Two-stage Fowler-Stephens orchiopexy in the management of intra-abdominal testes

Of 22 boys with an intra-abdominal testis 8 (12 testes) underwent the 2-stage Fowler-Stephens orchiopexy. During stage 1 the testicular artery and internal spermatic vein were ligated in situ 2 to 3 cm. superior to the intra-abdominal testis. The testicular vessels were transected inferior to the ligatures 6 months later and the testis was brought to the scrotum with the standard Fowler-Stephens orchiopexy technique. Patient age ranged from 1 to 6 years (mean 3.2 years). At followup 11 of 12 testes (92%) are in the scrotum and have a normal consistency and size, while 1 (8%) is atrophic. In this preliminary series the 2-stage Fowler-Stephens orchiopexy has a success rate equal or possibly superior to the standard Fowler-Stephens orchiopexy. Whether ultimate testicular function is improved, however, remains to be determined.