Research Article: Modified shehata surgery vs. laparoscopic One-stage orchiopexy for intra-abdominal cryptorchidism: a comparative retrospective study
Abstract:
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.
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.
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).
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.
Introduction:
The optimal surgical management of intra-abdominal cryptorchidism remains a significant challenge in pediatric urology ( 1 , 2 ). While orchiopexy is recommended within the first year of life to preserve testicular function and facilitate monitoring, the choice of technique for high-located testes remains contentious ( 3 ). One-stage laparoscopic orchiopexy is widely practiced but may be compromised by inadequate vascular length, leading to tension, testicular atrophy, or retraction ( 4 ). The Fowler-Stephens…
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