OBJECTIVETo explore the management of the impalpable testis in children.

METHODSFrom April 2003 to August 2005, 36 children aged 20 months to 8 years with impalpable testes underwent inguinal and laparoscopy explorations. The clinical data were reviewed, including the indications of laparoscopy and inguinal explorations and the correspondence between the ultrasonic and surgical

RESULTSOf the 36 cases (36 / 361 ) of impalpable testis (41 testes), laparoscopy and inguinal explorations revealed 18 results. testes to be vanishing ones, 21 located intra-abdominally and 2 scrotal nubbins. Manifestations were divided into 4 types according to the laparoscopic findings, and 9 testes fell into Type I, 9 Type II, 13 Type III and 10 Type IV. Orchidopexies were performed by traditional and laparoscopic techniques. The positive diagnoses by ultrasound accounted for 75% (27/36). The volumes of the contralateral testes of the cryptorchid children were larger than those with intra-abdominal testes and testicular nubbins. One case of testicular atrophy was detected by ultrasound in the follow-up period.

CONCLUSIONLaparoscopy should be performed as a routine in children with impalpable testes. Children with Type II testes need not undergo inguinal exploration. Inguinal and scrotal explorations are necessary for children with Type I testes. Preoperative ultrasonic examination of the contralateral testis helps to evaluate vanishing testes or testicular nubbins.