Alexander Vos1, Annebeth Meij-de Vries2, Anne Smets3, Jonathan Verbeke4, Hugo Heij2, Alida van der Steeg5. 1. Pediatric Surgical Center of Amsterdam, Emma Children's Hospital AMC and VU University Medical Center, Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: alexandergvos@gmail.com. 2. Pediatric Surgical Center of Amsterdam, Emma Children's Hospital AMC and VU University Medical Center, Box 22660, 1100 DD, Amsterdam, The Netherlands. 3. Academic Medical Center, Radiology department, Amsterdam, The Netherlands. 4. VU University Medical Center, Radiology Department, Amsterdam, The Netherlands. 5. Pediatric Surgical Center of Amsterdam, Emma Children's Hospital AMC and VU University Medical Center, Box 22660, 1100 DD, Amsterdam, The Netherlands. Electronic address: a.f.vandersteeg@amc.uva.nl.
Abstract
BACKGROUND: In patients with a non-palpable testis (NPT) on physical examination, the testis is assumed either to be situated intra-abdominally or to be hypoplastic or absent. Diagnostic laparoscopy in these boys is considered the preferable first step. In this study the diagnostic value of pre-operative ultrasound for NPT is assessed in comparison with laparoscopy. METHODS: All boys aged under the age of 17 years who were diagnosed with an NPT by a pediatric surgeon from 2000 till 2012 were evaluated. All patients of whom clinical, ultrasonographic, and operative findings were available were included. RESULTS: Ninety-six boys with 117 NPTs were included. With ultrasound 67 testes were detected in the inguinal canal, which was confirmed peroperatively for 61 testes. Of the 15 testes with an intra-abdominal position on ultrasound, 10 were found intra-abdominally during surgery. The positive predictive value of the ultrasonography is 91% for inguinally located testes and 67% for intra-abdominally located testes. CONCLUSION: Ultrasonography has a high positive predictive value for inguinally located testes. When ultrasound locates a testis in an inguinal location, a primary inguinal exploration can be considered, preventing an unnecessary diagnostic laparoscopy.
BACKGROUND: In patients with a non-palpable testis (NPT) on physical examination, the testis is assumed either to be situated intra-abdominally or to be hypoplastic or absent. Diagnostic laparoscopy in these boys is considered the preferable first step. In this study the diagnostic value of pre-operative ultrasound for NPT is assessed in comparison with laparoscopy. METHODS: All boys aged under the age of 17 years who were diagnosed with an NPT by a pediatric surgeon from 2000 till 2012 were evaluated. All patients of whom clinical, ultrasonographic, and operative findings were available were included. RESULTS: Ninety-six boys with 117 NPTs were included. With ultrasound 67 testes were detected in the inguinal canal, which was confirmed peroperatively for 61 testes. Of the 15 testes with an intra-abdominal position on ultrasound, 10 were found intra-abdominally during surgery. The positive predictive value of the ultrasonography is 91% for inguinally located testes and 67% for intra-abdominally located testes. CONCLUSION: Ultrasonography has a high positive predictive value for inguinally located testes. When ultrasound locates a testis in an inguinal location, a primary inguinal exploration can be considered, preventing an unnecessary diagnostic laparoscopy.
Authors: Kin Wai Edwin Chan; Kim Hung Lee; Hei Yi Vicky Wong; Siu Yan Bess Tsui; Yuen Shan Wong; Kit Yi Kristine Pang; Jennifer Wai Cheung Mou; Yuk Him Tam Journal: World J Clin Pediatr Date: 2015-11-08
Authors: Paweł Osemlak; Tomasz Żądkowski; Błażej Rogowski; Czesław Cielecki; Andrzej Wieczorek; Magdalena Woźniak; Grzegorz Jędrzejewski; Iwona Beń-Skowronek; Paweł Nachulewicz Journal: Wideochir Inne Tech Maloinwazyjne Date: 2017-04-27 Impact factor: 1.195