Undescended Testis.

3 yrs Mch is a K/C/O left undescended testis and right retractable testis. Patient was operated 2 years ago for it.Left Orchidopexy was done. He was given injection HCG 250 IM weekly 5 times. But still the problem persists..The left testis is undescended. What is the best treatment available with higher success rate..

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What was the pre op position of the lt.testis? Often when the testis is explored for undecscent, it may be found at the internal ring or still posterior and more intraabdominal. The age at which this child was operated is appropriate. On bringing down the testis frequently it is anchored to the bottom of the scrotum and even to the medial side of the thigh for a few days to prevent retraction. Ometimes if the testis can't be brought down till basof scrotum itis left at the lower most position say midway between the root of the scrotum and the bottom ofthe scrotum. It is also likely that as the child grew, the testis if not in the bottom of the scrotum shifts proximally. In cases where te testis can't be brought down it is often due to short vascular pedicle. In such cases, the pedicle is divided and the vessels are anaestomosed to the superficial branches of femoral artery in the groin.But this takes trained microsurgery . It appears that the initial surgeon could not bring it down sufficiently and also didn't prepare for microsurgery.

What surgery to perform now to correct this 100%
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Retracted lt testes post orchidoplexy as past history Well explained by dr purnanandam Yedavally Yes to prevent atrophy and thence future complications microvascular surgeon in a/w urosurgeon should go in team work

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