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Abstract
Background: Orchiopexy is the standard surgical treatment for palpable undescended testes in children. Routine ligation of the hernia sac during orchiopexy is traditionally performed; however, its necessity and impact on postoperative outcomes remain controversial.
Objective: The study was done to compare the postoperative outcomes of orchiopexy performed with sac ligation versus without sac ligation in children with palpable undescended.
Methodology: This randomized controlled trial included 60 male children ≤15 years of age with palpable undescended testes at Children Hospital & Institute of Child Health, Faisalabad, Pakistan. Patients were randomized into: Group A (n=30): Orchiopexy with sac ligation; Group B (n=30): Orchiopexy without sac ligation. Demographic data, operative time (minutes), and post-operative complications were recorded during the follow-up done at 1, 4, 8, and 12 weeks for assessment of hernia and other complications. Data were analyzed with SPSS v21, t-test and chi-square applied.
Results: A total of 60 patients were included, with comparable baseline characteristics between the two groups in terms of age, laterality of undescended testis, and preoperative findings. Group A (with sac ligation) had a significantly longer mean operative time (30.3 ± 3.0 minutes) than Group B (no sac ligation) at 21.0 ± 2.1 minutes (p < 0.001). No postoperative hernias were observed in either group. Postoperative pain scores were significantly lower in Group B, and the duration of hospital stay was shorter compared with Group A. Minor complications such as hematoma and wound infection occurred infrequently with no significant between the groups.
Conclusion: Orchiopexy without sac ligation significantly reduces operative time without increasing risk of post-operative hernia. Based on the study, it appears that routine sac ligation appears unnecessary in pediatric palpable undescended testes.
References
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