TREATMENT OF HIGH UNDESCENDED TESTES BY LOW SPERMATIC VESSEL LIGATION- AN ALTERNATIVE TO THE FOWLER-STEPHENS TECHNIQUE

Purpose: We determined whether testis viability after a Fowler-Stephen s orchiopexy depends on ligating the spermatic vessels high and far pr oximal to the undescended testis. Materials and Methods: Based on stud ies of testicular vascular anatomy we developed a technique of low spe rmatic vessel ligation and performed it on 39 high undescended testes in 33 patients. Results: Testis viability was 97% at 1 month and 93% ( 25 of 27) at 1 year. Conclusions: Ligation of the spermatic vessels do es not need to be performed high to ensure testis viability. Testicula r vascular anatomy supports low spermatic vessel ligation and by decre asing tension on the testis low spermatic vessel ligation may enhance viability. A 2-stage laparoscopic approach to the high undescended tes tis is difficult to justify on the basis of cost or outcome analysis.