Laparoscopic one-stage Fowler-Stephens orchiopexy preserving gubernaculum.

OBJECTIVE To assess gubernaculum-sparing laparoscopic one-stage Fowler-Stephens orchiopexy (FSO), in the management of high intrapelvic testis. MATERIAL AND METHODS Medical reports of boys who underwent laparoscopic one-stage FSO were retrospectively reviewed. High intrapelvic testis was defined as testis ≥3 cm away from ipsilateral internal ring. Testes were evaluated on physical examination at 3rd, 6th and 18th months after surgery. Children were evaluated as for their demographic data, operative findings, interventional details and outcomes. RESULTS Seven patients met inclusion criteria of the study. Six of 7 testis were small and had abnormal appearance, compared with the contralateral testis. Average distance of the testes from the internal ring was 4.2±1.1 cm (3 to 6). Average age at surgery was 6.1±4.2 years (2 to 12). Average follow-up period was 14±5.8 months (8 to 20), and 5 testis (71.4%) were considered to be normal in volume and scrotal location. Two testes were relatively atrophic and underwent orchiectomy. CONCLUSION Our preliminary results shows a good testicular survival rate for one-stage laparoscopic FSO. Sparing collateral vasculature of the gubernaculum is important.