Laparoscopy for the impalpable testes: Experience with 80 intra-abdominal testes

ObjectiveTo evaluate two-stage laparoscopic Fowler–Stephens (FS) orchidopexy for intra-abdominal testes.Materials and methodsA retrospective analysis was performed of the clinical findings, interventions and outcomes in 111 boys undergoing laparoscopy for 132 impalpable testes.ResultsThe median age was 5.7 years (1.1–14.6 years). Twenty-seven testes were absent. Eighty testes were intra-abdominal, of which 10 were removed laparoscopically due to anatomical anomalies (4), short spermatic cord (5) or atresia (1). Twenty-five testes were located in the groin. Laparoscopic FS procedure was performed for 65 intra-abdominal testes: 60 two-stage operations and five where the testes were removed during FS second stage due to short vas or testicular atrophy. Outcome was successful in 80%. One-stage laparoscopic orchidopexy without vessel division was performed in five intra-abdominal testes with satisfactory results in three. In general, the success rate is higher in boys with bilateral intra-abdominal testes, probably due to younger age at operation.ConclusionsAt our centre two-stage laparoscopic Fowler–Stephens orchidopexy for intra-abdominal testes showed results comparable to most other studies, but less satisfactory than a couple of recent studies. The median age at referral was higher than recommended. Operation at an earlier age may further improve the results.