Outcomes of Orchiopexy with or without Testicular Fixation Suture in the Scrotum for Palpable Inguinal Undescended Testis: A Comparative Observational Study

Résumé fourni par la source

Background: Undescended testis (UDT) is the most prevalent congenital urological anomaly in male neonates. Orchiopexy is the standard surgical treatment for palpable inguinal UDT. Whether placement of a testicular fixation suture within the subdartos pouch is necessary or potentially harmful remains a matter of ongoing debate. Objective: To compare operative variables, short-term postoperative complications, long-term anatomical outcomes, and guardian satisfaction between orchiopexy performed with and without a testicular fixation suture. Methods: A prospective observational comparative study was carried out from 2022 to 2025 across two tertiary centers in Bangladesh. The study involved 42 children aged from 6 months to 14 years with palpable inguinal UDT, who were randomly assigned to two groups: Group A (orchiopexy with a 3/0 Vicryl testicular fixation suture, n=21) and Group B (orchiopexy without fixation suture, n=21). The study compared operative duration, early complications at two weeks, ultrasound findings at six months, and guardian satisfaction levels using Chi-square or Fisher's exact test (SPSS v25), considering p<0.05 as statistically significant. Results: Operative duration was notably longer in Group A, with 61.9% exceeding 60 minutes, compared to none in Group B (p<0.001). Early postoperative complications occurred more frequently in Group A (66.7% vs. 19.0%; p=0.004). Long-term six-month outcomes were generally similar (p=1.000), although testicular atrophy was more common in Group A (23.8% vs. 4.8%), and testicular reascension was observed only in Group B (14.3%). No cases of torsion were reported in either group. Guardian satisfaction levels were high and similar between the two groups (p=0.488). Conclusion: Sutureless orchiopexy using a well-fashioned subdartos pouch significantly reduces operative time and early morbidity while achieving comparable long-term anatomical outcomes. These findings support sutureless orchiopexy as a safe and effective approach for palpable inguinal UDT in children.

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