• Unilateral cryptorchids can be used for breeding but as the condition is hereditary this should be actively discouraged and castration of both testicles recommended Testis: cryptorchidism.
• Bilateral cases should be castrated as hormonal and surgical treatments to effect descent are unethical and often unsuccessful.
• Abdominally retained testes may have an increased incidence of neoplasia Testis: neoplasia - overview.

Uses

• Castration of unilateral/bilateral cryptorchids Testis: cryptorchidism.

Advantages

• Both abdominal testicles can be removed.
• Secure closure of incision.
• Maximum exploration of abdomen is possible - allows access to testes at remote and unusual sites within the abdomen.

Disadvantages

• Allows removal of abdominal testicles only - not suitable for removal of inguinally retained testes.
• Considered more invasive than inguinal/parainguinal and may → increased post-operative complications.

Alternative techniques

• Laparoscopic removal of testicles in anesthetized or standing horses Abdomen: laparoscopy.
• 5 different non-laparascopic approaches:
  • Ventral midline (described here).
  • Inguinal Testis: cryptorchidectomy - inguinal / parainguinal.
  • Parainguinal Testis: cryptorchidectomy - inguinal / parainguinal: preferred by some surgeons because vaginal ring is not disrupted and the aponeurosis of the external abdominal oblique muscle is more easily sutured than the superficial inguinal ring.
  • Flank Testis: cryptorchidectomy - flank.
  • Suprapubic paramedian Testis: cryptorchidectomy - suprapubic paramedian - similar advantages to parainguinal approach.

Time required

Preparation

• General anesthesia induction and maintenance: 20 min.
• Aseptic preparation: 10-15 min.

Procedure

• 30-90 min.

Decision taking

Criteria for choosing test

• See Testis: cryptorchidism.
• The ventral midline approach (described here) allows maximum exposure for removal of enlarged testis, eg tumor Testis: neoplasia - overview, teratoma Teratoma, hydrocele/hematocele Testis: hematoma or testes at remote and unusual sites within the abdomen.
• Inguinal approach: allows removal of both abdominal/inguinal testicles or quick conversion to parainguinal approach.
• Parainguinal/inguinal Testis: cryptorchidectomy - inguinal / parainguinal approaches: smaller incision size, quicker and less convalescence.
• Suprapubic paramedian Testis: cryptorchidectomy - suprapubic paramedian/flank Testis: cryptorchidectomy - flank/ventral midline approaches: considered more invasive than inguinal/parainguinal and may → increased post-operative complications.
• Paramedian/flank approaches: allow removal of abdominal testicles only (not inguinally retained testes).
• Flank approach Testis: cryptorchidectomy - flank: can be conducted in standing animal.
• Laparoscopic removal Abdomen: laparoscopy of the testis is minimally invasive and can be conducted in the standing animal.

Risk assessment

• General anesthesia - dorsal recumbency Anesthesia: general - overview.