Laparoscopic Orchidopexy for the Nonpalpable Testis

Abstract

Background: The management of the nonpalpable testis continues to evoke controversy. Laparoscopy has been utilized as a diagnostic tool for localization. More recently, it has afforded us a surgical tool with which to perform orchidopexy. Methods: Over the past two years, 12 patients have undergone laparoscopic orchidopexy. Six gonads were defined as a "peeping testis," and six were true intra-abdominal testes. Results: The six patients with peeping testis had a successful one-stage laparoscopic procedure, defined as a testis in the scrotum without atrophy. Of the six patients with a true intra-abdominal testis, three had a successful one-stage procedure, and three requiring a staged procedure. Among those having a staged procedure, one was successful, one developed testicular atrophy, and one required testis removal because both the vas deferens and vessels were too short. Conclusion: Laparoscopic orchidopexy provides a significant advance for the management of the intra-abdominal testis. However, we must separate the intra-abdominal testis from the peeping testis if we are to get a true handle on the success rate.