A Comparison of Outcomes of Staged Laparoscopic traction Orchiopexy and Two Stage Fowler-Stephens Orchiopexy in the management of Intra-abdominal Testicle; Prospective controlled clinical trial study.

Abstract

Background and aim: An established and widely used procedure for intra-abdominal testis is laparoscopic orchiopexy. Unlike the two-stage Fowler-Stephens approach, which divides the testicular vessels, the traction technique is focused on elongating the vessels without cutting them. The current study compared two stage Stephen Fowler laparoscopic orchiopexy for the abdominal testis with phased laparoscopic traction orchiopexy (Shehata technique).. Methods: This prospective study was conducted at Pediatric Surgery Department, Zagazig University Hospitals on twenty-four patients with impalpable undescended testes. Patients were categorized into two groups; the first group underwent staged laparoscopic traction orchiopexy (Shehata technique), and the second group underwent staged laparoscopic Fowler Stephens orchiopexy (FSO). Results: There was an increase in frequency of diminished testicular vascularity at 1, 2 & 3 months in Group II compared to Group I but without statistical significance. No cases had testicular retraction in both Groups. Regarding testicular position, there was an increase in frequency of low scrotal position in Group I compared to Group II (91.7% versus 75%) but without statistical significance.Conclusion: The favoring results of Shehata technique make it as a good alternative to Fowler Stephens technique. As it results in significant elongation with preservation of TV and is associated with low rate of testicular atrophy However long-term follow- up is needed to assess its effect on fertility.