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A short vas deferens limiting successful laparoscopic testicular descent
Objective:
To highlight the problem of the short vas deferens in a single stage or staged laparoscopic orchidopexy.
Patients And Methods:
From October 1992 to February 1996, 23 patients (mean age 4.9 years, range 12 months to 12 years) underwent a laparoscopic staged Fowler-Stephens orchidopexy. During the second stage (open surgery), a short vas deferens was found in three patients; two testes were located retrovesically and one was in the internal inguinal ring. Two testes could not be brought into the scrotum, but only to the inguinal region, and one testis was placed in the scrotum but under tension.
Results:
The patients were followed for 12, 19 and 28 months; the testis under tension became fully atrophic. One of the two testes that could not be placed further than the inguinal canal developed marked hypotrophy, while the other "survived'.
Conclusions:
A laparoscopic staged Fowler-Stephens orchidopexy should not used in patients with a very short vas deferens; patients with such a short vas deferens are extremely rare.