Reoperation for cryptorchid testis in prepubertal child.

Twenty-two prepubertal patients with cryptorchid testes after having previous inguinal surgery were referred. These included 17 patients in whom orchidopexy had been unsuccessful. Five patients had prior surgery for hernia and/or hydrocele resulting in surgical entrapment of the testis. Five patients had bilateral disease. In 1 patient the testis was involved in Marlex mesh, 1 had had two prior orchidopexies, and 1 had prune belly syndrome. Postoperatively the testes were in good position in the scrotum in all 22 cases, with mean follow-up of 8.9 months. All testes were of normal size, and no atrophic testes ensued following the procedures. Principle factors for success in re-exploration included initial retrograde dissection of the testis and cord, intraperitoneal exposure, and subsequent dissection and adequate lengthening of the cord with protection of the spermatic vessels.