioned occult testis with long vas deferens. Recently, a modified method of this procedure has been recommended, the Fowler-Stephens staged surgery, that is, the initial surgery only cuts the spermatic cord vascular pedicle at a high position without testicular fixation. In the second stage, after the collateral circulation is enriched and established, the testicle is fixed in the scrotum, reducing the chance of testicular atrophy.

3. Treatment of testicular non-palpation After careful examination of the patients in supine and upright positions by two experienced urologists, those who could not palpate the testicles were called non-palpable testicles. About 85% of them were located in the inguinal region. Hali et al. performed inguinal exploration on 161 patients with non-palpable testicles and found no testicles in only 6 of them, 5 of which were not accompanied by hernia sacs. Further laparoscopy and intra-abdominal exploration confirmed that the testicles were absent. One case had a hernia sac on the same side in the abdominal cavity. Finding the testicles indicates that the presence or absence of testicles in patients with occult testes is closely related to the hernial sac. Therefore, Hali proposed that for testicles that are not touched by physical examination, imaging, and hormone stimulation tests, inguinal exploration should be the first choice for treatment. If there is a hernial sac in the inguinal groin but no testicles, further laparoscopy or laparotomy should be performed. If there is no hernial sac or testicles on the same side, it can be diagnosed as testicular absence and no further exploration is necessary. If laparoscopy finds vascular cords in the inner ring, it indicates that there may be residual testicular nodules in the abdominal cavity, which should be removed.

Cryptorchidism is a congenital disease, so there is no more accurate prevention method. Therefore, parents are advised to pay attention to their own health before giving birth and go to the hospital regularly to check the health of the fetus' ears. After the operation, friends should pay attention to supplementing the patient with high protein and eating foods that are easier to digest.