Laparoscopic Fowler Stephens orchidopexy for intra­abdominal testis

Abstract

The authors reported their experience in the laparoscopic orchidopexy for intra-abdominal testis (IAT). Since 2003, 173 laparoscopy for NPT were performed for a total of 181 testicular units. In 75 patients cord structures entering the inguinal ring were observed, and 43 had an inguinal exploration. In 34 patients a blind ending vas and vessels were observed and 8 showed testicular agenesis: these patients were managed by laparoscopy only. In 62 cases an intra-abdominal testes (IAT) were found: 42 had a primary orchidopexy and 22, with high IAT, were managed by a laparoscopic Fowler-Stephens (FS) procedure. In 12 testes we performed a two stage procedure while 10 had one stage. There were no differences in hospitalisation and early surgical complications were not recorded. Follow up ranged from 1 to 5 years. Of 22 patients who underwent FS orchidopexy, testicular atrophy developed in 4; the remaining are in scrotal position, with normal consistency and well perfused at color doppler ultrasound. Laparoscopy is essential in the surgical and therapeutic management of non-palpable testis. FS orchidopexy is reserved to high intra-abdominal testes that have a distance more than 3 cm from the internal inguinal ring. There were no differences between the group managed by one or two step FS. The minimal morbidity with an high success rate prove to be a significant contribution to the intra-abdominal testis management.