Obturator foramen approach. II. A new surgical approach for management of the short-pedicled undescended testicle.

A new approach for the management of the short-pedicled undescended testicle is presented. It was used in four patients with the testicle lying deep to the internal inguinal ring after all methods of cord elongation failed to bring the testicle down to the scrotum. The technique consists of passing the testicle through the obturator foramen to the scrotum. No complications were encountered, and the results have been satisfactory. Normally the vas deferens and testicular vessels describe a loop along their inguinal and pelvic course. The obturator foramen approach shunts this loop, which may be lacking in the undescended testicle lying deep to the internal inguinal ring.