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11–14 APRIL, 2018, HELSINKI, FINLAND
S9: GENITALIA 1
Moderators: Katja P. Wolffenbuttel (Netherlands), Marco Castagnetti (Italy)
ESPU Meeting on Thursday 12, April 2018, 14:00–14:38
14:00–14:05
S9-1 (LO)
★
SCROTAL VERSUS INGUINAL ORCHIDOPEXY IMPACT
ON POSTOPERATIVE PAIN AND COMPLICATIONS:
A RANDOMIZED CONTROLLED TRIAL
Luis H BRAGA
1
, Melissa MCGRATH
2
, Bethany EASTERBROOK
2
,
Kizanee JEGATHEESWARAN
2
, Natasha BROWNRIGG
3
, Jorge DEMARIA
4
and
Armando J LORENZO
5
1) McMaster University - McMaster Children's Hospital, Department of Surgery / Urology, Hamilton, CANADA -
2) McMaster University, McMaster Pediatric Surgery Research Collaborative, Hamilton, CANADA - 3) McMaster
University - McMaster Children's Hospital, Paediatrics, Hamilton, CANADA - 4) McMaster University - McMaster
Children's Hospital, Surgery, Hamilton, CANADA - 5) University of Toronto, Surgery, Toronto, CANADA
PURPOSE
To compare scrotal (SO) vs. inguinal orchidopexy (IO) impact on analgesic use, postoperative pain
scores and complication rates.
MATERIAL AND METHODS
AsuperiorityRCT including boys 10–95 months of age at surgery, diagnosed with palpable UDT was
conducted. Patients with non-palpable or bilateral testes, previous orchidopexies and concurrent
procedures were excluded. Block randomization with 1:1 allocation ratio to IO or SO was utilized,
as was a standardized anesthesia protocol with peri/post-operative analgesia. Primary outcome:
postoperative pain and analgesic use in hospital(FLACC/CHEOPS) and at home(PPPM/TPPS)
using validated pain scales. A 2-point difference in the pain scale was considered as minimally
important difference. Secondary outcomes: operative time (OpT), conversion and success rates,
and complications assessed at 6–8-week F/U.
RESULTS
Of 1093 screened patients, 154(14 %) were eligible and 112(72 %) recruited. Of the 99 boys who
completed F/U, 50 had IO and 49 SO. Baseline demographics are presented in table 1.
Characteristics
Inguinal n=50(%)
Scrotal n=49(%)
Median age at surgery (IQR)
22(IQR:13-64)
26(IQR:14-64)
Mean weight (kilograms±SD)
15±6.5
16±6.1
Location of testis
Canalicular
Above external inguinal ring
Below external inguinal ring
Pre-scrotal
17(34)
23(46)
10(20)
0(0)
15(31)
18(37)
14(28)
2(4)