S D Mark1, P J Davidson. 1. Department of Urology, Christchurch Hospital, New Zealand.
Abstract
BACKGROUND: The evaluation and management of the impalpable testis remains controversial. The authors' experience with laparoscopy for the treatment of this condition is reported here. METHODS: All children with impalpable testes underwent an examination under anaesthetic and if negative, a laparoscopy was performed to locate the testis. A prospective evaluation was undertaken to determine the success and morbidity of this approach. RESULTS: Thirty-six children (median age 2.5 years) underwent laparoscopy to localize 40 impalpable testes. In 32 patients with unilateral impalpable testis, 10 were intra-abdominal, nine were absent. In 13 patients, the vas and vessels entered the groin, and in 12 of these a small testis remnant was excised and in the other a normal-looking testis was brought down. In four patients with bilateral impalpable testes, one testis was absent, three testes were intra-abdominal and four were small testis remnants in the groin. The average laparoscopy time was 15 min, and 34 of 36 children were operated on as day-stay cases. One child had an omental hernia via a port site. CONCLUSION: Laparoscopy is safe and effective at localizing impalpable testes in children and can be performed as day-stay procedures in the majority of cases.
BACKGROUND: The evaluation and management of the impalpable testis remains controversial. The authors' experience with laparoscopy for the treatment of this condition is reported here. METHODS: All children with impalpable testes underwent an examination under anaesthetic and if negative, a laparoscopy was performed to locate the testis. A prospective evaluation was undertaken to determine the success and morbidity of this approach. RESULTS: Thirty-six children (median age 2.5 years) underwent laparoscopy to localize 40 impalpable testes. In 32 patients with unilateral impalpable testis, 10 were intra-abdominal, nine were absent. In 13 patients, the vas and vessels entered the groin, and in 12 of these a small testis remnant was excised and in the other a normal-looking testis was brought down. In four patients with bilateral impalpable testes, one testis was absent, three testes were intra-abdominal and four were small testis remnants in the groin. The average laparoscopy time was 15 min, and 34 of 36 children were operated on as day-stay cases. One child had an omental hernia via a port site. CONCLUSION: Laparoscopy is safe and effective at localizing impalpable testes in children and can be performed as day-stay procedures in the majority of cases.