Pre-scrotal access in inguinal-scrotal pathologies Dr. GERMAN QUEVEDO P. FACS FAAP Pediatric and Urology Service Japanese University Hospital Santa Cruz - Bolivia II World Congress of the World Federation of Association of Pediatrics Surgeons VII Congress of the Federation of Pediatric Surgical Associations of the South Cone of America Argentina - 2007

OBJETIVES Pre-scrotal access To present an alternative for the inguinal-scrotal pathologies To discuss the advantages and disadvantages of this access To present our experience with this access

Prospective work, from July 2004 to August 2007 MATERIAL AND METHODS Prospective work, from July 2004 to August 2007 Total: 220 patients Inguinal Hernia 92 Inguinal Cysts 20 Undescended reticules 68 Hydrocele 22 Acute scrotum 9 Testicular prosthesis 3 Testicular tumors 4 Testicular torsion 2 Ages: from 4 m a 13 y ( medium 4,8 y ) All surgeries were done by the same Pediatric Surgeon

RESULTS Palpables Undescended Testicules 70% were found in the inferior inguinal chanel 30% were found in the medium inguinal chanel 80% The aponeurotic fascia was respect 100% got a scrotal position 80% satisfactory 20% scrotal high position Medium surgical time was 30 min. Controls after 20 months of surgeries 80% return 100% success Corionic gonadotrofine

RESULTS Inguinal Hernia, Inguinal Cysts, Hydrocele - No relapse were found in any case - 100% were not opened the aponeuroses Testicular tumors Considering the tumorals sizes, the surgical time was to short Testicular torsion Immediate access with minimal mobilization for element's evaluation

Conclusion No manipulation in T. Tumors Short surgical time Minimal learn curve High percentage of respecting aponeuroses Only one incision for UDTs Easy access to the scrotum in UDTs Easy access and quickly evaluation in: Hydrocele, T. Tumors Acute scrotum, Inguinal hernia No manipulation in T. Tumors Excellent option for people that need to return to physical activity Excellent cosmetic

Orchidopexy??