Exploring efficacy of staged laparoscopic Fowler-Stephens orchidopexy via direct inguinal triangle approach for high undescended testis based on propensity score matching

CAO Qingwei; WANG Qian; YANG Binyi; LU Hongting

doi:10.3969/j.issn.1674-3806.2025.05.12

Abstract：Objective To explore the efficacy of staged laparoscopic Fowler-Stephens orchidopexy via direct inguinal triangle approach for high undescended testis.Methods Two hundred pediatric patients with high undescended testes who were treated in the Department of Pediatric Surgery of Linyi Central Hospital from February 2020 to February 2024 were recruited.The pediatric patients were divided into control group(receiving laparoscopic testicular descent and fixation via direct inguinal triangle approach)and observation group(receiving staged laparoscopic Fowler-Stephens orchidopexy via direct inguinal triangle approach)by random number table method,with 100 cases in each group.During the treatment process,11 cases dropped out in the control group,and 89 cases were eventually included.During the treatment process,2 cases dropped out in the observation group,and 98 cases were eventually included.Ultimately,75 pairs of the pediatric patients were successfully matched after conducting match at a ratio of 1∶1 through propensity score matching(PSM).The changes in testicular volume,sex hormone levels and testicular function were compared between the two groups before surgery and 6 months after surgery.The therapeutic effects and the occurrence of complications were compared between the two groups.Results Compared with that before operation,there was no significant change in testicular volume between the two groups after operation(P＞0.05),and there were no statistically significant differences in testicular volume and clinical efficacy between the two groups after operation(P＞0.05).Compared with those before operation,the levels of follicle-stimulating hormone(FSH)and estradiol(E2)decreased and the levels of testosterone(T),anti-Müllerian hormone(AMH),and inhibin B(INHB)increased in both groups after operation,with statistically significant differences(P＜0.05),but there were no statistically significant differences between the two groups after operation(P＞0.05).The total occurrence rates of complications in the observation group and the control group were 8.00％and 12.00％,respectively,with no statistically significant difference between the two groups(P＞0.05).Conclusion The staged laparoscopic Fowler-Stephens orchidopexy via direct inguinal triangle approach is safe and effective in treatment of high undescended testis.