Diagnostic Laparoscopy for the Management of Impalpable Testes.
10.4111/kju.2011.52.5.355
- Author:
Ji Hyun PARK
1
;
Yong Hyun PARK
;
Kwanjin PARK
;
Hwang CHOI
Author Information
1. Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Laparoscopy;
Testis
- MeSH:
Cryptorchidism;
Follow-Up Studies;
Gonadal Dysgenesis, 46,XY;
Humans;
Inguinal Canal;
Laparoscopy;
Male;
Orchiectomy;
Orchiopexy;
Testis
- From:Korean Journal of Urology
2011;52(5):355-358
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Controversy exists regarding the best approach to impalpable testes. We determined the usefulness of diagnostic laparoscopy for the management of impalpable testes. MATERIALS AND METHODS: Between 2000 and 2008, 86 patients with a mean age of 34 months underwent diagnostic laparoscopy. An inguinal canal exploration was performed in all cases, except in patients in whom the internal spermatic vessels terminated intraperitoneally with a blind end. RESULTS: The undescended testis was right-sided in 24 patients (27.9%), left-sided in 47 patients (54.7%), and bilateral in 15 patients (17.4%). Three patients (3.5%) had bilateral impalpable testes. The vas and vessels traversed the internal ring in 51 of 89 impalpable testes (57.3%); 20 (22.5%) were localized intraperitoneally, and 18 (20.2%) were diagnosed as vanishing testes. Open orchiopexies were performed on 24 testes (27.0%) and orchiectomies were performed on 43 nubbin testes (48.3%). After a mean follow-up period of 30 months, 12 of the 14 testes (85.7%) were viable following open conventional orchiopexy, compared with 6 of the 10 testes (60%) following a 1-stage Fowler-Stephens orchiopexy. CONCLUSIONS: Diagnostic laparoscopy is a very helpful and minimally invasive technique in the diagnosis of impalpable testes, especially when preoperative ultrasonography is not sufficiently informative.
