Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

15:52 - 15:55

S18-4

(PP)

IS THERE A DIFFERENCE IN OUTCOMES BETWEEN STAGED FOWLER-STEPHENS

AND SINGLE STAGED LAPAROSCOPIC ORCHIOPEXY FOR INTRA-ABDOMINAL

TESTES?

Alireza ALAM

, Ruben BLACHMAN-BRAUN

, George WAYNE

, Mariarita SALVITTI

, Angela GUPTA

, Joan DELTO

, Miguel

CASTELLAN

, Kristin KOZAKOWSKI

, Andrew LABBIE

and Rafael GOSALBEZ

1) Miami Children's Hospital, Department of pediatric urology, Miller School of Medicine, Miami, USA - 2) Department of

Pediatric Urology, Miami Children's Hospital, Department of Pediatric Urology, Miami, USA - 3) Miami Children's Hospital,

Department of pediatric urology, Miami, USA - 4) Miami Children's Hospital, Department of Pediatric Urology, Miami,

USA

PURPOSE

Standard treatment for intra-abdominal testes includes either single staged laparoscopic orchiopexy (SSLO) or staged

Fowler-Stephens (SFS). Empirically, neither has been a decidedly superior approach. We compare these two methods,

analyzing post-operative testicular atrophy and mal-positioning.

MATERIAL AND METHODS

A retrospective chart review identified 167 intra-abdominal testes corrected by laparoscopic orchiopexy between

November 2006 and November 2014; 94 testes(82 patients) were analyzed, comparing patient characteristics and

outcomes, e.g. age, intra-abdominal location and size, atrophy, and positioning.

RESULTS

Of the 94 testes, 37 underwent SFS orchiopexy, and 57, SSLO. The median age at surgery was 12 months (range: 6-

154): SFS median 16 (range 6-121) and SSLO median 11 (range 6-154). Median follow-up was 8.7 months (range: 1-

87). No post-SFS testes were mal-positioned, a significantly less likely result compared to 11 (19.3%) mal-positioned

SSLO testes (OR 0.05, 95% CI 0.01 - 0.43). SFS and SSLO each resulted in four atrophic testes (10.8% and 7.0%,

respectively), a statistically insignificant difference. Age and testicular position were not associated with outcome, but

preoperative smaller testes may predict post-operative atrophy (OR 4.38, 95% CI 0.99 - 19.384). There were no

recurrent undescended testicles.

CONCLUSIONS

Data from our institution indicates no difference between the two approaches in terms of post-operative atrophy;

however, SFS appears more successful in securing a prognostically favorable scrotal position. Atrophy does not seem

associated with other patient factors, i.e. age, testicular position, or comorbid anomalies, but it is likely linked to small

pre-operative testes.