title: Testicular outcome following laparoscopic second stage Fowler-Stephens orchidopexy.
abstract: OBJECTIVE
  To assess outcome after laparoscopic second-stage Fowler-Stephens orchidopexy (L2(nd)FSO).
  
  
  METHODS
  Retrospective review of 94 children (aged 0.75-16 years, median 2.75 years), who underwent L2(nd)FSO for 113 intra-abdominal testes between January 2000 and May 2009: 75 unilateral, 19 bilateral (11 synchronous; 8 metachronous). Follow-up (range 3 months-10.9 years, median 2.1 years) was available for 88 children (102 testes: 71 unilateral, 31 bilateral).
  
  
  RESULTS
  Testicular atrophy occurred in 9 out of 102 (8.8%), including 8 out of 71 (11.3%) unilateral and 1 out of 31 (3.2%) bilateral intra-abdominal testes (multivariate analysis: p = 0.59). Testicular ascent ensued in 9 out of 102 (8.8%), comprising four (5.6%) unilateral and five (16.1%) bilateral testicles (multivariate analysis: p = 0.11). Of the 18 bilateral testes brought to the scrotum synchronously none atrophied and four (22.2%) ascended, compared to one (7.7%) atrophy and one (7.7%) ascent among the 13 testes brought to the scrotum on separate occasions (Fisher exact test: p = 0.42 and p = 0.37, respectively). Mobilization of the testis through the conjoint tendon tended towards less ascent (multivariate analysis p = 0.08) but similar atrophy (p = 0.56) compared to mobilization through the deep-ring/inguinal canal. Logistical regression analysis identified no other patient or surgical factors influencing outcome.
  
  
  CONCLUSIONS
  This is the largest series of L2(nd)FSO to date. A successful outcome is recorded in 85 out of 102 (83.3%) testicles. Atrophy occurred in 8.8% and ascent in 8.8%.
authors.affiliation: Department of Paediatric Urology, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK. Electronic address: Swethan@doctors.org.uk.
authors.forename: Swethan
authors.initials: S
authors.lastname: Alagaratnam
authors.affiliation: Department of Paediatric Urology, University College London Hospitals NHS Foundation Trust, Euston Road, London, UK. Electronic address: Cnathaniel@doctors.org.uk.
authors.forename: Calvin
authors.initials: C
authors.lastname: Nathaniel
authors.affiliation: Department of Paediatric Urology, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK; Department of Paediatric Urology, University College London Hospitals NHS Foundation Trust, Euston Road, London, UK. Electronic address: Peter.Cuckow@gosh.nhs.uk.
authors.forename: Peter
authors.initials: P
authors.lastname: Cuckow
authors.affiliation: Department of Paediatric Urology, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK. Electronic address: Pgduffy@doctors.org.uk.
authors.forename: Patrick
authors.initials: P
authors.lastname: Duffy
authors.affiliation: Department of Paediatric Urology, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK. Electronic address: Imran.Mushtaq@gosh.nhs.uk.
authors.forename: Imran
authors.initials: I
authors.lastname: Mushtaq
authors.affiliation: Department of Paediatric Urology, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK; Department of Paediatric Urology, University College London Hospitals NHS Foundation Trust, Euston Road, London, UK. Electronic address: Abraham.Cherian@gosh.nhs.uk.
authors.forename: Abraham
authors.initials: A
authors.lastname: Cherian
authors.affiliation: Department of Paediatric Urology, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK; Department of Paediatric Urology, University College London Hospitals NHS Foundation Trust, Euston Road, London, UK. Electronic address: Divyesh.Desai@gosh.nhs.uk.
authors.forename: Divyesh
authors.initials: D
authors.lastname: Desai
authors.affiliation: Department of Paediatric Surgery, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK. Electronic address: Edward.Kiely@gosh.nhs.uk.
authors.forename: Edward
authors.initials: E
authors.lastname: Kiely
authors.affiliation: Department of Paediatric Surgery, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK. Electronic address: Agostino.Pierro@gosh.nhs.uk.
authors.forename: Agostino
authors.initials: A
authors.lastname: Pierro
authors.affiliation: Department of Paediatric Surgery, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK. Electronic address: David.Drake@doctors.org.uk.
authors.forename: David
authors.initials: D
authors.lastname: Drake
authors.affiliation: Department of Paediatric Surgery, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK. Electronic address: Paolo.DeCoppi@gosh.nhs.uk.
authors.forename: Paolo
authors.initials: P
authors.lastname: De Coppi
authors.affiliation: Department of Paediatric Surgery, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK. Electronic address: Kate.Cross@gosh.nhs.uk.
authors.forename: Kate
authors.initials: K
authors.lastname: Cross
authors.affiliation: Department of Paediatric Surgery, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK. Electronic address: Joe.Curry@gosh.nhs.uk.
authors.forename: Joe
authors.initials: J
authors.lastname: Curry
authors.affiliation: Department of Paediatric Urology, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK; Department of Paediatric Urology, University College London Hospitals NHS Foundation Trust, Euston Road, London, UK. Electronic address: Naima.Smeulders@gosh.nhs.uk.
authors.forename: Naima
authors.initials: N
authors.lastname: Smeulders
mesh_terms: D000293:Adolescent; D001284:Atrophy; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D015999:Multivariate Analysis; D056126:Orchiopexy / Q000379:methods*; D013737:Testis / Q000473:pathology; D016896:Treatment Outcome
keywords: Conjoint tendon; Cryptorchidism; Intra-abdominal testis; Laparoscopic Fowler–Stephens orchidopexy; Testicular ascent; Testicular atrophy