TITLE:
High Undescended Testis Treatment with Distal Espermatic Vessel Ligation (Koff-Sethi Technique)
AUTHORS:
Carlos A. F. Molina, Andrey G. Estevanato, Marcelo F. Cassini, Murilo F. Andrade, Silvio Tucci
KEYWORDS:
Cryptorchidism, Orchiopexy, Ischemia, Reperfusion
JOURNAL NAME:
Surgical Science,
Vol.5 No.6,
June
23,
2014
ABSTRACT: Objectives: To evaluate the results
obtained with the technique of distal spermatic vessel ligation in children with
upper or intra-abdominal undescended testis. Methods: Analysis of cryptorchid
patients treated with Koff-Sethi technique for orquiopexy. Patient series: 15
children with uni- or bilateral cryptorchidism. Postoperative gonad viability
was evaluated on the basis of clinical data, physical examination and
testicular scintigraphy. Results: Mean age was 5.4 years. Cryptorchidism was
unilateral in 10/15 (67%)
patients and bilateral in 5/15 (33%).
The total number of testicles operated was 25. Of these, 19/25 (76%) required
ligation of the spermatic vessels performed according to the Koff-Sethi
technique. Eighteen (98%) gonads remained well positioned in the scrotum and
one remained in a high position. Late evaluation revealed that 14/19 (74%) testicles had normal consistency
and volume upon palpation and 3/19 (16%)
were atrophic. Two patients did not return for late reevaluation. Scintigraphy
demonstrated good testicular perfusion in 14/17 (82%) gonads evaluated. The
patient with bilateral ligation of the spermatic vessels had good perfusion in
both gonads. Conclusions: Distal spermatic vessel ligation (Koff-Sethi
technique) is safe and useful for the treatment of high cryptorchid testicles.