A 1-year-old boy with prune-belly syndrome underwent unilateral laparoscopic clip ligation of the spermatic vessels with the hope of developing vasal collateral circulation. Six months later, the patient underwent ipsilateral second-stage orchiopexy on the right testis after division if the ligated spermatic vessels and contralateral Fowler-Stephens orchiopexy on the left testis in combination with major urinary tract reconstructions and abdominoplasty. For the following 1-year period, both testes were growing and comparable in size.