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Pediatric Surgery International

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01-12-2024 | Undescended Testis | Review

Comparison of scrotal and inguinal orchiopexy for palpable undescended testis: a meta-analysis of randomized controlled trials

Authors: Irfan Wahyudi, Putu Angga Risky Raharja, Gerhard Reinaldi Situmorang, Arry Rodjani

Published in: Pediatric Surgery International | Issue 1/2024

Abstract

Introduction

Scrotal and inguinal orchiopexy are two commonly used surgical approaches for palpable undescended testis (UDT), each with distinct advantages. However, the optimal approach remains a matter of debate, warranting a comprehensive meta-analysis of randomized controlled trials (RCTs) to guide clinical decision-making.

Materials and methods

A comprehensive literature search was conducted, adhering to PRISMA guidelines, to select RCTs comparing scrotal and inguinal orchiopexy for palpable UDT. Eight RCTs were selected for meta-analysis. Outcome measures included operative time, hospitalization duration, total complications, wound infection or dehiscence, testicular atrophy or hypotrophy, and testicular re-ascent rate. The evaluation of the study’s quality was conducted by utilizing the revised Cochrane risk-of-bias tool.

Results

Scrotal orchiopexy showed significantly shorter operative time compared to the inguinal approach (WMD: − 15.06 min; 95% CI: − 21.04 to − 9.08). However, there was no significant difference in hospitalization duration (WMD: − 0.72 days; 95% CI: − 1.89–0.45), total complications (OR: 1.08; 95% CI: 0.70–1.66), wound infection or dehiscence (OR: 0.73; 95% CI: 0.27–1.99), testicular atrophy or hypotrophy (OR: 1.03; 95% CI: 0.38–2.78), and testicular re-ascent (OR: 1.43; 95% CI: 0.67–3.06) between the two approaches. A small proportion of cases (7.3%) required conversion from scrotal to inguinal orchiopexy due to specific anatomical challenges.

Conclusion

Both scrotal and inguinal orchiopexy are safe and effective for palpable UDT, with comparable outcomes in terms of hospitalization and complications. Scrotal orchiopexy offers the advantage of shorter operative time. Clinicians can use this evidence to make informed decisions on the surgical approach for palpable UDT.

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Title: Comparison of scrotal and inguinal orchiopexy for palpable undescended testis: a meta-analysis of randomized controlled trials
Authors: Irfan Wahyudi
Putu Angga Risky Raharja
Gerhard Reinaldi Situmorang
Arry Rodjani
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Undescended Testis
Incision
Wound Infection
Published in: Pediatric Surgery International / Issue 1/2024
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-024-05655-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of scrotal and inguinal orchiopexy for palpable undescended testis: a meta-analysis of randomized controlled trials

Abstract

Introduction

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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