We assessed the feasibility and safety of performing single setting bilateral laparoscopic orchiopexy in boys with bilateral intra-abdominal testes.
Materials and Methods: A single surgeon experience was reviewed. The surgical technique was similar in all cases and on each
side, including infra-umbilical access, diagnostic evaluation, peritoneal mobilization lateral to the spermatic vessels and buy JQEZ5 inferior to the vas deferens, gubernacular transection, and a decision for or against a Fowler-Stephens procedure and testis relocation into the scrotum with fixation. Followup consisted of physical examination 14 days, 6 months and 1 year postoperatively, when testicular position and size were assessed. Intraoperative and postoperative selleck complications were noted.
Results: Single setting bilateral laparoscopic orchiopexy was attempted in a total of 42 testes in 21 boys with a median age of 9 months (range 7 to 52). It was completed in a total of 36 testes in 18 boys. All procedures were performed on an outpatient basis. Of the 42 testes orchiopexy was performed in 4 with Fowler-Stephens ligation, including at a 1 and 2-stage procedure in 2 each. Although the latter 2 cases
account for 2 of the 3 not completed at a single setting, excellent outcomes were achieved in these cases at the second setting, yielding bilateral intrascrotal testes in each. A third boy required a subsequent open procedure for relocation of a testis from an inferior pubic/superior scrotal position to a more dependent portion of the scrotum. Testicular position after laparoscopy was the mid lower scrotum in 38 cases, upper scrotum in 3 and inferior pubic/superior scrotal in 1. Atrophy was noted in 2 of the 42 testes (19 of 21 boys) at 6-month followup, including in 1 boy who underwent
a 1-stage Fowler-Stephens procedure and I who underwent nonFowler-Stephens orchiopexy. Of the 21 boys 16 required only 1 surgery to achieve viable intrascrotal testes at 1-year followup. Of the 21 boys 19 (91%) ultimately achieved bilateral viable intrascrotal testes. There was no correlation between patient age and the likelihood of success or failure. No patient experienced any complications or hospital admissions.
Conclusions: In boys with bilateral intra-abdominal testes single Florfenicol setting bilateral laparoscopic orchiopexy can be performed safely on an outpatient basis with a high degree of success. Most boys undergo a single surgery with the testes relocated to a satisfactory intrascrotal position without atrophy.”
“Purpose: Prader-Willi syndrome is associated with hypogonadism. Cryptorchidism is found in 93% of cases and considered a phenotypic criterion. Men with Prader-Willi syndrome are thought to be infertile. To study the fertility probability in boys with Prader-Willi syndrome we analyzed testicular histology in 8 prepubertal boys and 1 man.