Orchiopexy for intra-abdominal testes: factors predicting success.
OBJECTIVE
Intra-abdominal testes can be treated with several surgical procedures. We evaluated factors influencing the outcome of orchiopexy for intra-abdominal testis.


METHODS
We retrospectively reviewed 156 consecutive orchiopexies performed for intra-abdominal testis, defined as a nonpalpable testis on examination and located in the abdomen at surgery. All surgical approaches were included in the study. Primary outcome was the overall success rate and secondary outcomes were success based on surgical approach, age and a patent processus vaginalis. Success was considered a testis with normal texture and size compared to the contralateral testis at followup. Multivariate analysis was performed to determine factors predictive of success.


RESULTS
The overall success rate of all orchiopexies was 79.5%. Median patient age at orchiopexy was 12 months and mean followup was 16 months. Of the patients 117 had a patent processus vaginalis at surgery. One-stage abdominal orchiopexy was performed in 92 testes with 89.1% success. Of these cases 32 were performed laparoscopically with 96.9% success. One-stage Fowler-Stephens orchiopexy was performed in 27 testes and 2-stage Fowler-Stephens orchiopexy was performed in 37 with success in 63.0% and 67.6%, respectively. Multivariate analysis revealed that 1-stage orchiopexy without vessel division had more successful outcomes than 1 and 2-stage Fowler-Stephens orchiopexy (OR 0.24, p = 0.007 and 0.29, p = 0.19, respectively). Neither age at surgery nor an open internal ring was significant (p = 0.49 and 0.12, respectively).


CONCLUSIONS
The overall success of orchiopexy for intra-abdominal testis is 79.5%. While patient selection remains a critical factor, 1-stage orchiopexy without vessel division was significantly more successful and a laparoscopic approach was associated with the fewest failures for intra-abdominal testes.
Stec
Andrew A
AA
Division of Pediatric Urology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2765, USA. andrew.stec@vanderbilt.edu
Tanaka
Stacy T
ST
Adams
Mark C
MC
Pope
John C
JC
Thomas
John C
JC
Brock
John W
JW
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D013521:Urologic Surgical Procedures, Male / Q000379:methods