Guanglun Zhou 1 1 Laboratory of Pelvic Floor Muscle Function, Department of Urology, Shenzhen Children’s Hospital, Shenzhen, P.R. China , Jinjun Chen 1 1 Laboratory of Pelvic Floor Muscle Function, Department of Urology, Shenzhen Children’s Hospital, Shenzhen, P.R. China , Jianchun Yin 1 1 Laboratory of Pelvic Floor Muscle Function, Department of Urology, Shenzhen Children’s Hospital, Shenzhen, P.R. China , Xiaodong Liu 1 1 Laboratory of Pelvic Floor Muscle Function, Department of Urology, Shenzhen Children’s Hospital, Shenzhen, P.R. China , Jiahong Su 1 1 Laboratory of Pelvic Floor Muscle Function, Department of Urology, Shenzhen Children’s Hospital, Shenzhen, P.R. China , Shoulin Li 1 1 Laboratory of Pelvic Floor Muscle Function, Department of Urology, Shenzhen Children’s Hospital, Shenzhen, P.R. China
J Laparoendosc Adv Surg Tech A. 2022 Apr 18; Online ahead of print.
COMMENT
The high abdominal undescended testis is a challenging situation in pediatric urology. The surgery to put the testicle in the scrotal region without harming its vascularization is very important for the treatment of these cases. Fowler-Stephens surgery performed in two times is the best strategy to preservation of vascular supply to the testis. In this important paper the authors shows the benefits of performing open versus laparoscopic gubernaculum-sparing second-stage Fowler-Stephens orchiopexy (FSO). The gubernaculum is the most important structure in the inguinoscrotal stage of testicular migration (11 Favorito LA, Sampaio FJ, Javaroni V, Cardoso LE, Costa WS. Proximal insertion of gubernaculum testis in normal human fetuses and in boys with cryptorchidism. J Urol. 2000;164(3 Pt 1):792-4., 22 Favorito LA, Costa SF, Julio-Junior HR, Sampaio FJ. The importance of the gubernaculum in testicular migration during the human fetal period. Int Braz J Urol. 2014;40:722-9.). The knowledge of testicular and gubernaculum vascular anatomy is a key point in this procedure (33 Benzi TC, Logsdon NT, Sampaio FJB, Favorito LA. Testicular arteries anatomy applied to fowler-sthephens surgery in high undescended testis - a narrative review. Int Braz J Urol. 2022;48:8-17.). In this paper the authors retrospectively studied a cohort of patients who underwent laparoscopic first-stage FSO and open versus laparoscopic gubernaculum-sparing second-stage FSO and concluded that the second-stage gubernaculum-sparing FSO achieved high testicular survival rates and satisfactory testicular positions. Neither the open nor laparoscopic approach appeared superior, because the overall testicular survival rates and incidence of testicular ascent and other complications were equivalent between both groups.
REFERENCES
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1Favorito LA, Sampaio FJ, Javaroni V, Cardoso LE, Costa WS. Proximal insertion of gubernaculum testis in normal human fetuses and in boys with cryptorchidism. J Urol. 2000;164(3 Pt 1):792-4.
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2Favorito LA, Costa SF, Julio-Junior HR, Sampaio FJ. The importance of the gubernaculum in testicular migration during the human fetal period. Int Braz J Urol. 2014;40:722-9.
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3Benzi TC, Logsdon NT, Sampaio FJB, Favorito LA. Testicular arteries anatomy applied to fowler-sthephens surgery in high undescended testis - a narrative review. Int Braz J Urol. 2022;48:8-17.
Publication Dates
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Publication in this collection
26 Aug 2022 -
Date of issue
Sep-Oct 2022
