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 2.85years. 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.
References
[1]
F. X. Schneck and M. F. Bellinger, “Abnormalities of the Testes and Scrotum and Their Surgical Management,” In: P. C. Walsh, A. B. Retik, E. D. Vaughan and A. J. Wein, Eds., Campbell’s Urology, 8th Edition, Saunders Company, Philadelphia, 2002, pp. 2353-2394.
[2]
K. Choi, T. Park and K. S. Kim, “Laparoscopic Orchiopexy for Intra-Abdominal Testis: Complications and Technical Aspects,” Korean Journal of Urology, Vol. 41, 2000, pp. 420-424.
[3]
K. Jongwon, E. M. Gyeong and S. K. Kun, “Laparoscopic Orchiopexy for a Nonpalpable Testis,” Korean Journal of Urology, Vol. 51, No. 2, 2010, pp. 106-110.
[4]
M. A. Riquelme-Heras, S. Landa-Juárez, D. Miguel-Gómez, H. Meneses-Juárez and R. Andraca-Dumit, “Laparoscopic Orchidopexy in Palpable and Nonpalpable Undescended Testis,” Revista Mexicana de Urología, Vol. 69, No. 5, 2009, pp. 215-218.
[5]
C. H. Chui and A. S. Jacobsen, “Laparoscopy in the Evaluation of the Non-Palpable Undescended Testes,” Singapore Medical Journal, Vol. 41, No. 5, 2000, pp. 206-208.
[6]
S. G. Docimo, R. G. Moore, J. Adams and L. R. Kavoussi, “Laparoscopic Orchiopexy for the High Palpable Undescended Testis: Preliminary Experience,” Journal of Urology, Vol. 154, No. 4, 1995, pp. 1513-1515.
http://dx.doi.org/10.1016/S0022-5347(01)66919-2
[7]
P. A. Lee and C. P. Houk, “Cryptorchidism,” Current Opinion in Endocrinology, Diabetes & Obesity, Vol. 20, No. 3, 2013, pp. 210-216.
http://dx.doi.org/10.1097/MED.0b013e32835ffc7d
[8]
N. Cortesi, A. Baldini, P. Ferrari, et al., “Diagnosis of Bilateral Abdominal Cryptorchidism by Laparoscopy,” Endoscopy, Vol. 8, 1976, pp. 33-34.
http://dx.doi.org/10.1055/s-0028-1098372
[9]
I. S. Gill, J. H. Ross, G. T. Sung and R. Kay, “Needlescopic Surgery for Cryptorchidism: The Initial Series,” Journal of Pediatric Surgery, Vol. 35, No. 10, 2000, pp. 1426-1430. http://dx.doi.org/ 10.1053/jpsu.2000.16405
[10]
B. W. Lindgren, E. C. Darby, L. Faiella, et al., “Laparoscopic Orchiopexy: Procedure of Choice for the Nonpalpable Testis,” Journal of Urology, Vol. 159, No. 6, 1998, pp. 2132-2135.
http://dx.doi.org/ 10.1016/S0022-5347(01)63294-4
[11]
A. B. Retik and C. A. Peters, “Laparoscopic Management of the Impalpable Abdominal Testis, Editorial Comment,” Urology, Vol. 42, 1993, pp. 578-579.
http://dx.doi.org/10.1016/0090-4295(93)90279-J
[12]
G. W. Holcomb, J. W. Brock, W. W. Neblett, J. B. Pietsch and W. M. Morgan, “Laparoscopy for the Nonpalpable Testis,” The American Journal of Surgery, Vol. 60, 1994, pp. 143-147.
[13]
M. K. Moslemi, “Evaluation of Orchiopexy Practice Patterns in Patients with Cryptorchidism: A Single-Centre Study,” Journal of Pediatric Urology, Vol. 15, No. 13, 2013.
[14]
J. W. Brock, G. W. Holcomb and W. M. Morgan, “The Use of Laparoscopy in the Management of the Nonpalpable Testis,” Journal of Laparoendoscopic Surgery, Vol. 6, 1996, pp. 35-39.
[15]
P. P. Godbole, J. A. Morecroft and A. E. Mackinon, “Laparoscopy for the Impalpable Testis,” British Journal of Surgery, Vol. 84, No. 10, 1997, pp. 1430-1432.
http://dx.doi.org/10.1002/bjs.1800841024
[16]
A. A. Samadi, L. S. Palmer and I. Franco, “Laparoscopic Orchiopexy: Report of 203 Cases with Review of Diagnosis, Operative Technique, and Lessons Learned,” Journal of Endourology, Vol. 17, 2003, pp. 365-368.
http://dx.doi.org/10.1089/089277903767923128
[17]
B. W. Lindgren, E. C. Darby, L. Faiella, W. A. Brock, E. F. Reda, S. B. Levitt, et al., “Laparoscopic Orchiopexy: Procedure of Choice for the Nonpalpable Testis,” Journal of Urology, Vol. 159, No. 6, 1998, pp. 2132-2135.
http://dx.doi.org/10.1016/S0022-5347(01)63294-4
[18]
H. Lintula, H. Kokki, M. Eskelinen and K. Vanamo, “Laparoscopic versus Open Orchidopexy in Children with Intra-Abdominal Testes,” Journal of Laparoendoscopic & Advanced Surgical Techniques, Vol. 18, No. 3, 2008, pp. 449-456. http://dx.doi.org/10.1089/lap.2007.0176
