Management of the impalpable testis: the role of laparoscopy
Department of Paediatric Surgery, Royal
Liverpool Children's Hospital, Alder Hey, Eaton Rd, Liverpool L12 2AP,
UK
Correspondence to: Mr Baillie.
Accepted 24 June 1998
PURPOSE
To evaluate the use of laparoscopy in the
management of the impalpable testis.
DESIGNA retrospective analysis of the clinical
findings, interventions, and outcome in 87 consecutive boys undergoing
laparoscopy for 97 impalpable testes.
RESULTSFifty seven testes were either absent
(n = 35) or present as a small remnant (n = 22), which was removed
at contemporaneous groin exploration. There were 27 intra-abdominal
testes, including four hypoplastic testes, which were removed
laparoscopically. The 13 remaining viable testes were located in the
groin. Conventional orchidopexy followed laparoscopy for 21 testes, and
was successful in 17 cases. Two stage laparoscopically assisted Fowler
Stevens orchidopexies were performed for 13 intra-abdominal testes,
with eight satisfactory results. Ultrasound evaluation significantly reduced the number of conventional orchidopexies following laparoscopy.
IMPLICATIONSLaparoscopy is a rational and safe
approach for precise localisation of the impalpable testis.
Laparoscopically assisted two stage orchidopexy is a successful
treatment procedure for intra-abdominal testes.
© 1998 by Archives of Disease in Childhood
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