Pre-scrotal access in inguinal-scrotal pathologies

Dr. GERMAN QUEVEDO P. FACS FAAPPediatric and Urology ServiceJapanese University Hospital

Santa Cruz - Bolivia

II World Congress of the World Federation of Association of Pediatrics Surgeons

VII Congress of the Federation of Pediatric Surgical Associations of the South Cone of America

Argentina - 2007

To present an alternative for the inguinal-scrotal pathologies

To discuss the advantages and disadvantages of this access

To present our experience with this access

OBJETIVES

Pre-scrotal access

Prospective work, from July 2004 to August 2007

Total: 220 patients

Inguinal Hernia 92Inguinal Cysts 20Undescended reticules 68 Hydrocele 22Acute scrotum 9Testicular prosthesis 3Testicular tumors 4Testicular torsion 2

Ages: from 4 m a 13 y ( medium 4,8 y )

All surgeries were done by the same Pediatric Surgeon

MATERIAL AND METHODS

RESULTS• Palpables Undescended Testicules

70% were found in the inferior inguinal chanel 30% were found in the medium inguinal chanel

• 80% The aponeurotic fascia was respect

• 100% got a scrotal position 80% satisfactory 20% scrotal high position

• Medium surgical time was 30 min.

• Controls after 20 months of surgeries80% return 100% success

Corionic gonadotrofine

• Inguinal Hernia, Inguinal Cysts, Hydrocele

- No relapse were found in any case- 100% were not opened the aponeuroses

• Testicular tumors• Considering the tumorals sizes, the surgical time was to short

• Testicular torsion • Immediate access with minimal mobilization for

element's evaluation

RESULTS

Short surgical time Minimal learn curve High percentage of respecting aponeuroses Only one incision for UDTs Easy access to the scrotum in UDTs Easy access and quickly evaluation in: Hydrocele, T. Tumors Acute scrotum, Inguinal hernia No manipulation in T. Tumors Excellent option for people that need to return to physical activity Excellent cosmetic

Conclusion

Orchidopexy??