WOFAPS 2025 8th World Congress of Pediatric Surgery

shaheer ashraf, Shabbir Hussain

Liaquat National Hospital

Retrospective Analysis of Single-Stage Fowler-Stephens Orchiopexy: Outcomes and Complications

Introduction

Cryptorchidism is the most extensive congenital anomalies among infants of males having a reported incidence of 1–3% [1]. Focused on its various presentations and intra-abdominal testes depict a complex issue that is clinical because of their distance from the scrotum and increased threat of testicular atrophy, if not properly managed. If it is left unprocessed, cryptorchidism can lead to infertility, increased risk of psychological issues and testicular malignancy afterward in life. Timely interventions that are surgical is important to ensure optimal reproductive and endocrine results [2].

For high standard process of orchiopexy and intra-abdominal testes may not provide sufficient mobilization due to the shorter length of the spermatic vessels [3]. The method of Fowler-Stephens Orchiopexy (FSO), originally formed to examine this issue comprises segregating the testicular vessels to acknowledge the testis to achieve the scrotum by focusing on collateral movement from the deferential and cremasteric arteries. Traditionally, carried out in two phases, a single step Fowler-Stephens orchiopexy (SSFSO) has considered as a major alternative, minimising the need for various surgeries and reducing the burden on both patients and systems of healthcare systems [4].

This research will examine the results, efficacy, and complications associated with SSFSO in managing elevated intra-abdominal cryptorchidism. Through robust analysis of standards of selection of patient, postoperative results, and intraoperative approaches, it helps to assess the success of SSFSO [5]. Examining the benefits and disadvantages of SSFSO is essential for enhancing long-term testicular feasibility and purpose and cleansing surgical decision-making among exaggerated patients. The results of this study adds to the raising body of literature maintaining self-effacingly unrelenting and well-organized approaches to cryptorchidism management.

Objectives

Operational Definitions

Intra Abdominal Testes: Intra abdominal testes is defined as undescended testicles positioned deeper with abdominal cavity, often prior to the inner inguinal ring, making surgical stumble into the scrotum harder and complex [6].

Single-Stage Fowler-Stephens Orchiopexy (SSFSO): SSFSO is a surgical approach for er intra-abdominal testes while testicular vessels are legated and the testis is replaced to the scrotum in a particular process [4].

Success Rate: Postoperative positioning of the testis within the scrotum shows victorious surgical position without proof of atrophy, compromised supply of blood, or important complexities, making sure conserved testicular purpose and optimal anatomical result [7].

Testicular Atrophy: Testicular atrophy is based on the loss or shrinkage of testicular tissue, often leading from declined blood supply, infection, trauma, or surgical complexities, resulting to impaired reproductive and hormonal function [8].

Hypotheses

H1: There is a significant impact of surgical success rate of SSFSO among patients with intra-abdominal undescended testes.

H2: There is a significant impact of postoperative complications, comprising re-ascent, testicular atrophy, and wound-associated issues among patients with intra-abdominal undescended testes.

Methodology

​ This retrospective cohort study will be carried out by assessing records of medical of patients who undergo SSFSO for huge testes of abdominal at the institution over a specified period. The research will help to assess the complications and outcomes linked with SSFSO. Data collection will comprise of preoperative imaging findings, patient demographics, details of the surgical method, postoperative follow-up data, and intraoperative observations. All patients will undergo SSFSO including either open ligation or laparoscopic of the testicular vessels, followed by urgent relocation and mobilization of the testis into the scrotum [9].

Patients will be examined at postoperative intermission of 1 month, 6 months, and 12 months to assess testicular position, viability, and the occurrence of complexities. The key result was described as victorious testicular preservation in the scrotum without atrophy, assessed with the help ofclinical examination representing sufficient collateral flow of blood. Complications will be examined and classified, involving testicular atrophy robust postoperative decrease in size, retraction including testis not outstanding in scrotum, surgical site infections, and spermatic cord torsion [10].

Inclusion criteria will comprise of patients diagnosed with abdominal testes through intraoperative or imaging assessment, without syndromic situations influencing testicular feasibility, and where typical orchiopexy will be unfeasible because of small vascular pedicles. Patients with preoperative testicular atrophy, noteworthy comorbidities contraindicating surgery, or cases necessitating two-stage Fowler-Stephens measures will be excluded. Comparative analysis will be conducted to assess the rates of success across various subgroups of patients focused on clinical variables and surgical approach, giving insight into predictors of positive results following SSFSO.

Conclusion

This study will offer a robust analysis of SSFSO in the handling of abdominal testes, showing rates of success and possible complications. The results will suggest that while SSFSO will be a feasible option, cautious selection of patients and scrupulous surgical technique will be important for increasing results. Further prospective studies will be confirmed to process surgical strategies and increase testicular function and preservation.

References