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

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.

Keywords

Fowler–Stephens - laparoscopic - orchidopexy - two-stage - undescended testis

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