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TÜRKÇE
Oral Presentation - 60
Two-stage Fowler Stephens orchidopexy for intraabdominal testes
H Emir, Ş Emre, R Özcan, A Alptekin, M Eliçevik, SNC Büyükünal, Y Söylet
Istanbul University Medical Faculty Department of Pediatric Surgery Division of Pediatric Urology
Aim: To evaluate the clinical outcomes of patients who underwent two-stage Fowler-Stephens (TSFS) procedure for intra-abdominal testis retrospectively
Patients and methods: The medical records of 39 children (Mean age:64 months, range: 11 months -11 years) who underwent TSFSprocedure between 1992-2010 were analyzed retrospectively. During laparoscopic evaluation in the first stage, if an intraabdominal testis can not be pulled to the contralateral internal inquinal ring, we perform TSFS procedure. Otherwise we perform single stage orchidopexy and this group of patients, disorders of sexual developments, vanishing testes are not included in this study. In the second stage, if there is not testiculat atrophy, orchidopexy is performed either by a standart open surgical procedure or laparoscopically. The testis is mobilized to the scrotum on a flap of peritoneum containing the collateral vessels. The follow-up period ranges between 3 months and 16 years (mean: 5.7 years).
Results: TSFS procedure was performed for 48 intraabdominal testes in 39 patients (Right:16, left: 14, bilateral: 9). The mean interval between the two stages was 7.3 months (r: 3 -13 months). Three testes were recorded as a small testis in the first laparoscopic evaluation. In the second stage, orchiectomy was indicated for testicular atrophy in 2 testes (4%), including the one which was defined as a small testis at the first stage. Orchidopexy was performed in the other 46 testes by standart open surgical procedure in 30 and laparoscopically in 16. One testis can be mobilized to the distal inguinal canal and the other 45 testes was located in the scrotum uneventfully except one with a pedicule injury. Of these 45 testes on the follow-up, 40 were palpable in the scrotum and testicular atrophy developed in the 5,including the testes which were noted as small at two stages. The succeess rate of TSFS orchidopexy is 83% (40/48).
CONCLUSION: Two stage is an effective treatment modality for intraabdominal testes if the spermatic cord have inadequate lenght to reach the scrotum. At present time we have been performing the second stage laparoscopically also.
İntraabdominal testislerde iki aşamalı Fowler-Stephens orşiopeksisi
H Emir, Ş Emre, R Özcan, A Alptekin, M Eliçevik, SNC Büyükünal, Y Söylet
İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Çocuk Cerrahisi Anabilim Dalı Çocuk Ürolojisi Bilim Dalı
Aim: To evaluate the clinical outcomes of patients who underwent two-stage Fowler-Stephens (TSFS) procedure for intra-abdominal testis retrospectively
Patients and methods: The medical records of 39 children (Mean age:64 months, range: 11 months -11 years) who underwent TSFSprocedure between 1992-2010 were analyzed retrospectively. During laparoscopic evaluation in the first stage, if an intraabdominal testis can not be pulled to the contralateral internal inquinal ring, we perform TSFS procedure. Otherwise we perform single stage orchidopexy and this group of patients, disorders of sexual developments, vanishing testes are not included in this study. In the second stage, if there is not testiculat atrophy, orchidopexy is performed either by a standart open surgical procedure or laparoscopically. The testis is mobilized to the scrotum on a flap of peritoneum containing the collateral vessels. The follow-up period ranges between 3 months and 16 years (mean: 5.7 years).
Results: TSFS procedure was performed for 48 intraabdominal testes in 39 patients (Right:16, left: 14, bilateral: 9). The mean interval between the two stages was 7.3 months (r: 3 -13 months). Three testes were recorded as a small testis in the first laparoscopic evaluation. In the second stage, orchiectomy was indicated for testicular atrophy in 2 testes (4%), including the one which was defined as a small testis at the first stage. Orchidopexy was performed in the other 46 testes by standart open surgical procedure in 30 and laparoscopically in 16. One testis can be mobilized to the distal inguinal canal and the other 45 testes was located in the scrotum uneventfully except one with a pedicule injury. Of these 45 testes on the follow-up, 40 were palpable in the scrotum and testicular atrophy developed in the 5,including the testes which were noted as small at two stages. The succeess rate of TSFS orchidopexy is 83% (40/48).
CONCLUSION: Two stage is an effective treatment modality for intraabdominal testes if the spermatic cord have inadequate lenght to reach the scrotum. At present time we have been performing the second stage laparoscopically also.