Staged laparoscopic traction versus laparoscopic staged Fowler- Stephens for intra-abdominal testis: A systematic review and metaanalysis

Background: In pediatric urology, undescended testes are frequently seen. The superiority of the Fowler-Stephensorchiopexy (FSO) or Shehata’s traction orchiopexy (STO) procedures for intra-abdominal testes (IAT) is up for dispute.The two methods and their results in patients with IATs are compared in this systematic review and meta-analysis.Patients and Methods: In addition to a manual Google search, we conducted searches in PubMed, Scopus, Web ofScience, Google Scholar, and the Cochrane Library between 2008 and July 2023. All studies that compared the STO andFSO in the treatment of IATs were included, whether they were case-control, cross-sectional, cohort observational, orrandomized controlled trials. An open Meta Analyst was used for the meta-analysis. The odds ratio (OR) for dichotomousvariables and the mean difference for continuous variables were used to compare the two methods.Results: The final meta-analysis contained five publications. With a statistically significant P value 0.03), the comparisonrevealed that the STO was linked to a greater success rate (87%) than the FSO approach (66%). The OR was reportedto be 2.749 (95% confidence interval: 1.101, 6.864). The STO was observed to cause less atrophy compared with theFSO technique, as no cases of atrophy were observed in the STO technique, however, FSO was associated with a 12.6%atrophy rate with a statistically significant P value. The OR was observed to be 0.171 (95% confidence interval: 0.043,0683, P=0.013).Conclusion: In IAT children, STO may have a higher success and lower atrophy rates than FSO, despite statisticalsignificance, however, randomized controlled trials with larger sample sizes and many compared parameters are neededto confirm these findings.