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[Two-stage Fowler-Stephens orchidopexy in intra-abdominal undescended testes]
Dieu My Ta1, Gyula Réti1, Eszter Koós2
11 Borsod-Abaúj-Zemplén Vármegyei Központi Kórház és Egyetemi Oktatókórház, Velkey László Gyermekegészségügyi Központ, Gyermeksebészeti, Traumatológiai és Égési Osztály Miskolc, Szentpéteri kapu 72-76., 3526 Magyarország.
Introduction:
The optimal surgical technique for bringing intra-abdominally retained testes into the scrotum remains controversial. The most commonly applied procedure is Fowler-Stephens orchidopexy, while the vessel-sparing Shehata technique has emerged az an alternative approach.
Objective:
The aim of this study was to evaluate the long-term outcomes of the two-stage Fowler-Stephens orchidopexy in patients with intra-abdominally retained testes, with particular emphasis on surgical success and testicular atrophy rates, and to compare the results and data reported in the international literature.
Method:
A retrospective analysis was conducted using MedWorks database, including children who underwent two-stage Fowler-Stephens orchidopexy at the Department of Pediatric Surgery, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, between January 1, 2004 and December 31, 2023. The procedure was considered successful if the testis was consistently palpable in the scrotum during follow-up examinations and demonstrated preserved perfusion.
Results:
Fowler-Stephens orchidopexy was performed in 42 children, including 6 bilateral cases resulting in total of 48 operated testes. The mean age at the time of the first procedure was 3.3 years (range: 0.9-13 years). Testicular atrophy occurred in three cases following the first stage. After the second procedure, the testis was palpable in the scrotum in 32 cases, while it was non-palpable in 4 children.
Discussion:
Overall, a success rate of 82.5% and a testicular atrophy rate of 17.5% were observed, consistent with outcomes reported in the international literature (67-98%).
Conclusion:
Two-stage Fowler-Stephens orchidopexy remains an effective and reliable surgical method for the treatment of intra-abdominally retained testes. Although the testicular atrophy rate appears to be slightly higher compared with the Shehata technique, the overall success rate is favorable and consistent with the international literature. Orv Hetil. 2023; 167(28): 1113-1119.