Open versus laparoscopic staged Fowler-Stephens orchiopexy: impact of long loop vas.
J Urol
; 182(5): 2435-9, 2009 Nov.
Article
en En
| MEDLINE
| ID: mdl-19765743
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 ANDMETHODS:
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.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Laparoscopía
/
Criptorquidismo
Límite:
Child, preschool
/
Humans
/
Male
Idioma:
En
Revista:
J Urol
Año:
2009
Tipo del documento:
Article
País de afiliación:
Canadá