The Role of Laparoscopy in the Management of Non- palpable Undescended Testes
Kerbala Journal of Medicine,
2012, Volume 5, Issue 11, Pages 1231-1237
Abstractackground:Cryptorchidism is one of the most common genitourinary disorders in young boys. Management of non- palpable undescended testis is a surgical challenge involving evaluation and surgical management. The objective of this study is to present our initial experience with laparoscopy in patients with non- palpable testis.
Patients and methods: Laparoscopy was performed under general anesthesia on 25 patients. If the internal spermatic vessels and vas deferens made their way into the internal inguinal ring, the inguinal canal was dissected. Laparoscopic orchiopexy or orchiectomy was performed in cases with intra-abdominal testis. If the internal spermatic vessels found terminated intraperitoneally with a blind-end, the case was considered as a vanishing testis.
Results:Twenty five boys, aged from 2.5 years to 32 years (median 8.7 years) were identified with 30 non- palpable testes. In five of the 30 non- palpable testes, the vas and the vessels were through the internal ring, and the inguinal region needed dissection. Orchiopexy was performed on 4 testes and orchiectomy was performed on one atrophic testis. Twenty of 30 testes were intra-abdominally localized. Laparoscopic orchiopexy was performed in 16 testes and laparoscopic orchiectomy was performed in 4 testes. Five boys were diagnosed as vanishing testes.
Conclusions: Laparoscopy seems to offer a safe and reliable diagnostic and therapeutic option to patients with non- palpable testes.
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