Laparoscopy for the impalpable testes: Experience with 80 intra-abdominal testes

• Published in: Journal of pediatric urology Vol. 5; no. 5; pp. 389 - 392
• Main Authors: Hvistendahl, G.M, Poulsen, E.U
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2009
• Subjects: Adolescent; Child; Child, Preschool; Cryptorchidism - surgery; Fowler–Stephens orchidopexy; Humans; Infant; Intra-abdominal testes; Laparoscopy; Male; Pediatrics; Retrospective Studies; Two stage; Urologic Surgical Procedures, Male - methods; Urology; Fowler–Stephens orchidopexy; Laparoscopy; Intra-abdominal testes; Two stage
• ISSN: 1477-5131; 1873-4898
• DOI: 10.1016/j.jpurol.2009.04.004

Abstract Objective To evaluate two-stage laparoscopic Fowler–Stephens (FS) orchidopexy for intra-abdominal testes. Materials and methods A retrospective analysis was performed of the clinical findings, interventions and outcomes in 111 boys undergoing laparoscopy for 132 impalpable testes. Results The median age was 5.7 years (1.1–14.6 years). Twenty-seven testes were absent. Eighty testes were intra-abdominal, of which 10 were removed laparoscopically due to anatomical anomalies (4), short spermatic cord (5) or atresia (1). Twenty-five testes were located in the groin. Laparoscopic FS procedure was performed for 65 intra-abdominal testes: 60 two-stage operations and five where the testes were removed during FS second stage due to short vas or testicular atrophy. Outcome was successful in 80%. One-stage laparoscopic orchidopexy without vessel division was performed in five intra-abdominal testes with satisfactory results in three. In general, the success rate is higher in boys with bilateral intra-abdominal testes, probably due to younger age at operation. Conclusions At our centre two-stage laparoscopic Fowler–Stephens orchidopexy for intra-abdominal testes showed results comparable to most other studies, but less satisfactory than a couple of recent studies. The median age at referral was higher than recommended. Operation at an earlier age may further improve the results.