101 / 330
101
19–22 APRIL, 2017, BARCELONA, SPAIN
(62.5%): 3 (37.5%) in the ejaculate a 2 (25%) in urine after masturbation. Mean hormone levels
were LH: 5.3 mg/dL, FSH:6.9 mg/dL, testosterone 531 mg/dL. MRI revealed prostates hypoplastic
in 55.6% and absent in 22.3%. Absence of at least one seminal vesicle was seen in 55.6%. No vasal
abnormality was noted. Mean Cr=1.64 mg/dL.
CONCLUSIONS
Patients with PBS may have normal sexual hormonal levels and motile sperm in the ejaculate or
post masturbation urine. Our study highlights a high prevalence of prostate and seminal vesical
abnormalities that may represent an important cause for their infertility.
14:02–14:14
Discussion
14:14–14:17
S9-5 (PP)
LAPAROSCOPIC MANAGEMENT FOR INTRA-ABDOMINAL
TESTIS: A PEDICULAR TRACTION OR PEDICULAR
SECTION? A MULTICENTRIC STUDY
Valeska BIDAULT
1
, Nathalie BOTTO
2
, Elisabeth CARRICABURU
1
, Thomas BLANC
2
,
Matthieu PEYCELON
1
, Carmen CAPITO
2
, Goharig ENEZIAN
1
, Alaa CHEIKHELARD
2
,
Arnaud BONNARD
1
, Henri LOTTMAN
2
, Alaa EL GHONEIMI
1
, Yves AIGRAIN
2
and Annabel PAYE JAOUEN
3
1) Robert Debre Hospital, Pediatric urology, Paris, FRANCE - 2) Hopital Necker, Pediatric urology, Paris, FRANCE -
3) Hôpital Robert Debre, Chirurgie viscérale et urologie pédiatrique, Paris, FRANCE
PURPOSE
To evaluate laparoscopic spermatic pedicular traction (Shehata technique, ST, 2008) for the treat-
ment of unpalpable testis, as an alternative to gold standard pedicular section (Fowler Stephens,
FS), successful in 83% and associated with a 8%-risk of testicular atrophy.
MATERIAL AND METHODS
Intra-abdominal testis of 78 patients in two pediatric surgery centers were managed laparoscopi-
cally either by staged FS orchidopexy or ST according to the surgeon preference and retrospec-
tively analyzed. Testicular position and size were compared (Fischer’s exact test/Wilcoxon-Mann
Whitney).
RESULTS
90 testis (Jan 2011-June 2016) were pulled-down by 58 ST and 32 FS (12 bilateral). Median age at
surgery was 23,5 months (ST group) and 16,8 months (FS group) (p=0,013). Scrotal pulling-down
of the testis was performed after a median period of 2,3 months (ST group) and 4,8 months (FS
group)(p=2,4). No complication occurred during surgery. ST had dropped in 5 cases, and required
a redo procedure in 3 cases. Mean follow-up was 12 versus 9,7 months (p=0,82); the testis was in
the scrotum in 86,2% cases after ST and 79% after FS (p=1), and testicular atrophia occurred in
10,3% in ST and 12,5% in FS (p=0,74).
CONCLUSIONS
This study shows similar results of ST and FS in the medium-term, and could unable pediatric
surgeons to prefer ST who preserves the natural vascularization of the testis. Precise evaluation of
size and position of the testis during the first laparoscopic time is essential to assess the results of
each surgical technique. Evaluation of a standardized description form is in process.