Modified shehata surgery vs. laparoscopic One-stage orchiopexy for intra-abdominal cryptorchidism: a comparative retrospective study.

OBJECTIVE

To compare the therapeutic outcomes of a modified Shehata surgery with a condensed 4-week interstage interval vs. conventional laparoscopic one-stage orchiopexy for intra-abdominal cryptorchidism.

METHODS

We retrospectively analyzed 70 children with unilateral intra-abdominal cryptorchidism (July 2020-June 2022), allocated to modified Shehata (Group A, n = 35) or one-stage orchiopexy (Group B, n = 35). The modified procedure involved laparoscopic traction/fixation followed by second-stage orchiopexy at 4 weeks. Primary outcomes were testicular volume and blood flow (Doppler) assessed at 1, 3, and 6 months postoperatively. Secondary outcomes included serum testosterone (T), estradiol (E2), follicle-stimulating hormone (FSH) at 6 months, complication rates, success rate, and total treatment cost.

RESULTS

Baseline characteristics were comparable. Group A demonstrated significantly larger testicular volume at all postoperative timepoints (P < 0.05) and superior blood flow at 6 months (97.1% vs. 77.1% 'Rich' flow, P = 0.032). Regarding secondary outcomes, Group A had more favorable 6-month hormonal profiles (higher T, lower FSH/E2, P < 0.05), a lower surgery-related complication rate (0% vs. 17.14%, P = 0.033), and a higher success rate (100% vs. 82.86%, P = 0.033), but incurred higher total cost (P < 0.001).

CONCLUSION

The modified Shehata surgery with a 4-week interval yields superior testicular development, perfusion, endocrine function, and lower complications compared to one-stage orchiopexy, albeit at higher cost.