| Title | Open versus laparoscopic staged fowler-stephens orchiopexy: impact of long loop vas. | | Author(s) | Dave S, Manaboriboon N, Braga LH, Lorenzo AJ, Farhat WA, Bägli DJ, Khoury AE, Salle JL | | Institution | Divisions of Urology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada. | | Source | J Urol 2009 Nov; 182(5):2435-9. | | Abstract | PURPOSE: There is a paucity of literature on factors associated with testicular atrophy following second stage laparoscopic Fowler-Stephens orchiopexy. We hypothesized that dissection of a long looping vas during this procedure could compromise testicular blood supply, leading to testicular atrophy.
MATERIALS AND METHODS: Following an initial laparoscopic testicular vessel ligation, a second stage Fowler-Stephens orchiopexy was performed in 73 testes (laparoscopic in 61, open in 12). The presence of a long looping vas was noted from the first stage operative notes. Doppler ultrasound was performed postoperatively to confirm testicular atrophy.
RESULTS: Atrophy rate at a mean followup of 13.5 months was 20.5% (15 of 61 in laparoscopic and 0 of 12 in open orchiopexy). None of the 5 long looping vas testes atrophied following open orchiopexy, compared to 5 of 6 (83%) following laparoscopic orchiopexy (p = 0.03). Analyzing the laparoscopic group alone, a long looping vas was significantly associated with risk of atrophy (p <0.01).
CONCLUSIONS: The presence of a long looping vas was associated with a higher atrophy rate following laparoscopic second stage Fowler-Stephens orchiopexy. Laparoscopic management of the long looping vas may be more challenging and, therefore, in such cases open Fowler-Stephens orchiopexy may result in better success rates by preserving the integrity of the collateral vessels. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 19765743 |
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