Outcomes of Bilateral Laparoscopic Orchiopexy for Bilateral Intra-abdominal Testes

To report the results of bilateral laparoscopic orchiopexy in a large cohort of patients with bilateral intra-abdominal testes.

Due to the rarity of bilateral intra-abdominal testes, outcomes of laparoscopic bilateral orchiopexy are poorly defined. This retrospective study reviews pediatric patients undergoing bilateral laparoscopic orchiopexy for bilateral intra-abdominal testes from a large pediatric tertiary care center from 2012-2021.

A total of 35 patients with 70 testicle units were included. Median age at time of first surgery was 1.8 years old with a median follow-up of 24.2 months. Seventeen patients had comorbidities. Majority of procedures were 2-stage (31, 88.6%). Two patients underwent unilateral orchiectomy for atrophic testes after the first stage, resulting in 68 testes available for postoperative assessment. Postoperative outcomes demonstrated normal size in 62.9% (44/70), atrophy in 17.1% (12/70), and non-palpable in 17.1% (12/70). Testicular position at follow-up was dependent scrotum in 68.6% (48/70), high scrotum in 8.6% (6/70), inguinal in 2.9% (2/70), and non-palpable in 17.1% (12/70). Of the 48 testes located in the dependent scrotum, 39 were normal in size, and 9 were atrophic. Five patients out of 35 (14.2%) had bilateral nonfunctional testes, while 11 patients (11/35, 31.4%) had bilateral dependent testes of normal size. No significant difference in outcomes was observed between patients with and without comorbidities.

Bilateral laparoscopic orchiopexy is the gold standard for bilateral intra-abdominal testes. However, this diagnosis is associated with a high risk of atrophic/non-palpable testes in 34.2% of cases and complete anorchia in 14.2%.