Analysis of laparoscopic orchidopexy in intra-abdominal testis

Neissner, C. and Ebert, A. K. and Roesch, W. H. (2011) Analysis of laparoscopic orchidopexy in intra-abdominal testis. UROLOGE, 50 (5). 573-+. ISSN 0340-2592, 1433-0563

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Abstract

Laparoscopy is an established diagnostic procedure but is less frequently used as a therapeutic method for impalpable testes. To compare the results of the classic two-stage orchidopexy described by Fowler-Stephens with a testicular vessel-sparing single-stage approach in the management of intra-abdominal testes we retrospectively analyzed our data. From January 2005 to September 2010, 105 patients (mean age 32 months) underwent laparoscopy for impalpable testes. In cases of intra-abdominal testes, laparoscopic orchidopexy was performed either in a two-stage procedure including initial ligation of the testicular vessels or as a direct single-stage procedure without ligation of the vessels. The results of both approaches were evaluated postoperatively clinically and by ultrasonography. Among the 122 impalpable testes 63 were located intra-abdominally; single-stage orchidopexy was performed in 29 testes whereas a two-stage approach was conducted in 14 testes. Fourteen gonads had to be removed due to atrophy and in six cases no testis was found at all. In the other 59 cases inguinal exploration followed resulting in 22 orchidopexies, 34 removals and 3 blind-ending vessels. During a mean follow-up of 17 months none of the 29 testes treated by single-stage orchidopexy atrophied or reascended. By contrast, two cases of atrophy, one reascent and one subumbilical wound infection occurred after the two-stage procedure. Considering our excellent experiences with single-stage management, we conclude that the single-stage approach is a reliable, safe and efficacious treatment modality of intra-abdominal testes. However, the two-stage procedure including testicular vessel ligation should be restricted to high abdominal testes with very short vessels.

Item Type: Article
Uncontrolled Keywords: MANAGEMENT; LIGATION; ORCHIOPEXY; VESSELS; Cryptorchidism; Impalpable testis; Intra-abdominal testis; Laparoscopic orchidopexy; Fowler-Stephens technique
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Urologie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 18 Jun 2020 08:06
Last Modified: 18 Jun 2020 08:06
URI: https://pred.uni-regensburg.de/id/eprint/20873

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