title: Staged Fowler-Stephens and Single-stage Laparoscopic Orchiopexy for Intra-abdominal Testes: Is There a Difference? A Single Institution Experience.
abstract: OBJECTIVE
  To compare single-stage laparoscopic orchiopexy (SSLO) and staged Fowler-Stephens (SFS) procedures in the management of intra-abdominal undescended testes, and to analyze postoperative atrophy and malpositioning as end points.
  
  
  METHODS
  A retrospective chart review identified laparoscopic orchiopexy patients with intra-abdominal testes between November 2006 and November 2014. Of 167 patients who had laparoscopic orchiopexy, 73 (85 testes) were identified as having laparoscopic orchiopexy. Baseline characteristics, as well as testicular scrotal position and size at follow-up, were recorded. Regression analysis was performed to compare outcomes between patients who underwent SFS and SSLO.
  
  
  RESULTS
  Of the 85 laparoscopic orchiopexies, 35 underwent SFS and 50 had SSLO. Patient demographics were comparable in both groups. The median age at surgery was 12 months (5-151 months), and the average follow-up was 17.3 months. On follow-up, there were 0 recorded cases of SFS patients with abnormally positioned testes postoperatively, whereas there were 10 (20.0%) SSLO patients who had abnormally positioned testes (odds ratio: 0.05, 95% confidence interval: 0.01-0.44). Differences in atrophy rates were not significant.
  
  
  CONCLUSIONS
  These results suggest that there may be no difference between the 2 approaches in terms of postoperative atrophy. However, the SFS appears to be more successful in securing a favorable scrotal position. Atrophy does not seem to be associated with other patient factors. Prospective, randomized studies are indicated to further explore outcome differences between the 2 approaches.
authors.affiliation: Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL. Electronic address: aalamsaheb38@gmail.com.
authors.forename: Alireza
authors.initials: A
authors.lastname: Alam
authors.affiliation: Urology Department, Mount Sinai Medical Center, Miami Beach, FL.
authors.forename: Joan C
authors.initials: JC
authors.lastname: Delto
authors.affiliation: Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL.
authors.forename: Ruben
authors.initials: R
authors.lastname: Blachman-Braun
authors.affiliation: Urology Department, Mount Sinai Medical Center, Miami Beach, FL.
authors.forename: George
authors.initials: G
authors.lastname: Wayne
authors.affiliation: Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL; Department of Pediatric Urology, Texas Children's Hospital and Baylor School of Medicine, Houston, TX.
authors.forename: Angela G
authors.initials: AG
authors.lastname: Mittal
authors.affiliation: Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL.
authors.forename: Miguel
authors.initials: M
authors.lastname: Castellan
authors.affiliation: Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL.
authors.forename: Kristin
authors.initials: K
authors.lastname: Kozakowski
authors.affiliation: Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL.
authors.forename: Andrew
authors.initials: A
authors.lastname: Labbie
authors.affiliation: Division of Pediatric Urology, Nicklaus Children's Hospital, Miami, FL.
authors.forename: Rafael
authors.initials: R
authors.lastname: Gosalbez
mesh_terms: D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D056126:Orchiopexy / Q000379:methods*; D011184:Postoperative Period; D012189:Retrospective Studies; D013737:Testis / Q000601:surgery*; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods*