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Treatment of High Undescended Testes by Low Spermatic Vessel Ligation: An Alternative to the Fowler-Stephens Technique

1996; Lippincott Williams & Wilkins; Volume: 156; Issue: 2S Linguagem: Inglês

10.1016/s0022-5347(01)65820-8

1527-3792

Stephen A. Koff, Parminder S. Sethi,

Sexual Differentiation and Disorders

No AccessJournal of UrologyAndrology/Testes1 Aug 1996Treatment of High Undescended Testes by Low Spermatic Vessel Ligation: An Alternative to the Fowler-Stephens Technique Stephen A. Koff and Parminder S. Sethi Stephen A. KoffStephen A. Koff and Parminder S. SethiParminder S. Sethi View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65820-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined whether testis viability after a Fowler-Stephens orchiopexy depends on ligating the spermatic vessels high and far proximal to the undescended testis. Materials and Methods: Based on studies of testicular vascular anatomy we developed a technique of low spermatic vessel ligation and performed it on 39 high undescended testes in 33 patients. Results: Testis viability was 97 percent at 1 month and 93 percent (25 of 27) at 1 year. Conclusions: Ligation of the spermatic vessels does not need to be performed high to ensure testis viability. Testicular vascular anatomy supports low spermatic vessel ligation and by decreasing tension on the testis low spermatic vessel ligation may enhance viability. A 2-stage laparoscopic approach to the high undescended testis is difficult to justify on the basis of cost or outcome analysis. References 1 : The role of testicular vascular anatomy in the salvage of high undescended testes. Aust. New Zeal. J. Surg.1959; 29: 92. Google Scholar 2 : Surgical treatment of the high undescended testis. Surg., Gynec. & Obst.1967; 124: 605. Google Scholar 3 : The "long-loop vas" orchiopexy for the high undescended testis. Amer. Surg.1972; 38: 69. Google Scholar 4 : Prune belly syndrome. In: Surgical Pediatric Urology. Edited by . Philadelphia: W. B. Saunders Co.1977: 240. 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Link, Google Scholar 13 : Preliminary ligation of the gonadal vessels prior to orchiopexy for the intra-abdominal testicle: a staged Fowler-Stephens procedure. World J. Urol.1984; 2: 266. Google Scholar From the Section of Pediatric Urology, Children's Hospital and Division of Urology, Department of Surgery, Ohio State University Medical Center, Columbus, Ohio.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byElyas R, Guerra L, Pike J, DeCarli C, Betolli M, Bass J, Chou S, Sweeney B, Rubin S, Barrowman N, Moher D and Leonard M (2018) Is Staging Beneficial for Fowler-Stephens Orchiopexy? A Systematic ReviewJournal of Urology, VOL. 183, NO. 5, (2012-2019), Online publication date: 1-May-2010.Kamisawa H, Kojima Y, Mizuno K, Imura M, Kohri K and Hayashi Y (2018) Spermatogenesis After 1-Stage Fowler-Stephens Orchiopexy in Experimental Cryptorchid Rat ModelJournal of Urology, VOL. 183, NO. 6, (2380-2384), Online publication date: 1-Jun-2010.Dave S, Manaboriboon N, Braga L, Lorenzo A, Farhat W, Bägli D, Khoury A and Salle J (2018) Open Versus Laparoscopic Staged Fowler-Stephens Orchiopexy: Impact of Long Loop VasJournal of Urology, VOL. 182, NO. 5, (2435-2439), Online publication date: 1-Nov-2009.LORENZO A, SAMUELSON M, DOCIMO S, BAKER L and LOTAN Y (2018) COST ANALYSIS OF LAPAROSCOPIC VERSUS OPEN ORCHIOPEXY IN THE MANAGEMENT OF UNILATERAL NONPALPABLE TESTICLESJournal of Urology, VOL. 172, NO. 2, (712-716), Online publication date: 1-Aug-2004.LINDGREN B, FRANCO I, BLICK S, LEVITT S, BROCK W, PALMER L, FRIEDMAN S and REDA E (2018) LAPAROSCOPIC FOWLER-STEPHENS ORCHIOPEXY FOR THE HIGH ABDOMINAL TESTISJournal of Urology, VOL. 162, NO. 3 Part 2, (990-993), Online publication date: 1-Sep-1999.SAMPAIO F, FAVORITO L, FREITAS M, DAMIAO R and GOUVEIA E (2018) ARTERIAL SUPPLY OF THE HUMAN FETAL TESTIS DURING ITS MIGRATIONJournal of Urology, VOL. 161, NO. 5, (1603-1605), Online publication date: 1-May-1999.THORUP J, CORTES D and VISFELDT J (2018) GERM CELLS MAY SURVIVE CLIPPING AND DIVISION OF THE SPERMATIC VESSELS IN SURGERY FOR INTRA-ABDOMINAL TESTESJournal of Urology, VOL. 162, NO. 3 Part 1, (872-874), Online publication date: 1-Sep-1999.LINDGREN B, DARBY E, FAIELLA L, BROCK W, REDA E, LEVITT S and FRANCO I (2018) LAPAROSCOPIC ORCHIOPEXY: PROCEDURE OF CHOICE FOR THE NONPALPABLE TESTIS?Journal of Urology, VOL. 159, NO. 6, (2132-2135), Online publication date: 1-Jun-1998.KING L (2018) ORCHIOPEXY FOR IMPALPABLE TESTISJournal of Urology, VOL. 160, NO. 6 Part 2, (2457-2460), Online publication date: 1-Dec-1998.Law G, Perez L and Joseph D (2018) Two-Stage Fowler-Stephens Orchiopexy With Laparoscopic Clipping of the Spermatic VesselsJournal of Urology, VOL. 158, NO. 3, (1205-1207), Online publication date: 1-Sep-1997. Volume 156Issue 2SAugust 1996Page: 799-803 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Stephen A. Koff More articles by this author Parminder S. Sethi More articles by this author Expand All Advertisement PDF downloadLoading ...