Management of the Abdominal Undescended Testicle

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Abstract
Of the orchiopexies performed for abdominal undescended testicles 85% resulted in satisfactory testicular growth and position. Of these cases 3/4 were boys with prune belly syndrome. Recent experience using the Fowler-Stephens procedure to salvage intra-abdominal undescended testicles was satisfactory. An analysis of the failures in 5 testes early in this series, resulting in partial atrophy, has helped to avoid technical errors through attention to the following details: preservation of a broad pedicle of peritoneum overlying the mobilized vas, avoidance of any dissection of the spermatic cord and high ligation of the spermatic vessels well above the point of confluence of the vas and spermatic vessels. Although the Fowler-Stephens procedure has some risk of testicular ischemia and atrophy, it is the preferred way to gain mobility on a short tethering gonadal vascular pedicle.