Surgical repair of undescended testicle.

Orchiopexy by our method has given uniformly good results. We have had no direct nor indirect hernias after this dissection. We have had no complications attributable to the complete dissection we recommend. This dissection should give an increase in spermatic cord length averaging 6.5 centimeters. If the vas deferens is completely freed, an additional 2.5 centimeters of length is gained. This increase in length is four times that obtained by the routine classical dissections confined to the inguinal canal. All testicles absent from the scrotum should be transplanted by the sixth year. Earlier operation may be made necessary by troublesome hernia, pain, or torsion. Adequate incision, division of the floor of the inguinal canal, and retroperitoneal dissection assure good exposure. Division of the lateral spermatic ligament and elimination of the sides of the spermatic surgical triangles allow the testicle to exit from the external ring only. This will result in viable testicles in the depth of the scrotum, attached to intact blood supplies and vasa deferentia, and without tension, this giving the best chance to have normal spermatogenic testicles at puberty.