Anatomical risk factors for spermatic cord torsion and their involvement in the choice of orchidopexy technique.
OBJECTIVE
We aim by this article to present a literature review on the anatomical risk factors for spermatic cord torsion and their involvement the different techniques of orchidopexy.


MATERIALS AND METHODS
The literature review was conducted following PRISMA check-list, using PubMed database and the Mesh terms: testis, torsion, anomaly, orchidopexy. Techniques of surgical management provided by the EMC (French medico-surgical encyclopedia) were also used.


RESULTS
Database research identified 500 articles, and 16 mores articles were added from the review of the references lists of relevant articles. At the end, 42 articles were useful for our review including 6 reviews, 5 cross-sectional studies, 14 cohorts, 10 case reports, 1 meta-analysis, 1 letter, and 5 experimental studies. High insertion of the tunica vaginalis, a long mesorchium, deficient attachment of the epididymis to the testis, and anomalies of the gubernaculum testis are the anatomical predispositions for spermatic cord torsion. After reduction of torsion, many surgical techniques for the fixation of the testis have been suggested including: conventional technique by triangulation with or without fasciotomy, window orchidopexy, scrotal pouch, and vaginal eversion with or without dartos fixation.


CONCLUSION
The most common anatomical factor associated with spermatic cord torsion is the high insertion of the tunica vaginalis. Vaginal eversion with fixation to the dartos might be superior to other known techniques and seems promising to become standard.
['Beaud|Nicolas|N|', 'Kanbar|Anthony|A|', 'Abdessater|Maher|M|']
D003430:Cross-Sectional Studies D006801:Humans D008297:Male D056126:Orchiopexy D012307:Risk Factors D013086:Spermatic Cord Torsion D013737:Testis
Spermatic cord Torsion Orchidopexy Testis Fixation Anatomy