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[Impalpable testis: value of one-stage surgical descent]
Malika Ait Ali Slimane1, Frédéric Auber, Philine De Vries
1Service de Chirurgie Viscérale Infantile, Hôpital d'Enfants Armand-Trousseau, Paris, France.
Summary
One-stage testicular descent without spermatic vessel ligation is effective for intra-abdominal undescended testes. This approach shows better outcomes than the two-stage Fowler-Stephens technique, with minimal risks of failure.
Area of Science:
- Pediatric Surgery
- Urology
- Minimally Invasive Surgery
Context:
- Undescended testes, specifically intra-abdominal impalpable testes, present a surgical challenge.
- Laparoscopic exploration is crucial for diagnosis and management planning.
Purpose:
- To evaluate the efficacy of one-stage testicular descent without spermatic vessel ligation for intra-abdominal impalpable testes.
- To compare the outcomes of one-stage descent with the traditional two-stage Fowler-Stephens technique.
Summary:
- A retrospective study of 98 impalpable testes in 90 children revealed 43 intra-abdominal testes.
- One-stage descent (n=22) resulted in 81% scrotal testes, while two-stage descent (n=16) yielded 62.5% scrotal testes.
- The one-stage method demonstrated a higher success rate and fewer complications compared to the two-stage approach.
Impact:
- One-stage testicular descent without spermatic vessel ligation is a viable and preferable option for managing intra-abdominal impalpable testes.
- This technique minimizes risks of testicular atrophy and incomplete descent, offering improved patient outcomes.