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

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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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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jalan Diponegoro No. 71, Jakarta, 10430, Indonesia

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

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  1. Irfan Wahyudi
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  2. Putu Angga Risky Raharja
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Contributions

Irfan Wahyudi: conceptualization, methodology, validation, data curation, writing—original draft preparation. Putu Angga Risky Raharja: conceptualization, methodology, formal analysis, data curation, writing—original draft preparation. Gerhard Reinaldi Situmorang: methodology, writing—review andediting. Arry Rodjani: methodology, writing—review and editing. All the authors reviewed the final manuscript.

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Correspondence to Irfan Wahyudi.

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Wahyudi, I., Raharja, P.A.R., Situmorang, G.R. et al. Comparison of scrotal and inguinal orchiopexy for palpable undescended testis: a meta-analysis of randomized controlled trials. Pediatr Surg Int 40, 74 (2024). https://doi.org/10.1007/s00383-024-05655-7

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