Abstract
Purpose: To present our experience with laparoscopic management of the non-palpable undescended testis. Patients and Methods: Between Nov. 2010 and Oct. 2012, 47 non-palpable testes in 41 patients were evaluated prospectively by laparoscopy. The age of the patients at the time of surgery varied from 1 to 9 years with a mean age of 2.85 years. Testicular viability and location were evaluated by physical examination and Doppler ultrasonography after 1 and 3 months. Results: Out of 49 testicular units, 47 (95.9%) were successfully treated by laparoscopic orchiopexy. 45 testicular units (91.8%) were treated by one-stage laparoscopic orchiopexy, 2 (4.1%) were treated by two-stage laparoscopic orchiopexy and 2 (4.1%) diagnosed as vanishing testis with detection of blind end spermatic vessels and vas deferens during laparoscopy. Physical examination and Doppler study demonstrated that 46 of 47 testes (97.9%) were viable and 45 of 47 (95.7%) were located in the lower scrotum and 2 of 47 (4.3%) in the upper scrotum at the end of follow-up. Conclusion: The laparoscopy is a reliable technique for diagnosis and treatment of the non-palpable intra-abdominal testis with high success and survival rates of the testes.
Highlights
An undescended testis is one of the most common clinical disorders of childhood, occurring in approximately 3% of full-term newborns, 21% of premature newborns, and 0.8% - 1.8% of 1-year-old boys [1]
We aimed to present our experience with laparoscopic management of the non-palpable, intra-abdominal, undescended testis
Patient selection and assessment: This prospective study was conducted between Nov. 2010 and Oct. 2012, Patients were consecutively enrolled from patients referred to the urology and pediatric clinics at Ghodran Hospital, Baljurashi, Kingdom of Saudi Arabia (KSA) for treatment of undescended testis
Summary
An undescended testis is one of the most common clinical disorders of childhood, occurring in approximately 3% of full-term newborns, 21% of premature newborns, and 0.8% - 1.8% of 1-year-old boys [1]. A non-palpable testis is defined as, a testis not palpated by any examination technique, including pre-operatively under anaesthesia [4]. Non-palpable undescended testis management basically includes four surgical techniques: 1) Open orchidopexy in stages; 2) Fowler-Stephens orchidopexy in which spermatic vessels are sectioned and the deferential artery is preserved in 1 or 2 stages by open or laparoscopic approach; 3) Testicular autotransplant with spermatic vessel section and microsurgical anastomosis to the epigastric vessels and 4) laparoscopic orchidopexy
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