Re: Long-Term Outcome of Low Scrotal Approach Orchiopexy without Ligation of the Processus Vaginalis

Dealing with pre-scrotal cryptorchidism is a common practice for pediatric urologists. Surgical correction is the standard care for these children. There are several surgical techniques which can be performed with no definitive long-term results presented in the literature. In general practice, ligation of patent processus vaginalis (PV) is routinely performed during orchiopexy to avoid an inguinal hernia. In this retrospective study, the authors present their long-term outcomes for patients who underwent low scrotal approach orchiopexy without PV ligation. Intraoperative findings show 10 testes with widely patent PV and not widely patent in 217 testes. The authors choose to ligate only these 10 widely patent PV and, in these other 217 testes, only low scrotal orchiopexy was performed. In a median follow-up of 44 months (range 20-73), only one complication in ‘no widely patent PV’ group (wound infection) and one complication (reascending testis) in ‘widely patent PV’ group occurred. As the authors mentioned in their paper, two major concerns with ligation of PV are to obtain a sufficient cord length for appropriate orcihopexy and prevent an inguinal hernia. During their follow-up, there were no reascending testis or hernia occurred in ‘non-ligated PV’ group. In conclusion, low scrotal approach ochiopexy is a safe procedure for patients with prescrotal crytorchidism and ligation of PV is not absolutely indicated when the PV is not widely patent