Current Practice and Outcomes in the Management of Intra-abdominal Testes

Fowler-Stephens orchidopexy is the most widely used technique for the surgical management of intra-abdominal testes with laparoscopy being the preferred approach. The aim of this study was to review all two-stage laparoscopic Fowler-Stephens orchidopexies performed in one pediatric surgical unit over a 7-year period.

A retrospective case series of all patients undergoing two-stage laparoscopic Fowler-Stephens orchidopexy was performed. Primary outcome measure was testicular atrophy at follow-up. Secondary outcomes included testicular atrophy at second-stage operation and testicular ascent requiring redo surgery.

A total of 83 two-stage laparoscopic Fowler-Stephens orchidopexy were performed, with outcome data available for 67. Median age at first stage was 1 year 11 months. No testes had undergone atrophy at the second-stage laparoscopy. Median follow-up was 1 year. The overall success rate was 86.4%. Seven patients were noted to have an atrophic testis at the initial clinic review. Five patients required redo orchidopexy for testicular ascent. Of these, two patients had a successful result, two patients subsequently had testicular atrophy and one awaits redo surgery.

We conclude that Fowler-Stephens orchidopexy has a relatively good outcome. The rates of reoperation after the two-stage Fowler-Stephens orchidopexy were low in this study. Overall success rate compares very favorably to published literature.