Laparoscopy in the Management of Impalpable Testis: Series of 64 Cases

Ismail, Khalid; Ashour, Mohamed; El-Afifi, Mahmoud; Hashish, Amel; El-Dosouky, Nagi; Nagm, Mohamed; Hashish, Mohamed
July 2009
World Journal of Surgery;Jul2009, Vol. 33 Issue 7, p1514
Academic Journal
The undescended testis represents one of the most common disorders of childhood. Laparoscopy has been widely used for the diagnosis and treatment of non-palpable testis. In this study, we investigated and evaluated the usefulness of laparoscopy in the diagnosis and treatment of the non-palpable testis. From January 2003 to January 2008, we used laparoscopy in the management of 64 patients with 75 impalpable testes. The patients’ ages varied from 1 to 15 years (median 4.6 years). The sites and sizes of the testes were localized by abdominopelvic ultrasonography (US) in all 64 children. One-stage laparoscopic orchiopexy was performed for 26 testes, staged Fowler Stephens orchiopexy for 17 testes, and laparoscopic orchidectomy for five testes. Follow-up by clinical examination and color Doppler US was performed in every patient who underwent orchiopexy. There were 11 patients with bilateral non-palpable testes. The overall diagnostic agreement of US with laparoscopy was seen for only 16 of 75 testes (21.3%). The results of diagnostic laparoscopy were varied and showed various pathologic conditions and positions of the testes, such as 20 low intraabdominal testes (26.6%), 17 high intraabdominal testes (22.7%), and 18 testes (24%) that had entered the inguinal canal. Associated inguinal hernia was present in four patients. After a mean follow-up period of 26 months (6 months–5 years) all testes were seen to be located in the bottom of the scrotum, with the exception of three testes that had retracted to the neck of the scrotum and two testes that had atrophied (2.7%). Laparoscopy has proven to be the only diagnostic modality where the findings provide a clear, dependable direction for definitive management of impalpable testes. It allows an accurate diagnosis and simultaneous definitive treatment.


Related Articles

  • Results of orchiopexy for the undescended testis. Taran, Irina; Elder, Jack S. // World Journal of Urology;Jun2006, Vol. 24 Issue 3, p231 

    The undescended testis is one of the most common congenital abnormalities of the genitourinary system. Outcomes of orchiopexy include (1) having a viable, palpable testis in the scrotum, (2) fertility, as measured by paternity rates or semen analysis in adulthood and (3) risk of testicular...

  • Diagnostic and Therapeutic Management of Impalpable Testis in the Era of Laparoscopy. Shaikh, Shahid Ahmed // World Journal of Laparoscopic Surgery;May-Aug2010, Vol. 3 Issue 2, p75 

    Undescended testis is one of the common urogenital abnormality encountered. Annandale was the first person to perform orchidopexy in 1877. At present single stage, Stephen-Flower's staged, procedure is being carried out for impalpable intra-abdominal undescended testis with open and laparoscopy...

  • cryptorchidism. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p206 

    A definition of the term "cryptorchidism" is presented. It refers to a developmental disorder of male infants in which the testes fail to descend normally into the scrotum.

  • Undescended Testicles. Anderson, Bradley // Pediatrics for Parents;May/Jun2012, Vol. 28 Issue 5/6, p16 

    The article offers the author's view regarding undescended testis in boys which he said is one of the most prevalent urologic conditions in boys. It notes that a surgery should be performed when undescended testis is discovered no matter how old a child is. Several reasons on why surgery for...

  • cryptorchid, cryptorchis.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p552 

    A definition of the medical term "cryptorchid or cryptorchis," which refers to an individual in whom either or both testicles have not descended into the scrotum, is presented.

  • cryptorchidism, cryptorchism.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p553 

    A definition of the medical term "cryptorchidism or cryptorchism," which refers to the failure of the testicles to descend into the scrotum, is presented.

  • monorchism. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p513 

    An encyclopedia entry for "monorchism" is presented. It refers to the presence of only a single testis. It probable causes are surgery and congenital absence of the testis.

  • ULTRASOUND, SCROTAL  // Davis's Comprehensive Handbook of Laboratory & Diagnostic Tests ;Jan2006, p1295 

    Ultrasound procedures are diagnostic, noninvasive, and relatively inexpensive. They take a short time to complete, do not use radiation, and cause no harm to the patient. Scrotal ultrasound is used for the evaluation of disorders of the scrotum. It is valuable in determining the internal...

  • Caput Epididymis Diameter. Francavilla, S. // Fertility Weekly;11/10/2014, p2 

    The article presents a study which aims to define the relevance of U.S. determination of caput epididymis diameter in non-obstructive azoospermia (NOA). The study involved 100 consecutive azoospermic men in the semen analysis and scrotal examination while parameters to testicular side were...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics