Objective: In two-stage orchidopexy, adhesions formed after the first stage usually cause difficulty during the second operation and may even lead to injury to the testis itself or to the spermatic cord. We investigated whether the use of adhesion-preventing barriers in the abdominal or pelvic region during surgery could lessen adhesions formed during two-stage orchidopexy and thus ease dissection.
Material And Methods: The study subjects comprised 21 male, albino, 30-day-old Wistar rats that were divided into three equal groups. In Group 1, the right testes were enveloped in adhesion barriers after dissection and sutured to the inguinal canal. In Group 2, the right testes were sutured to the inguinal canal without the barriers. In Group 3 (sham-operated group), all testes were dissected but no suturing was performed. Rats were sacrificed after 21 days and the ipsilateral testes were harvested.
Results: Dissection of barrier-enveloped testes was relatively easy; however, no significant (p < 0.535) difference was seen in adhesion scores between Groups 1 and 2. Total tissue collagen was estimated by means of the hydroxyproline content. Tissue hydroxyproline levels were 16.04 +/- 8.58, 13.20 +/- 6.34 and 14.71 +/- 5.51 microg/mg wet tissue in Groups 1-3, respectively and these differences were not significant. The histopathologic evaluation revealed significant differences only in the thickness of the tunica albuginea in Groups 1 and 2 (110.0 +/- 30.0 vs 77.1 +/- 21.3 microm, respectively; p < 0.038).
Conclusion: The adhesion scores and the biochemical and histopathological examinations showed that an adhesion barrier is not beneficial in two-stage orchidopexy.
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http://dx.doi.org/10.1080/00365590410029150 | DOI Listing |
Urologia
January 2025
Department of Pediatric and Neonata Surgery, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India.
Introduction: Laparoscopic Fowler Stephens orchidopexy, single stage or two-stage, is now routinely performed in non-palpable testis. We performed second stage orchidopexy as open inguinal approach and compared the outcome of this approach to two-staged laparoscopic orchidopexy.
Methods: We performed a prospective randomized interventional study of two different approaches for intra-abdominal testis.
J Pediatr Urol
October 2024
Service of Radiology, University of Sassari Medical School, Sassari, Italy.
Background: Treatment of high cryptorchidism can be challenging, often with frustrating results. We report 25 years of experience in the treatment of the cryptorchidism with very short spermatic vessels using an original two-stage orchiopexy that preserves the spermatic vessels.
Methods: We reviewed the clinical charts of children affected by cryptorchidism with very short spermatic vessels treated through our original surgical approach in tree Institutes of Pediatric Surgery.
Eur J Pediatr Surg
August 2024
Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
Introduction: Intra-abdominal testis (IAT) remains a challenging and controversial subset within the management of cryptorchidism. While Fowler-Stephens orchidopexy (FSO) is still being advocated as the gold standard for the treatment of this entity, there is new and conflicting evidence on the comparative outcomes between single- or two-stage laparoscopic FSO (LFSO). The aim of the study is to investigate whether staging has benefits in children receiving LFSO.
View Article and Find Full Text PDFJ Pediatr Urol
October 2024
Pediatric Surgery Unit, Alexandria Faculty of Medicine, Egypt; Pediatric Surgery Meta-Analysis Study Group (PeSMA), Turkey.
Introduction: The management of intra-abdominal testis (IAT) represents a significant clinical challenge, necessitating the transposition of the testis from the abdominal cavity to the scrotum. This procedure is rendered complex by the abbreviated length of the testicular vessels.
Objective: Our purpose in this study was to conduct a systematic review and meta-analysis comparing Shehata technique (ST) versus Fowler Stephens technique (FST) in treating patients with IAT.
Ann Med Surg (Lond)
August 2023
Department of Pediatric Surgery.
Unlabelled: One of the ways to treat undescended testicles is to use orchiopexy surgery, which is modified into the two-stage Fowler-Stephens technique in cases of short or immobile testes. The disadvantage of using this technique is the probability of testicular ischaemia following the sudden closure of the testicular artery; although the collateral arteries prevent atrophy, the testis loses its germ cells during this stress and may no longer be functional. Therefore, this study aims to examine the changes in testicular tissue regarding necrosis and infarction after the occlusion of the vessels.
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