Long-Term Outcome Of Laparoscopic Fowler-Stephens Orchiopexy In Boys With Intra-Abdominal Testis

Main Category: Urology / Nephrology
Also Included In: Pediatrics / Children's Health
Article Date: 26 Apr 2009 - 1:00 PDT

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UroToday.com - This study retrospectively reviewed 36 pediatric patients who underwent a 2-step Fowler-Stephens procedure via laparoscopy. The patients were followed for 10 to 17 years. Three patients were excluded and the 33 remaining patients were contacted by telephone. There were 12 patients (7 with right and 5 with left intra-abdominal testes) who agreed to undergo clinical examination and volumetric measurement of both testes using color Doppler ultrasound. Patient age ranged from 13 to 26 years (average 14.7).

The group found that 2 patients (16.7%) had an atrophic testis in the scrotum and 10 (83.3%) had a viable testis in the scrotum. The operated testis was smaller than the normal testis in all cases, despite the good vascularization detected on echo color Doppler ultrasound. Long term outcomes in pediatric patients are difficult to ascertain since children move typically without warning to their physicians and then when they reach adulthood, they rarely see a physician until medically necessary.

Their findings indicated that greater than 83% of patients who underwent a 2-step Fowler-Stephens procedure using laparoscopy had satisfactory results. One method to help answer this question would be to follow the children prospectively with yearly contacts to try capturing any changes in address and/or health status. However, this is time consuming and costly. Also, we might likely only hear from these patients when something is wrong.

Esposito C, Vallone G, Savanelli A, Settimi A
J Urol. 2009 Apr;181(4):1851-6.
doi:10.1016/j.juro.2008.12.003

Written by UroToday.com Medical Editor Pasquale Casale, MD

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