One-stage Fowler-Stephens Orchiopexy for Intra-abdominal Testes

Abstract

Objective: Although most intra-abdominal testes can be delivered to normal scrotal position by the conventional method in the hands of an experienced pediatric surgeon, some very high testes cannot. We evaluate the results of one-stage Fowler-Stephens orchiopexy for intra-abdominal testes. Methods: From 2000 to 2003, 7 intra-abdominal testes in 6 patients treated by one-stage Fowler-Stephens orchiopexy were followed up for at least 1 year. The position and size of testes were checked. Special attention was paid to protect collateral circulation between spermatic and vasal vessels by leaving a strip of peritoneum attached to the lower spermatic cord. Results: The ages of the patients ranged from 1 to 5 years (mean, 3 years). The associated anomalies were giant omphalocele in 1 and right renal agenesis in 1. Diagnosis was made by diagnostic laparoscopy in 4 patients, magnetic resonance image in 1 and high inguinal exploration in 1. Two patients had undergone negative explorations at other hospitals. Five testes were brought into the scrotum by one operation, and the other 2 by a second operation. All six testes were in normal scrotal position, but one in the high scrotum. No atrophy of any testes has so far been noted. Conclusions: One-stage Fowler-Stephens orchiopexy should be tried for intra-abdominal testes. Although our results are very good, more patients and long-term follow-up are desirable for a better evaluation of the result of this operation.