EVOLUTION OF THE SINGLE MID SCROTAL INCISION IN CASES OF UNDESCENDED TESTIS (UDT) SINGLE SURGEON'S 15 YEAR EXPERIENCE IN KENYA
Safwat S. Andrawes, M. Med. Surgery, M.Sc. Urology.
Nairobi Hospital, Nairobi, Kenya.
BACKGROUND:The classic approach for operating UDT was the inguinal approach. This study shows how the single Incision became the first approach in our practice with comparable results.
METHODS: All cases done by one surgeon in the period 2003 - 2018 were studied. A total of 346 patients, 515 testes. The mean age, approach used, complications were reported.
RESULTS: Patients' age ranged from 1 to 19 years, mean age 5.2 years, only 46 patients (13%) came between 1 - 2 years of age. In the years 2003 - 2008, the Inguinal to Scrotal approach was 74:51 cases, while 2008 - 2013, it was 55:132, lastly, 2013 - 2018 became 20:170, mainly Mid Scrotal Approach as the primary method for all cases in the groin, high or low. The Conversion from Scrotal to Inguinal was 14 cases (3%) Ascent cases were 27 cases (6%), comparable in both approaches, half of the ascent cases, 13 (2.5%) became Atrophic. Follow-up period was from 6 months to 10 years. The recovery of the Scrotal approach was faster and smooth. Average inguinal operative time was 40 minutes, while scrotal cases were 20 minutes.
CONCLUSIONS: Single Incision Mid Scrotal Approach has become our method of choice for all extra abdominal UDT. It has comparable good results, reduces operative time, more cosmetic and less painful. It's very useful also for all cases of Re-do surgery, iatrogenic, and in bilateral cases The end results depend on the size and the site of the testis before surgery, but not on the approach, so we recommend to use it as the primary approach.
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