Paediatric Surgery (Ukraine). 2026. 2(91): 107-119. doi: 10.15574/PS.2026.2(91).107119
Konoplitskyi V. S., Sheremetiev V. O., Korobko Yu.Ye.
National Pirogov Memorial Medical University, Vinnytsia, Ukraine

For citation: Konoplitskyi VS, Sheremetiev VO, Korobko YuYe. (2026). A Current trends in the diagnosis and management of undescended testis in children. Paediatric Surgery (Ukraine). 2(91): 107-119. doi: 10.15574/PS.2026.2(91).107119.
Article received: Jan 09, 2026. Accepted for publication: Jun 15, 2026.

Cryptorchidism remains one of the major challenges in pediatric urology and andrology due to its adverse impact on reproductive health and the increased risk of long-term complications. The lack of uniform terminology, heterogeneous classification systems, and the complexity of selecting the optimal surgical strategy hinder the standardization of treatment. Despite the wide range of orchiopexy techniques – from classical procedures (Keetley-Torek, Sokolov, Petrivalsky-Shoemaker) to Fowler–Stephens modifications and contemporary laparoscopic approaches (Shehata, Sepulveda) – treatment outcomes depend on testicular location, patient age, and the surgeon’s experience.
Aim – to systematize contemporary data on surgical management of cryptorchidism, evaluate the efficacy and complication rates of different approaches, and identify problematic aspects hindering the development of unified diagnostic and therapeutic algorithms.
Classical techniques are effective for palpable undescended gonads but may be associated with vascular injury and secondary testicular re-ascent. The two-stage Fowler–Stephens procedure increases the success rate of orchiopexy for high intra-abdominal testes from 60% to 90%. Laparoscopic techniques, including the Shehata and Sepulveda procedures, provide controlled testicular traction while preserving vascular perfusion, achieving success rates of 90-97%. Moreover, these approaches are associated with lower rates of postoperative complications and recurrence. Microsurgical testicular autotransplantation provides a viability rate of approximately 90% graft survival rate but requires advanced microsurgical expertise. The choice of surgical approach depends on testicular location. In cases of intra-abdominal testes, the rate of unfavorable outcomes reaches 13%, particularly following the one-stage Fowler-Stephens procedure.
Conclusions. Contemporary surgical techniques for cryptorchidism achieve high success rates when the surgical approach and operative technique are individualized. However, the absence of a unified classification system and standardized treatment algorithms continues to limit treatment standardization.
No conflict of interest was declared by the authors.
Keywords: cryptorchidism, undescended testis, surgical treatment, inguinal approach, laparoscopy, children, mobilization, operative stages.

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