PURPOSE: Increased use of video laparoscopy in the diagnosis and treatment of the impalpable testis has encouraged use of the 2-stage Fowler-Stephens orchiopexy. To date, however, few limited studies exist to indicate whether clipping and division of the spermatic vessels alone may cause histological abnormalities in the intra-abdominal testis. MATERIALS AND METHODS: We evaluated histology and volume of 44 intra-abdominal testes in 35 patients between 4 months and 14 years old at stages 1 and 2 of the Fowler-Stephens procedure. RESULTS: There was a significant reduction in the number of spermatogonia and seminiferous tubules 6 months after ligation and division of the spermatic vessels. No differences were found in the number of Sertoli cells or testicular volume before and after clipping and division of the spermatic vessels. CONCLUSIONS: Ligation of the spermatic vessels during stage 1 orchiopexy for intra-abdominal testicles is associated with a significant reduction of spermatogonia. However, no significant changes were observed in the volumetric characteristics of the testicles. Further studies are necessary to evaluate the repercussions of these changes in future fertility.
PURPOSE: Increased use of video laparoscopy in the diagnosis and treatment of the impalpable testis has encouraged use of the 2-stage Fowler-Stephens orchiopexy. To date, however, few limited studies exist to indicate whether clipping and division of the spermatic vessels alone may cause histological abnormalities in the intra-abdominal testis. MATERIALS AND METHODS: We evaluated histology and volume of 44 intra-abdominal testes in 35 patients between 4 months and 14 years old at stages 1 and 2 of the Fowler-Stephens procedure. RESULTS: There was a significant reduction in the number of spermatogonia and seminiferous tubules 6 months after ligation and division of the spermatic vessels. No differences were found in the number of Sertoli cells or testicular volume before and after clipping and division of the spermatic vessels. CONCLUSIONS: Ligation of the spermatic vessels during stage 1 orchiopexy for intra-abdominal testicles is associated with a significant reduction of spermatogonia. However, no significant changes were observed in the volumetric characteristics of the testicles. Further studies are necessary to evaluate the repercussions of these changes in future fertility.
Authors: Khalid A Ismail; Mohamed H M Ashour; Mahmoud A El-Afifi; Amel A Hashish; Nagay E El-Dosouky; Mohamed Negm; Mohamed S Hashish Journal: Afr J Paediatr Surg Date: 2017 Oct-Dec