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Staged Fowler Stephens, Who Requires a Third Procedure?

Mitchell Hayes1,2, Amir Patel3,4, Casey Seideman1,2

  • 1Department of Urology, Oregon Health & Science University, Portland, OR, USA.

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|May 19, 2021
PubMed
Summary
This summary is machine-generated.

The two-stage Fowler-Stephens orchiopexy is effective for high intra-abdominal testes, though subsequent testicular ascent rates are hard to determine. Repeat orchiopexy rates are reported between 2.6-7.5%.

Keywords:
CryptorchidismFowler-StephensOrchiopexyOutcomesTesticular ascentUndescended testicle

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Area of Science:

  • Pediatric Urology
  • Surgical Outcomes
  • Testicular Maldescent

Background:

  • The two-stage Fowler-Stephens orchiopexy is a standard surgical approach for managing high intra-abdominal testes in pediatric patients.
  • While testicular ascent is a known outcome, challenges in defining appropriate position and reporting repeat procedures exist.

Purpose of the Study:

  • To review the available evidence on the rate of subsequent testicular ascent after two-stage Fowler-Stephens orchiopexy.
  • To determine the rate of repeat surgery required for testicular maldescent following the initial procedure.

Main Methods:

  • A systematic review of 16 studies concerning two-stage Fowler-Stephens orchiopexy.
  • Analysis of reported postoperative testicular positions and rates of repeat orchiopexy.

Main Results:

  • Follow-up revealed 0-13% of testicles in inappropriate positions (6-37 months post-op).
  • Rates of repeat orchiopexy varied, with available data suggesting 2.6-7.5%.
  • Inconsistent definitions of appropriate position and small sample sizes limited precise outcome assessment.

Conclusions:

  • Two-stage Fowler-Stephens orchiopexy demonstrates high success in managing high intra-abdominal testes.
  • Accurate assessment of testicular ascent rates is challenging due to study limitations.
  • Further research is needed on long-term outcomes and repeat procedure rates.