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Re: Outcome of Bilateral Laparoscopic Fowler-Stephens Orchidopexy for Bilateral Intra-Abdominal Testes
PEDIATRIC UROLOGY
201
Editorial Comment: Some studies of undescended testes indicate that cryptorchidism is more common on the right than the left side.1,2 Despite what turns out to be a predisposition toward undescended testis being more common on the right side, embryonal migration appears to be symmetrical, at least early in development. Douglas A. Canning, MD 1. Scorer CG and Farrington GH: Congenital Deformities of the Testis and Epididymis. New York: Appleton-Century-Crofts 1971; chapt 10, pp 136e146. 2. Cendron M, Huff DS, Keating MA et al: Anatomical, morphological and volumetric analysis: a review of 759 cases of testicular maldescent. J Urol 1993; 149: 570.
Re: Outcome of Bilateral Laparoscopic Fowler-Stephens Orchidopexy for Bilateral Intra-Abdominal Testes A. S. Safwat, H. M. Hammouda, A. A. Kurkar and N. K. Bissada Assiut University Hospital, Assiut, Egypt Can J Urol 2013; 20: 6951e6955.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.04.034 available at http://jurology.com/ Editorial Comment: The authors report on 48 testes in 24 boys (median age 31.6 months) who underwent bilateral laparoscopic Fowler-Stephens orchiopexy for bilateral intra-abdominal testes. Of the patients 6 underwent single stage repair and 18 underwent staged Fowler-Stephens orchiopexy. Testicular position after laparoscopy was mid to lower scrotum in 43 cases. Five testes retracted into the inguinal canal, of which 3 required a subsequent inguinal approach. Atrophy was observed in 2 testes with a followup of 18 months. Bilateral impalpable testes are the most difficult to correct. The testes are high and often have short vessels. The reported surgical success (91.6%) with 2 operations is excellent and is an improvement over results following single stage Fowler-Stephens orchiopexy through an inguinal incision.1 Douglas A. Canning, MD 1. Kirsch AJ, Escala J, Duckett JW et al: Surgical management of the nonpalpable testis: the Children’s Hospital of Philadelphia experience. J Urol 1998; 159: 1340.
Re: Congenital Spigelian Hernia and Ipsilateral Cryptorchidism: Raising Awareness among Urologists Z. R. Balsara, A. E. Martin, J. S. Wiener, J. C. Routh and S. S. Ross Divisions of Urology, Pediatric Surgery and Abdominal Transplant Surgery, Department of Surgery and Department of Pediatrics, Duke University Medical Center, Durham, North Carolina Urology 2014; 83: 457e459.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.04.035 available at http://jurology.com/ Editorial Comment: The authors report on a male infant who presented simultaneously with undescended testis and a spigelian hernia. Although I was not aware of this association, it turns out that nearly half of the reported cases of pediatric spigelian hernias have been associated with ipsilateral cryptorchidism. Because the defect in the spigelian hernia is relatively narrow, the risk of incarceration is relatively high. For this reason early diagnosis is important. As a result, all of us who treat children with undescended testes need to be aware of the potential for spigelian hernias and to be alert for them. Douglas A. Canning, MD
201
Editorial Comment: Some studies of undescended testes indicate that cryptorchidism is more common on the right than the left side.1,2 Despite what turns out to be a predisposition toward undescended testis being more common on the right side, embryonal migration appears to be symmetrical, at least early in development. Douglas A. Canning, MD 1. Scorer CG and Farrington GH: Congenital Deformities of the Testis and Epididymis. New York: Appleton-Century-Crofts 1971; chapt 10, pp 136e146. 2. Cendron M, Huff DS, Keating MA et al: Anatomical, morphological and volumetric analysis: a review of 759 cases of testicular maldescent. J Urol 1993; 149: 570.
Re: Outcome of Bilateral Laparoscopic Fowler-Stephens Orchidopexy for Bilateral Intra-Abdominal Testes A. S. Safwat, H. M. Hammouda, A. A. Kurkar and N. K. Bissada Assiut University Hospital, Assiut, Egypt Can J Urol 2013; 20: 6951e6955.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.04.034 available at http://jurology.com/ Editorial Comment: The authors report on 48 testes in 24 boys (median age 31.6 months) who underwent bilateral laparoscopic Fowler-Stephens orchiopexy for bilateral intra-abdominal testes. Of the patients 6 underwent single stage repair and 18 underwent staged Fowler-Stephens orchiopexy. Testicular position after laparoscopy was mid to lower scrotum in 43 cases. Five testes retracted into the inguinal canal, of which 3 required a subsequent inguinal approach. Atrophy was observed in 2 testes with a followup of 18 months. Bilateral impalpable testes are the most difficult to correct. The testes are high and often have short vessels. The reported surgical success (91.6%) with 2 operations is excellent and is an improvement over results following single stage Fowler-Stephens orchiopexy through an inguinal incision.1 Douglas A. Canning, MD 1. Kirsch AJ, Escala J, Duckett JW et al: Surgical management of the nonpalpable testis: the Children’s Hospital of Philadelphia experience. J Urol 1998; 159: 1340.
Re: Congenital Spigelian Hernia and Ipsilateral Cryptorchidism: Raising Awareness among Urologists Z. R. Balsara, A. E. Martin, J. S. Wiener, J. C. Routh and S. S. Ross Divisions of Urology, Pediatric Surgery and Abdominal Transplant Surgery, Department of Surgery and Department of Pediatrics, Duke University Medical Center, Durham, North Carolina Urology 2014; 83: 457e459.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.04.035 available at http://jurology.com/ Editorial Comment: The authors report on a male infant who presented simultaneously with undescended testis and a spigelian hernia. Although I was not aware of this association, it turns out that nearly half of the reported cases of pediatric spigelian hernias have been associated with ipsilateral cryptorchidism. Because the defect in the spigelian hernia is relatively narrow, the risk of incarceration is relatively high. For this reason early diagnosis is important. As a result, all of us who treat children with undescended testes need to be aware of the potential for spigelian hernias and to be alert for them. Douglas A. Canning, MD