Features of Surgical Treatment for Inguinal Testicular Retention (Cryptorchidism) in Children

To study the surgical treatment of inguinal testicular retention in children, with a focus on the problem of a shortened spermatic cord, and to develop a modified approach to improve the effectiveness of orchiopexy. A retrospective study was conducted on 541 children with cryptorchidism who underwent surgery in the Pediatric Urology Department of the Osh Interregional Children's Clinical Hospital between 2010 and 2024. Diagnosis was established clinically and by ultrasound. Inguinal retention was diagnosed in 392 (72.5%) patients. Recurrences of cryptorchidism were recorded in 38 (7.0%) children, primarily associated with a shortened spermatic cord and late age at primary surgery. In 53 (9.8%) cases, orchiectomy was performed due to the absence of viable testicular tissue. Based on an analysis of complications, a modified orchiopexy technique was developed. This technique includes retroperitoneal blunt mobilization of testicular vessels using atraumatic forceps (DeBakey type). This technique allows for lengthening the spermatic cord by 1.5–4 cm and performing a single-stage testicular descent without tension on the vascular structures. A shortened spermatic cord is a significant risk factor for recurrence and complications in inguinal testicular retention. The proposed modified approach with retroperitoneal mobilization of vessels improves the safety and effectiveness of single-stage orchiopexy while preserving gonadal vascularity and can be recommended for clinical use in cases of anatomical limitations.