Comparative Study of Surgical Results with and without Ligation of Hernia Sac in Orchiopexy of Pediatric Patients with Undescended Testis

Introduction: Undescended Testis (UDT) is a congenital anomaly and its common complications include testicular malignancy, infertility, testicular torsion, risk of trauma. Treatment of UDT is surgical (orchiopexy), and since it is always with a hernia sac, one stage of the surgery is separating, cutting and ligation of the hernia sac, in order to avoid an inguinal hernia. In this study, we investigated whether surgical procedure without inguinal hernia sac ligation and only with separating and cutting it at the deep ring level could be a more appropriate alternative to the classic surgical procedure.

Methods: This clinical trial was conducted in march 2012-2013 in kermanshah university of medical sciences, on children of 2 months to 11 years old with UDT. The patients were followed up for 3to 4years.

Result: A total of 109 patients underwent orchiopexy during the study. Among them, 38.33% underwent orchiopexy with ligation of the hernia sac and 61.46% underwent orchiopexy without ligation of the hernia sac and with separating and cutting sac at the deep inguinal ring. No cases of an inguinal hernia were observed in the two groups during the follow-up period of 4-5 years. Other complications such as wound infection, hydrocele, , hematoma, and hemorrhage at the surgical site also did not differ significantly between the two groups.

Conclusions: Regarding the findings of this study, it appears that the use of the non-ligation technique does not increase inguinal hernia, and can be a good alternative to the classical method of hernia sacligation