Current Practice and Outcomes in the Management of Intra-abdominal Testes

Eur J Pediatr Surg. 2015 Oct;25(5):409-13. doi: 10.1055/s-0034-1383854. Epub 2014 Jul 31.

Abstract

Introduction: Fowler-Stephens orchidopexy is the most widely used technique for the surgical management of intra-abdominal testes with laparoscopy being the preferred approach. The aim of this study was to review all two-stage laparoscopic Fowler-Stephens orchidopexies performed in one pediatric surgical unit over a 7-year period.

Methods: A retrospective case series of all patients undergoing two-stage laparoscopic Fowler-Stephens orchidopexy was performed. Primary outcome measure was testicular atrophy at follow-up. Secondary outcomes included testicular atrophy at second-stage operation and testicular ascent requiring redo surgery.

Results: A total of 83 two-stage laparoscopic Fowler-Stephens orchidopexy were performed, with outcome data available for 67. Median age at first stage was 1 year 11 months. No testes had undergone atrophy at the second-stage laparoscopy. Median follow-up was 1 year. The overall success rate was 86.4%. Seven patients were noted to have an atrophic testis at the initial clinic review. Five patients required redo orchidopexy for testicular ascent. Of these, two patients had a successful result, two patients subsequently had testicular atrophy and one awaits redo surgery.

Conclusion: We conclude that Fowler-Stephens orchidopexy has a relatively good outcome. The rates of reoperation after the two-stage Fowler-Stephens orchidopexy were low in this study. Overall success rate compares very favorably to published literature.

MeSH terms

  • Adolescent
  • Atrophy
  • Child
  • Child, Preschool
  • Cryptorchidism / pathology
  • Cryptorchidism / surgery*
  • Humans
  • Infant
  • Laparoscopy / methods*
  • Male
  • Orchiopexy / methods*
  • Recurrence
  • Testis / pathology
  • Testis / surgery
  • Treatment Outcome