Mapping testicular blood supply in gubernaculum-sparing second-stage Fowler-Stephens procedure.
Surg Endosc
; 28(11): 3158-61, 2014 Nov.
Article
em En
| MEDLINE
| ID: mdl-24879140
ABSTRACT
BACKGROUND:
Testicular survival following second-stage Fowler-Stephens (FS) procedure depends upon adequate arterial supply. There is evidence that testicular survival rates are greater following gubernaculum-sparing second-stage FS procedure. The importance of collateral vessels in preservation of the testis has been hypothesised, but never shown in the literature. We aim to map the collateral blood supply to the testicle in gubernaculum-sparing, laparoscopic-assisted, second-stage FS procedure for intra-abdominal testicles.METHODS:
Selected patients undergoing a second-stage FS procedure were photographed prior to pexy in the Dartos pouch. Photographs were evaluated for the extent of vascular collateralisation between gubernacular, deferential and the ligated spermatic artery. RESEARCH Twenty-five patients with 28 undescended testicles underwent staged FS procedure over a 7.5-year period between 2005 and April 2013. Mean age at operation was 2.44 years, and all testicles were delivered to the scrotum. Mean follow-up was 3.29 years, and all patients were reviewed by the operating consultant. Testicular survival rate was 100 %. Representative photographs clearly demonstrate substantial cremasteric vessels running along the gubernaculum with robust collateralisation to the deferential vessel and the spermatic arterial stump.CONCLUSION:
These images confirm the presence of robust collateral between the cremasteric and deferential vessels at second-stage FS procedure. Preservation of these collaterals in a gubernaculum-sparing approach may explain the excellent results seen in this series.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Testículo
/
Criptorquidismo
/
Orquidopexia
Limite:
Adult
/
Aged
/
Humans
/
Male
Idioma:
En
Revista:
Surg Endosc
Assunto da revista:
DIAGNOSTICO POR IMAGEM
/
GASTROENTEROLOGIA
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Reino Unido