Laparoscopic Orchiopexy for a Nonpalpable Testis.
10.4111/kju.2010.51.2.106
- Author:
Jongwon KIM
1
;
Gyeong Eun MIN
;
Kun Suk KIM
Author Information
1. Department of Urology, University of Ulsan College of Medicine, Seoul, Korea. kskim2@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Testis;
Laparoscopy
- MeSH:
Atrophy;
Child;
Follow-Up Studies;
Glycosaminoglycans;
Humans;
Laparoscopy;
Medical Records;
Orchiopexy;
Postoperative Period;
Retrospective Studies;
Scrotum;
Survival Rate;
Testis
- From:Korean Journal of Urology
2010;51(2):106-110
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We evaluated the efficacy and the availability of laparoscopic orchiopexy to manage a nonpalpable intra-abdominal testis and studied outcomes including the testicular survival rate and associated complications. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 67 children (86 testicular units) who underwent laparoscopic orchiopexy for a nonpalpable intra-abdominal testis between 1996 and 2008. The mean patient age was 2.4 years (median, 1 year; range, 0.5-9 years), and the mean follow-up period was 21.8 months (range, 0.3-138.4 months). Testicular viability and orchiopexed positioning were evaluated within 1 month and beyond 3 months. RESULTS: Of 86 testes, 69 testes were treated with primary laparoscopic orchiopexy (PLO) sparing the internal spermatic vessel, 14 testes were treated with one-stage Fowler-Stephens laparoscopic orchiopexy 1, and 3 testes were treated with two-stage Fowler-Stephens laparoscopic orchiopexy 2. The testicular survival rates were 97.7% (84/86) within 1 month and 93.7% (59/63) beyond 3 months. Of 59 viable testes followed up beyond 3 months, 48 (81.4%) testes were positioned in the lower scrotum and 11 (18.6%) testes in the mid to high scrotum. CONCLUSIONS: Laparoscopic orchiopexy was successful for a nonpalpable intra-abdominal testis with a high testicular survival rate irrespective of the location from the internal ring. However, atrophy of the testis or upward migration of the testis can occur during follow-up, so we suggest watchful, periodic follow-up evaluating the viability and location of orchiopexed testes that are located in the lower scrotum in the immediate postoperative period or during short-term follow-up.
