Laparoscopic Fowler-Stephens orchiopexy: The Westchester Medical Center experience

Background and Purpose: The Fowler-Stephens orchiopexy is performed laparoscopically both as a single-stage as well as a two-stage procedure. We hypothesize that with the right technique, the single-stage procedure is just as successful as the two-stage procedure. Methods: The records of all boys who underwent a laparoscopic Fowler-Stephens orchiopexy (LFSO) for a non-palpable testis at our institution from August 1995 to February 2007 were reviewed. Office charts and operative reports were reviewed for all patients. Results: There were 48 testes that were brought down by a LFSO. Of these, 38 were performed in one stage and 10 were performed in two stages. The overall success rate was 91.1%. Conclusions: We conclude that both single-stage and two-stage laparoscopic Fowler-Stephens orchiopexies are effective treatment options for children with intra-abdominal testes. In this series, the overall success rate for one stage LFSO was 94.3%. Avoiding manipulation of the vas deferens and epididymis appears to be the key to a high success rate.