Staged Fowler Stephens, Who Requires a Third Procedure?

Mitchell Hayes, Amir Patel, Casey Seideman

Research output: Contribution to journalReview articlepeer-review


Purpose of Review: The two-stage Fowler-Stephens orchiopexy is a well-described surgical approach for most pediatric urologists tackling the high intra-abdominal testis. Testicular ascent is a well-reported outcome of the surgery and a problem that could be fixed with a repeat procedure. The purpose of this review is to determine the rate of subsequent testicular ascent and repeat surgery after a two-stage Fowler-Stephens using best available evidence. Recent Findings/Result: We selected 16 studies that pertained to our topic. 0–13% of testicles were deemed to be in an inappropriate position on follow-up (6–37 months). The definition of appropriate postoperative position varied between studies and rates of repeat procedures were sparsely available. Available data reports a repeat orchiopexy rate of 2.6–7.5% after two-stage Fowler-Stephens. Summary: Two-stage Fowler-Stephens orchiopexy is a highly successful surgical technique to manage high intra-abdominal testes. Rates of testicular ascent are difficult to ascertain due to varying definitions and small sample sizes. While repeat procedures are typically indicated, the actual rate of repeat orchiopexy is rarely reported and long-term outcomes following a third procedure is sparse.

Original languageEnglish (US)
Article number32
JournalCurrent urology reports
Issue number6
StatePublished - Jun 2021


  • Cryptorchidism
  • Fowler-Stephens
  • Orchiopexy
  • Outcomes
  • Testicular ascent
  • Undescended testicle

ASJC Scopus subject areas

  • Urology


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