Outcomes of Bilateral Laparoscopic Orchiopexy for Bilateral Intra-abdominal Testes.

OBJECTIVE

To report the results of bilateral laparoscopic orchiopexy in a large cohort of patients with bilateral intra-abdominal testes.

METHODS

Due to the rarity of bilateral intra-abdominal testes, outcomes of laparoscopic bilateral orchiopexy are poorly defined. This retrospective study reviews pediatric patients undergoing bilateral laparoscopic orchiopexy for bilateral intra-abdominal testes from a large pediatric tertiary care center from 2012-2021.

RESULTS

A total of 35 patients with 70 testicle units were included. Median age at time of first surgery was 1.8 years old with a median follow-up of 24.2 months. Seventeen patients had comorbidities. Majority of procedures were 2-stage (31, 88.6%). Two patients underwent unilateral orchiectomy for atrophic testes after the first stage, resulting in 68 testes available for postoperative assessment. Postoperative outcomes demonstrated normal size in 62.9% (44/70), atrophy in 17.1% (12/70), and non-palpable in 17.1% (12/70). Testicular position at follow-up was dependent scrotum in 68.6% (48/70), high scrotum in 8.6% (6/70), inguinal in 2.9% (2/70), and non-palpable in 17.1% (12/70). Of the 48 testes located in the dependent scrotum, 39 were normal in size, and 9 were atrophic. Five patients out of 35 (14.2%) had bilateral nonfunctional testes, while 11 patients (11/35, 31.4%) had bilateral dependent testes of normal size. No significant difference in outcomes was observed between patients with and without comorbidities.

CONCLUSION

Bilateral laparoscopic orchiopexy is the gold standard for bilateral intra-abdominal testes. However, this diagnosis is associated with a high risk of atrophic/non-palpable testes in 34.2% of cases and complete anorchia in 14.2%.