Testicular Volume Changes in Laparoscopic Staged Fowler-Stephens Orchiopexy: Studying the Impact of Testicular Vessel Division
| Autor: | Irene M. McAleer, Antoine E. Khoury, Irene Young, Joshua Chamberlin, Ahmed Abdelhalim, Miriam Fahim, Elias Wehbi, Heidi A. Stephany, Kai-wen Chuang |
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| Rok vydání: | 2019 |
| Předmět: |
Male
endocrine system medicine.medical_specialty Time Factors Databases Factual Both testes Testicular volume Urology medicine.medical_treatment 030232 urology & nephrology Risk Assessment Statistics Nonparametric Cohort Studies 03 medical and health sciences Postoperative Complications 0302 clinical medicine Cryptorchidism Testis medicine Humans Orchiopexy Retrospective Studies Intraoperative Care Testicular atrophy business.industry Vascular compromise Ultrasound Infant Newborn Organ Size medicine.disease Treatment Outcome 030220 oncology & carcinogenesis Vascular flow Scrotum Laparoscopy Volume loss business Follow-Up Studies |
| Zdroj: | Urology. 127:113-118 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/j.urology.2019.01.030 |
| Popis: | Objective To study the effect of testicular vessel division on testicular volume during laparoscopic staged Fowler Stephens orchiopexy (LSFSO). Methods Testicular dimensions were prospectively measured intraoperatively at both first (S1) and second stages (S2) of LSFSO, and with scrotal ultrasound 3-12 months postoperatively. Testicular volumes were compared to reference ranges. Volume changes were tracked with a change of >20% considered clinically significant. Results A total of 52 nonpalpable testes treated with LSFSO between 2008 and 2018 were included in the study. After a median follow-up of 6.8 (3-91.3) months, 46 (88.5%) testes were palpable in a scrotal location without adjunctive procedures and 39 (75%) maintained vascular flow on duplex ultrasound. One testis retracted to an inguinal position and was successfully treated with inguinal orchiopexy for an overall success of 90.4% (47/52). Of 36 testes with intra- and postoperative testicular volume documentation, only 2 (5.6%) had significant volume loss after S1. Both testes had catch-up growth after S2. Eight (22.2%) testes had significant volume loss after S2. At follow-up, 24 (66.7%) testes were smaller than the mean for age, of which 20 (83.3%) were small at baseline. Only 41.7% of testes larger than mean for age at follow-up, were small at baseline (P = .02). Conclusion Significant testicular volume loss does not occur after testicular vessel division at S1, but expected in approximately 1 quarter of testes after S2. We propose that testicular atrophy after LSFSO is primarily due to defective testicular development and rarely due to vascular compromise during S2. |
| Databáze: | OpenAIRE |
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