Abstract
To date, laparoscopy has gradually become the gold standard for treatment of non-palpable testicles (NPT) with different success and complication rates. In this study, we aimed to evaluate outcomes of laparoscopic approaches for NPT. We reviewed data of 82 consecutive patients who underwent laparoscopic treatment for unilateral NPT at two institutions by two high volume surgeons from 2004 January to 2014 December. Laparoscopic-assisted orchidopexy (LAO) and two-stage Fowler-Stephens technique (FST) was performed for 45 and 37 patients, respectively. Age (at surgery), follow-up time, laterality of testes, and postoperative complications were analyzed. Modified Clavien classification system (MCCS) was used for evaluating complications. The median age (at surgery) and median follow-up time were 18 (range: 6-56) and 60 (range: 9-130) months, respectively. Overall success rate for two laparoscopy techniques was 87.8% during the maximal follow-up time. We observed wound infection in two, hematoma in one, testicular atrophy in five, testicular re-ascending in two patients at follow-up period. There was no statistical difference between two laparoscopic techniques for grade I (five vs. two patients, p = 0.14) and grade IIIb MCCS complications (five vs. two patients, p = 0.44). Our results have shown that two laparoscopic approaches have low complication rates.
Highlights
Undescended testis (UT) is the most common congenital anomaly of genitalia in newborn male infants
We aimed to evaluate our laparoscopic treatment outcomes and postoperative complications with modified Clavien classification system (MCCS) over 10-year period
Hematoma was not observed in patients who performed two-stage Fowler–Stephens technique (FST), but it was observed only in one patient after laparoscopicassisted orchidopexy (LAO)
Summary
Undescended testis (UT) is the most common congenital anomaly of genitalia in newborn male infants. It occurs in approximately 3% of term and 30% of preterm infants [1]. The etiology is still unclear, despite its frequency. Some factors are effective in occurrence of UT such as low birth weight, short gestational period, low intra-abdominal pressure, chromosomal anomalies, and hormonal factors [2, 3]. Diagnosis and treatment of UT is important because of fertility improvement and adequate physical examination (for increased risk of testicular malignancy) [4]
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