CU 09. The treatment of bilateral high intraa bdominal cryptorchidism in adults with cryptorchidopexy under laparoscopy

Objective: To investigate the feasibility and advantages of onestage treatment of high intra-abdominal cryptorchidism under laparoscopy.

Materials and Methods: There were 3 cases of intra-abdominal cryptorchidism in this study. Two of the patients were 28 and 21 years old. Another one converted to open surgery because of primary abdominal cocoon was found during operation that caused peritoneal cavity indiscernible. The other two cases of intra-abdominal cryptorchidism were at the level of iliac vessels superior to internal ring. Preoperative sex hormone level of one patient was normal, and the testosterone level of the other patients was slightly decreased. The right spermatic vessel was completely isolated to the inferior vena cava, and the left was at the level of renal vascular. The vas deferens was isolated to the entrance of the seminal vesicle. Free testis were brought into the external ring via medial side of internal inguinal ring in shortest distance.

Results: The two operations were both successful. Another case with abdominal cocoon that caused peritoneal cavity indiscernible converted to open surgery and undescended successfully. The cryptorchidism was brought down to the scrotum among which one side was undescened to the entrance of the scrotum due to the strong tention. The operative time was 2.5 and 3.5 h with little bleeding. The postoperative hospital stay was 7 and 8 days respectively. No complications were observed. The followed-up was lasted for 5-8 months. No testicular atrophy and retraction occurred. Initial sense of traction in one case disappeared one week later.

Conclusions: One-stage treatment of high intra-abdominal cryptorchidism under laparoscopy is of small injury, quick recovery and satisfying effect. The potential of primary abdominal cocoon should be considered.